Hemangiopericytoma of the lacrimal sac

Hemangiopericytomas are soft tissue tumors composed of pericapillary pericytes. These tumors are rare in the lacrimal sac. To the author's knowledge, only four previous cases of these tumors occurring in the lacrimal sac have been reported. A primary hemangiopericytoma of the lacrimal sac in a 34-year-old female is reported. Total excision with the surrounding tissue appears to be the treatment of choice for this tumor.

Successful management of mechanical complications following acute myocardial infarction--a case report

Rupture of the heart as a complication of myocardial infarction is one of the most common causes of in-hospital mortality. Rupture of the free wall of the ventricle or interventricular septum has a poor prognosis when treated conservatively. So, rupture of the heart after infarction requires prompt diagnosis and early surgical repair despite the high overall incidence of early operative mortality before hemodynamic deterioration and multiorgan failures develop. Rupture of the left ventricle results in pseudoaneurysm if the overlying pericardium adhers to the surface of the heart. Pseudoaneurysms which rarely develop after infarction, tend to rupture. Their presence alone is an indicator for operation because of the very poor prognosis following rupture. We experienced successful management of 2 rare complications after acute myocardial infarction: ventricular septal defect and pseudoaneurysm. The first patient was a 49-year-old man who had an apical septal defect. His electrocardiogram showed Q wave in leads V2-V6, II, III, and aVF but a coronary angiogram showed normal findings. He was successfully treated by patch closure of the septal defect. The second patient was a 65-year-old female who had false aneurysm of the left ventricle. She had neither chest pain nor abnormality on the electrocardiogram. A coronary angiogram showed complete occlusion of the distal circumflex artery. Under cardiopulmonary bypass, the neck of the aneurysmal sac was successfully closed with a prolene suture.

A case of localization-related epilepsies suspected of panic disorder

Some localization-related epilepsies have autonomic symptoms as well as psychic symptoms. As these symptoms are similar to those of panic disorder, it is important to discriminate between the two disorders. In such cases, VTR-polygraphic examination is necessary for the correct diagnosis.

Primary endobronchial granular cell myoblastoma

Granular cell myoblastoma is a common lesion of uncertain histogenesis. It commonly affects the tongue, breast, and subcutaneous tissues. However, its occurrence in the tracheobronchial tree is rare. Although generally a benign lesion, isolated malignant granular cell myoblastoma as well as its coexistence with other primary bronchogenic carcinomas has been documented. In spite of recent anecdotal reports advocating endoscopic removal of this lesion, we believe definitive surgical excision is a more rational choice of treatment.

Determination of intrinsic association constant of mouse monoclonal IgM antibody to human hepatitis B surface antigen

The ultracentrifugation technique utilizing Airfuge was employed to determine the intrinsic association constant of mouse monoclonal IgM antibodies to human hepatitis B surface antigen (HBsAg). The IgM antibody was reduced to Fab fragments by tryptic digestion in the presence of mercaptoethanol, followed by two passages over a Sephacryl S-200 column. The centrifugation conditions were optimized to sediment Fab-HBsAg complexes, leaving the unbound Fab in the supernatant. The analyses of the binding data by Scatchard and Sips methods yielded good agreement, and the intrinsic association constants ranged from 0.13 to 5.3 X 10(7) (l/mol) for three IgM antibodies. The heterogeneity indices deduced from the Sips analysis were 1.0. The present protocol would allow determination of the intrinsic association constant for the binding of a multivalent antibody to a comparatively large antigen bearing multiple combining sites.

Molecular characterization of the epitope in prostate and breast tumor-associated PR92 antigen

In our previous report, monoclonal antibody PR92 has defined prostate- and breast tumor-associated PR92 antigen. The molecular nature of PR92 antigen, especially the epitope involved in specific interaction with PR92 monoclonal antibody, is described. PR92 antigen was purified from the cell extract or tissue culture medium of prostate cancer cell line DU145 by means of monoclonal antibody-coupled Sepharose 4B affinity chromatography, followed by a Sephacryl S-500 chromatography. Physical and chemical characterization, coupled with high-performance liquid chromatography, determined that PR92 antigen is a glycoprotein with a molecular weight of about 470,000, comprising repeating subunits of about 44,000. Sialic acid was found to form a critical part, while D-galactose and N-acetylgalactosamine were also involved, in the epitope structure. PR92 antigen is rich in serine, threonine, proline, glycine, and alanine and poor in aromatic amino acid residues. The carbohydrate moieties may be predominantly O-linked to polypeptide chains which contribute directly or indirectly to maintain the integrity of the epitope. Elucidation of the molecular nature of PR92 antigen may help understand the mechanism of shedding into the body fluids during tumor progression.

