Clinical significance of no-reflow phenomenon observed on angiography after successful treatment of acute myocardial infarction with percutaneous transluminal coronary angioplasty

The clinical significance of the angiographic no-reflow phenomenon was evaluated in 93 patients with acute myocardial infarction treated by percutaneous transluminal coronary angioplasty (PTCA). On the basis of the post-PTCA angiograms, patients were divided into three groups: normal angiogram (group 1, n = 65), slight no-reflow (group 2, n = 13), and severe no-reflow (group 3, n = 15). Regional wall motion in the chronic phase was depressed in groups 2 and 3 compared with group 1. The proportion of the area of the transmural infarction to that of the total infarction determined by scintigraphy was higher in groups 2 and 3 than in group 1. A significantly higher incidence of myocardial rupture and of death resulting from cardiac causes was observed in group 3 compared with group 1. The severity of this phenomenon immediately after an emergency PTCA correlated well with the severity of myocardial damage, with patients having severe no-reflow showing the poorest prognosis.

Geographic differences in seasonal variation of mean birth weight in Japan

Seasonal variation of mean birth weight (MBW), mean gestational period (MGP), and MBW at 40 weeks of gestation (MBW40) in the 15 different prefectures of Japan were analyzed using vital statistics from 1974 to 1983. MBW generally shows a bimodal pattern with two peaks in spring and autumn and two troughs in summer and winter. Seasonality exhibits a general geographic trend: The autumn peak loses its height and the spring peak increases its amplitude as one moves from north to south. This trend suggests that environmental factors are associated with the creation of seasonality in MBW. For MGP the pattern is relatively unimodal with a deep trough in winter; however, a late summer small dip is observed in most cases. According to an analysis of coincidence between the two time series (MBW and MGP) and correlation analysis, the seasonal variation in birth weight basically depends on the gestational period. For MBW40, which represents the fetal growth rate, the seasonality shows a pattern similar to that of MBW. A statistically significant coincidence and a correlation are observed between the time series of MBW and MBW40. These results suggest that the two processes of fetal growth (gestational period and fetal growth rate) are associated with the creation of seasonality in MBW.

[Serial 123I-IMP SPECT in a case of cryptococcal meningoencephalitis]

We performed serial brain perfusion SPECT studies using 123I-IMP in the course of cryptococcal meningoencephalitis. Increased perfusion was detected in the cerebellum coinciding with the appearance of the abnormality on MRI. The perfusion in the lesion was then decreased as the abnormality on MRI disappeared. Cryptococcal meningoencephalitis should be also taken in the differential diagnosis when the inflammatory brain lesion shows increased perfusion.

Thermophilic bacilli have split cytochrome b genes for cytochrome b6 and subunit IV. First cloning of cytochrome b from a gram-positive bacterium (Bacillus stearothermophilus)

The genes of Bacillus stearothermophilus K1041 encoding cytochrome b(6) (Bacillus cytochrome b is referred to as cytochrome b(6) for its resemblance to plastid b6) and subunit IV of the quinol:cytochrome c oxidoreductase (bc1 complex) were cloned and sequenced. For preparation of the probe for cloning, polymerase chain reaction was carried out using oligonucleotide mixtures targeting for N-terminal regions of cytochrome bc and subunit IV of the thermophilic Bacillus PS3. The deduced amino acid sequences contained 224 residues of 25,425 daltons for cytochrome b(6) and 173 residues of 19,371 daltons for subunit IV, and both open reading frames were separated by 67 base pairs. Cytochrome b and subunit IV contained 4 and 3 hydrophobic transmembrane segments, respectively, indicating that the fourth segment of subunit IV (eighth segment of cytochrome b) is lacking. Four histidine residues supposed to ligand two protohemes were conserved, but the two His in the fourth segment were separated by 14 amino acid residues like cytochrome b6, not like mitochondrial cytochrome b. The residues that might have conferred the two quinol-binding sites were mostly conserved, but especially the third His residue in the fourth segment of mitochondrial cytochrome b was replaced by Arg in Bacillus cytochrome b6 as in cytochrome b6. These characteristics and quantitative comparison of the protein sequences indicate that this Bacillus sequence is unique and meanwhile rather close to the cyanobacteria-plastids type than the purple bacteria-mitochondria type.

