Detection of anti-type VII collagen IgE antibodies in epidermolysis bullosa acquisita

BACKGROUND

Epidermolysis bullosa acquisita (EBA) is a rare pemphigoid disease involving autoantibodies to type VII collagen (COL7), a major structural component of anchoring fibrils. IgE autoantibodies to type XVII collagen (BP180) have been identified in bullous pemphigoid (BP), the prototype of pemphigoid diseases. Although the pathogenic relevance of IgG anti-COL7 has been investigated, that of IgE in EBA remains unclear.

OBJECTIVES

To reveal the presence and pathogenic relevance of IgE anti-COL7 in EBA.

METHODS

We examined IgE antibodies in 109 patients with EBA by indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA).

RESULTS

IIF with normal human skin revealed IgE reactivity in the basement membrane zone in 29 (26·6%) cases. To verify whether the IgE antibodies were specific to COL7, we performed IIF with 21 clearly positive cases and the skin of a patient with dystrophic EBA, which does not involve COL7. All cases showed negative results, indicating that IgE antibodies were specific to COL7. In a modified IgG COL7 ELISA for IgE, 16 (14·7%) cases were positive (three and 13 cases were negative and positive on IIF, respectively). We compared anti-COL7 IgG and IgE, and found a weak but significant correlation (r = 0·459, P < 0·001). EBA is clinically divided into a mechanobullous (MB; noninflammatory) type and an inflammatory (INF) type resembling BP. Of the IIF-positive cases, 11 of 30 (37%) had INF and nine of 48 (19%) had MB.

CONCLUSIONS

This study is the first to demonstrate the presence of circulating anti-COL7 IgE in patients with EBA, which may correlate with the clinical phenotype.

Characteristics of a granular electronic system in Heusler-type Fe2+xV1-xAl

We report comprehensive measurements of the magnetic, transport, and thermal properties of the Heusler-type compound Fe2+xV1-xAl, with x values near the ferromagnetic quantum critical point, xc ∼ 0.05. At T ∼ 60 K, a prominent Schottky-like anomaly appeared in the specific heat; this anomaly was correlated with a smaller pseudo-gap formation in magnetic susceptibility, magnetoresistance, and thermoelectric power. Furthermore, a magnetic anomaly observed in the magnetic susceptibility and resistivity at T ∼ 4 K was suppressed significantly by applying a magnetic field. A magnetically inhomogeneous phase arose below T ∼ 60 K, which appeared to consist of ferromagnetic and paramagnetic clusters.

Structural basis for the recognition of isoleucyl-adenylate and an antibiotic, mupirocin, by isoleucyl-tRNA synthetase

An analogue of isoleucyl-adenylate (Ile-AMS) potently inhibits the isoleucyl-tRNA synthetases (IleRSs) from the three primary kingdoms, whereas the antibiotic mupirocin inhibits only the eubacterial and archaeal IleRSs, but not the eukaryotic enzymes, and therefore is clinically used against methicillin-resistant Staphylococcus aureus. We determined the crystal structures of the IleRS from the thermophilic eubacterium, Thermus thermophilus, in complexes with Ile-AMS and mupirocin at 3.0- and 2.5-A resolutions, respectively. A structural comparison of the IleRS.Ile-AMS complex with the adenylate complexes of other aminoacyl-tRNA synthetases revealed the common recognition mode of aminoacyl-adenylate by the class I aminoacyl-tRNA synthetases. The Ile-AMS and mupirocin, which have significantly different chemical structures, are recognized by many of the same amino acid residues of the IleRS, suggesting that the antibiotic inhibits the enzymatic activity by blocking the binding site of the high energy intermediate, Ile-AMP. In contrast, the two amino acid residues that concomitantly recognize Ile-AMS and mupirocin are different between the eubacterial/archaeal IleRSs and the eukaryotic IleRSs. Mutagenic analyses revealed that the replacement of the two residues significantly changed the sensitivity to mupirocin.