Effects of hypothermia and hemodilution on oxygen metabolism and hemodynamics in patients recovering from coronary artery bypass operations

The coexistence of hypothermia and hemodilution in patients in the intensive care unit immediately postoperatively after coronary artery bypass graft operations presents concerns regarding the adequacy of hemodynamics and oxygen metabolism. We evaluated the hemodynamic status and oxygen metabolism during the postoperative recovery period in six patients with moderate hemodilution (hematocrit value 34% +/- 3%) and in eight patients with marked hemodilution (hematocrit value 23% +/- 2%). All patients were well sedated and paralyzed with pancuronium bromide during the study period, during which their body temperature was slowly returning toward normal. In both groups, cardiac index at 34 degrees C was about 40% lower than at 37 degrees C. This was associated with 50% higher systemic vascular resistance and 30% lower oxygen availability to tissue. Oxygen consumption, however, was proportionally lower (45%) and coronary perfusion pressure was higher (28%) at 34 degrees C than at 37 degrees C; thus neither mixed venous nor coronary sinus blood oxygen saturation was compromised under hypothermic conditions. Although the trends in hemodynamic changes were similar in both groups, cardiac indices in patients with marked hemodilution were higher than cardiac indices in those with moderate hemodilution at all temperatures. This observation indicates that the hemodilution-induced rise in cardiac index remains intact even under hypothermic conditions. Under the conditions we studied, hypothermia with or without hemodilution had no significant adverse effects on hemodynamics and oxygen metabolisms of the whole body or of the heart.

Effects of CGS-13080, a thromboxane inhibitor, on pulmonary vascular resistance in patients after mitral valve replacement surgery

Pulmonary hypertension with an elevated pulmonary vascular resistance was observed during the immediate recovery period in patients who underwent mitral valve surgery. In eight such patients, intravenous infusion of CGS-13080, imidazo(1,5-a)pyridine-5-hexanoic acid (a thromboxane synthetase inhibitor), at a dose range of 0.08-0.1 mg/kg/hr, effectively reduced pulmonary hypertension (from a mean pulmonary arterial pressure of 36 +/- 2 to 31 +/- 2 torr) and pulmonary vascular resistance (from 339 +/- 38 to 238 +/- 37 dynes.sec.cm-5) within 30 minutes and remained reduced for the entire infusion period (48 hours in five patients and 18 hours in three patients). Mean arterial pressure or systemic vascular resistance were not significantly affected by the drug infusion. Serum thromboxane B2 levels (a stable metabolic product of thromboxane A2) were significantly reduced after administration of the compound, with the maximum effect of greater than 90% reduction. All patients tolerated the drug infusion without significant side effects.

Monoclonal antibody PR92 with restricted specificity for tumor-associated antigen of prostate and breast carcinoma

A unique mouse hybridoma, PR92, was obtained using human prostate adenocarcinoma cell line DU145. The monoclonal antibody produced by the PR92 clone was reactive with DU145, MCF-7 (breast adenocarcinoma), and CHAGO (lung carcinoma), but not with normal cell lines and 16 other cell lines of cancerous origin. A homologous solid-phase sandwich radioimmunoassay (PR92-RIA) was developed utilizing PR92 monoclonal antibody. The PR92-RIA recognized unique antigen present in DU145 cell extract but did not detect 16 other known tumor-associated markers. In preliminary studies, the PR92-RIA measured greater than 5 units/ml level of PR92 monoclonal antibody-binding antigen in 23 of 31 (74%) serum specimens of active prostate cancer and 27 of 31 (87%) active breast carcinoma patients. Only 1 of 79 (1%) sex-matched normal donors and 1 of 57 (2%) benign disease control patients showed the serum antigen level greater than 5 units/ml. A high degree of correlation was observed between the PR92 antigen activity and the clinical status of four prostate and four breast cancer patients during therapeutic treatment. Thus, the PR92-RIA detects new tumor-associated antigen which may be useful in detection and monitoring of prostate and breast carcinoma patients.