[Clinical studies using measurement of N-telopeptides of type 1 collagen (NTx) in patients with bone metastasis--comparison with bone scintigraphy and other metabolic bone markers]

Urinary metabolites of N-telopeptide of type 1 collagen cross-links (NTx) are known as a bone resorption marker. We performed a multi-center trial of NTx measurement in evaluation of bone metastasis. In total, 251 patients with or without bone metastasis from various malignancies were studied. Comparing with other bone markers such as urinary total deoxypyridinoline, osteocalcin, and bone specific alkaline phosphatase, NTx was the most sensitive one to detect bone metastasis and its levels correlated well with the extensiveness of bone metastasis. Measurement of NTx will be useful to determine to order bone scan in patients with malignancy and to monitor the clinical course in patients with bone metastasis.

[Detection and localization of enlarged parathyroid glands in patients with hyperparathyroidism using 99mTc-methoxyisobutylisonitrile (MIBI): a study of subtraction scintigraphy with 99mTc-pertechnetate]

In this study we investigated the detectability of abnormal parathyroid gland(s) by 99mTc-methoxyisobutylisonitrile (MIBI) scintigraphy in patients with hyperparathyroidism. The subjects were 6 patients with primary hyperparathyroidism (PHP) with a single adenoma and 13 patients with renal hyperparathyroidism (RHP) on chronic maintenance hemodialysis. The imaging data of 99mTc-pertechnetate were subtracted from those of 99mTc-MIBI (MIBI-Tc), and number and location of the positive images on scintigrams were compared with those obtained by conventional scintigraphy using 201Tl-Cl and 99mTc-pertechnetate (Tl-Tc). All of the patients underwent surgery, and the number and location of the abnormal parathyroid glands were confirmed. The number of resected parathyroid glands were 6 in PHP and 52 in RHP. The detectability of MIBI-Tc was 83.3% in PHP and 51.9% in RHP, while that of Tl-Tc was 100% and 44.2%, respectively. Although no statistically significant difference in the detectability was found between MIBI-Tc and Tl-Tc, the number of false positives with MIBI-Tc was less than that with Tl-Tc. The detectability of MIBI-Tc depended on the size of the parathyroid gland. The maximal diameter and weight of the smallest parathyroid gland detected were 15 mm and 290 mg in PHP, and 9 mm and 50 mg in RHP. The existence of the thyroid gland did not reduce the detectability of MIBI-Tc. In conclusion, MIBI-Tc was clinically very useful for the detection of abnormal parathyroid glands in patients with hyperparathyroidism.

Depletion of glutathione and hepato-toxicity caused by vinyl ethers in mice

4-Nitrophenyl vinyl ether (NPVE) and phenyl vinyl ether (PVE) administered i.p. in mice lowered hepatic non-protein sulfhydryl (NP-SH) content, but did not elevate the serum glutamate pyruvate transaminase (GPT) activity. n-Butyl vinyl ether (BVE) showed no significant effects either on the NP-SH content or on the serum GP activity. Mice pretreated with buthionine sulfoximine were sensitive to the potential toxicity of NPVE. These results showed that aryl vinyl ethers, NPVE and PVE, are more toxic than the alkyl vinyl ether, BVE, and that glutathione plays an important role on the protection of hepatic injury by reactive metabolite(s) derived from vinyl ethers.

[Study on tumor accumulation property of 99mTc-HM-PAO and 99mTc-MIBI in rabbits bearing VX-2 cancer]

Each of blood flow imaging agents has a potential usefulness as an agent for tumor scintigraphy. The usefulness for tumor scintigraphy of two agents, i.e. cerebral blood flow scintigraphy agent 99mTc-HM-PAO and myocardial blood flow scintigraphy agent 99mTc-MIBI, was comparatively studied using rabbits bearing VX-2 cancer. From then to twenty days after the implantation of VX-2 cancer into the femoral region of five rabbits, tumor to soft tissue accumulation ratio (T/S ratio) of each agent was calculated in early images (5 min after injection) and in late images (50 min after injection). Compared with 99mTc-MIBI, the T/S ratio of 99mTc-HM-PAO was higher and, moreover, the washout was delayed. These results suggest that there is a difference in tumor accumulation property between these two agents.

Cloning and sequence analysis of a hamster liver cDNA encoding a novel putative carboxylesterase

A full-length cDNA encoding for a putative carboxylesterase was isolated from a hamster liver cDNA library. The cDNA consisting of 1911 base pairs contained an open reading frame of 1683 base pairs encoding for a polypeptide of 561 amino-acid residues, including 27 N-terminal amino-acid residues for signal peptide. The deduced amino-acid sequence of the cDNA is in 67% homology with the amino-acid sequence of rabbit form 2 carboxylesterase, which has not yet been cloned. It also had many structural features highly conserved among carboxylesterase isozymes.

cDNA cloning and expression of Cry j II the second major allergen of Japanese cedar pollen

We have isolated and sequenced a cDNA clone coding for Cry j II, the second major allergen of Japanese cedar (Cryptomeria japonica) pollen. A 1.7-kilobase cDNA clone contained an open reading frame coding for a 514-amino acid protein, including a putative signal peptide of 54 amino acid and three potential glycosylation sites. The deduced amino acid sequence of the Cry j II shows significant identities to those of the polygalacturonases associated with fruit-ripening in tomato (40%) and avocado (43%) and found in pollen of maize (34%). Cry j II cDNA product expressed in E. coli was recognized by human IgE from patients suffering from cedar pollinosis, suggesting that recombinant Cry j II might be used as an allergen for the clinical diagnosis of cedar pollinosis.

[Analysis of the seasonal variations in mean birth weight and mean gestational period of 47 prefectures in Japan]

Seasonal variations of the mean gestational period (MGP) and mean birth weight (MBW) are examined by the traditional method of time-series analysis during the period from 1979 to 1983 in Japan. The results of the present study support the existence of a seasonal rhythm of MGP. Generally MGP showed a deep trough in winter and a shallow one in summer to early autumn. This pattern was similar to that of MBW. The two time series showed a statistically significant coincidence in their monthly fluctuations, and a statistically significant correlation was also observed for their amplitude. According to these results, we concluded that the seasonality in MGP plays an important role in creating the seasonality in MBW. However, the seasonality in MGP can not be the only definitive factor that totally regulates the seasonal variations in MBW. The relationship between the two time series is considered to be different among different seasons as well as regions. For example, we observed a decrease of the seasonal index in winter in the same month for both MBW and MGP, but not necessarily in summer. This suggests that the etiology of the decrease in seasonal variations is different between summer and winter.

A case of fulminant myocarditis rescued--by long-term percutaneous cardiopulmonary support

We report the case of a 41-year-old man with acute fulminant myocarditis. The patient went into cardiac standstill immediately after admission and was placed on a percutaneous cardiopulmonary support system. The system remained in place for 302 h, after which the patient recovered from cardiogenic shock without complications and has returned to normal life.

Characteristics of a purified dog hepatic microsomal N,O-acyltransferase

Dog liver microsomes have at least three different enzymes that are capable of the deacylation of amides, N-arylhydroxamic acids and carboxylesters, the acyltransfer of N-arylhydroxamic acids and the N-acetylation of arylamines. As judged by SDS-PAGE stained with silver nitrate, one of these enzymes was purified to homogeneity by sequential treatment with Triton X-100, ion-exchange column chromatography, gel filtration and chromatofocusing. The protein was a glycoprotein trimer with a subunit weight of approximately 60 kDa. It showed microheterogeneity on analytical isoelectric focusing (IEF) in polyacrylamide with pls of 5.4-5.6. Following digestion with endoglycosidase H, its subunit weight was reduced to approximately 58 kDa, and it appeared to be homogeneous on IEF with a pl of approximately 5.6. A monoclonal antibody prepared against this enzyme also reacted with the pl 6.0 carboxylesterase of rat liver microsomes, but did not react with the other two dog hepatic acyltransferases. Conversely, a polyclonal antibody raised against the rat esterase reacted with the dog enzyme. The N-terminal sequence of the enzyme was Y-P-S-L-P-P-V-V-D-T-V-Q-G-K-V-, which was homologous to the form 1 carboxylesterase of rabbit liver and the pl 6.0 carboxylesterase of rat liver. Immunohistochemical analyses showed the presence of this enzyme in the epithelium of dog liver and urinary bladder, human liver and rat liver, esophagus, forestomach, glandular stomach, small and large intestines, renal tubules, trachea and prostate and alveolar cells of lung. Since this enzyme is present in the urothelium, it may be important for the activation of urinary metabolites of carcinogenic arylamines for the initiation of bladder carcinogenesis in the dog.

Cloning and sequencing of cDNA coding for Cry j I, a major allergen of Japanese cedar pollen

cDNA clones coding for Cry j I, a major allergen of the Japanese cedar (Cryptomeria japonica) pollen, have been isolated. Two of the clones were sequenced and found to code for a putative 21-residue signal peptide and a 353-residue mature protein with a derived molecular weight of 38.5 KDa. Five possible N-linked glycosylation sites were found in the sequence. Comparison of the nucleotide sequences of the two clones revealed sixteen nucleotide differences and these led to five amino acid exchanges in the mature allergen, indicating that an isoform of the Cry j I molecule exists. The deduced amino acid sequence of the Cry j I shows 46-48% identities with those of the Amb a I family and Amb a II, the major allergens of short ragweed. These findings should facilitate study of the structure-function relationship between the allergen and the immunocompetent cells.

[Main household occupation and mean birth weight in Japan 1984]

By using the 1984 vital statistics released on magnet tapes by the Japanese government, we observed in the present study how the mean birth weight (MBW) varies from one group of mothers who fall under the same category of "main household job" to another. In so doing, we compared the MBWs among different job categories in terms of mother's age, baby's sex, and parity. The obtained results are summarized as follows: 1) The MBW of primiparae and male babies was found to be significantly different among the job categories in the age range of 20-39. In the group of multiparae and male babies, however, all the age ranges older that twenty showed significant differences in the MBW among the job categories. In the group of female babies, the significant difference was found in the age range of 20-39 and all the ranges older than twenty for primiparae and multiparae, respectively. 2) The above results were considered to be caused mainly by the low MBW in the category of "other" for primiparae, and by the high MBW in "part-time farming" and the low MBW in "other" for multiparae.

[Analysis of the trends of mean birth weight at an obstetric facility in Osaka during the past 30 years (1962-1991)]

Annual trends of mean birth weight (MBW) at an obstetric facility in the city of Osaka were examined, based on the data in the delivery records for 30 years from January 1962 through December 1991. MBW at this facility had been decreasing during the years of 1975-1985, after being adjusted for parity (primipara/multipara) and the infants' sex. In addition, annual trends of the rate of intrauterine growth and mean gestational period, which are considered to be the two major processes to governing birth weight, were retarded or shortened during almost the same time. Among some possible factors with causal impacts on birth weight, the advance in maternal age, the lowered parity, and the increase in premature delivery may explain these findings. Additionally, it was suggested that the change of socio-economical environment, including the lifestyle of women, may have did not agree with the decreasing trends of MBW.

Adaptive feedback cancellation with frequency compression for hearing aids

The use of an adaptive feedback canceler (AFC) for howling suppression in hearing aids seems very attractive since it is not only unaffected by the changes in the operating environment, but it also limits signal degradation due to the feedback signal. This, however, requires a reference signal which is correlated with the feedback signal but not with the input signal. In hearing aids, such a signal is hard to obtain. The output signal could be used as reference if its correlation with the input signal could sufficiently be removed. If the reference signal is correlated with the input signal, the input signal will also be canceled by the AFC. Here, the use of a frequency compressor as a decorrelator is proposed. The performance of this system is then investigated via digital simulation. Results indicated that with the use of the proposed system and the proper choice of system parameters, an increase of about 18 dB in the howling margin could be achieved with minimal deterioration in output signal quality.

[Analysis of geographical differences in the seasonal variation of mean birth weight in Japan (1974-1983)]

Geographical differences in the seasonal variation in mean birth weight (MBW) were examined by a traditional time series analysis based on the birth data of 47 different prefectures in Japan for the period from January 1974 to December 1983. The general pattern on the seasonality in MBW has two peaks in spring and autumn, and two troughs in summer and winter. There is a general trend in the seasonality with the autumn-peak-dominant pattern observed in the northern part of Japan (Hokkaido, Tohoku, Kita-Kanto) giving way to the spring-peak-dominant pattern in the southwest. Another interesting finding is that there is high statistical significance as a general tendency, in the seasonality among immensely populated prefectures such as Tokyo, Kanagawa, Aichi, Osaka, and Fukuoka, while in the case of scarcely populated rural prefectures, the time series fluctuates almost randomly. Some socio-cultural and biometerological hypotheses were evaluated to explain these results.

[Anesthetic management of a patient with Bernard-Soulier syndrome]

Bernard-Soulier syndrome (BSS) is a hereditary hemorrhagic disease characterized by prolonged bleeding time due to abnormal platelet aggregation and giant platelets. Transfusion of platelet-rich plasma is the only treatment available for the hemorrhagic episodes in patients with this disease. A 20-year-old female with BBS was scheduled for sagittal osteotomy of the mandibular rami under general anesthesia. Anesthesia was induced with fentanyl and diazepam, and was maintained with nitrous oxide, fentanyl, and 0.5% enflurane. No exacerbation of the bleeding tendency was observed during or after the surgery. We consider that the use of halothane should be avoided in patients with BBS because it may inhibit the aggregation of platelets and prolong the bleeding time.