Etoposide prevents apoptosis in mouse liver with D-galactosamine/lipopolysaccharide-induced fulminant hepatic failure resulting in reduction of lethality

D-Galactosamine (GalN)/lipopolysaccharide (LPS)-induced liver injury is an experimental model of fulminant hepatic failure in which tumor necrosis factor alpha (TNF-alpha) plays a pivotal role. We examined the effects of etoposide on GalN/LPS-induced fulminant hepatic failure. Mice were given an intraperitoneal dose of GalN (800 microg/g body weight)/LPS (100 ng/g body weight) with and without intraperitoneal etoposide (10 microg/g body weight) treatment. Liver injury was assessed biochemically and histologically. TNF-alpha levels in the serum, and apoptosis of hepatocytes and CPP32/caspase-3 in the liver, were determined. GalN/LPS treatment caused lethal liver injury in 87% of animals (13 of 15). The effect was associated with significant increases in TNF-alpha and alanine transaminase (ALT) levels in serum, the number of apoptotic hepatocytes, CPP32/caspase-3 activity, and TNF receptor 1 (TNFR1) mRNA expression in the liver. Etoposide (10 microg/g body weight) was given 3 times (at 50, 26, and 4 hours before GalN/LPS administration). Treatment of GalN/LPS-treated mice with etoposide reduced apoptosis of hepatocytes, resulting in reduction of lethality (13% [2 of 15]), while another topoisomerase II inhibitor, IRCF-193, showed no significant effect. The antilethal effect of etoposide was also confirmed in GalN/TNF-alpha-induced fulminant hepatic failure. Etoposide treatment reduced CPP32/caspase-3 activity in the liver, although it did not alter the serum TNF-alpha levels or hepatic TNFR1 mRNA expressions. In addition, etoposide treatment enhanced the mRNA and protein expression of Bcl-xL, an antiapoptotic molecule in the liver. The present findings suggest that etoposide prevents endotoxin-induced lethal liver injury by up-regulation of Bcl-xL, and that etoposide could be useful for the treatment of TNF-alpha-mediated liver diseases.

Inflammatory pseudotumor of the liver diagnosed by needle liver biopsy under ultrasonographic tomography guidance

Inflammatory pseudotumor of the liver is a rare benign lesion, but exploratory laparotomy and a hepatectomy are often performed unnecessarily after various misdiagnoses, including liver abscess, hepatocellular carcinoma, metastatic liver tumor, and cholangiocarcinoma. We present a case of hepatic inflammatory pseudotumor in a 17-year-old man in whom diagnosis was confirmed by liver needle biopsy under ultrasonographic tomography (UST) guidance. He had complained of fever and right hypochondralgia 2 months after being operated for appendicitis. He was admitted to our hospital because of the persistence of these symptoms and the presence of a hepatic mass lesion detected by UST. He had hepatomegaly, with tenderness; leukocytosis and elevated erythrocyte sedimentation rate and C-reactive protein level were noted. UST showed a hypoechoic mass in the liver and pre-contrast computerized tomography (CT) revealed a low-density area with an ill defined margin, which was barely enhanced by the contrast medium. On the basis of the patient's clinical symptoms and the laboratory data and imaging studies, the presence of a liver abscess was suspected and antibiotics were administered. One month after the initiation of the antibiotic therapy, UST demonstrated that the portal vein had dilated serpiginously and penetrated into the mass. As the heterogeneous appearance displayed by post-enhanced CT indicated the need for a differential diagnosis of the hepatic mass lesion to rule out hepatocellular carcinoma, percutaneous needle biopsy was performed, under UST guidance. Histopathological examination demonstrated marked infiltration of plasma cells and fibrosis, findings which were consistent with those of hepatic inflammatory pseudotumor. There was a spontaneous reduction of the hepatic pseudotumor without continuous antibiotics and this reduction was documented on follow-up UST and CT.

Additive and inhibitory effects of simultaneous treatment with growth factors on DNA synthesis through MAPK pathway and G1 cyclins in rat hepatocytes

Several growth factors play an important role in liver regeneration. Once hepatic injury occurs, liver regeneration is stimulated by hepatocyte growth factor (HGF), transforming growth factor (TGF)-alpha, and heparin-binding epidermal growth factor-like growth factor (HB-EGF), whereas TGF-beta1 terminates liver regeneration. In this study, we analyzed the effect of a combination of HGF and epidermal growth factor (EGF) on mitogen-activated protein kinase (MAPK) activity and G1 cyclin expression in primary cultured rat hepatocytes. Treatment with a combination of HGF and EGF, in comparison with that of either HGF or EGF, induced tyrosine phosphorylation of both c-Met and EGF receptor (EGFR) independently and additively stimulated MAPK activity and cyclin D1 expression, resulting in additive stimulation of DNA synthesis. On the other hand, although TGF-beta1 treatment did not affect tyrosine phosphorylation of c-Met and EGFR, MAPK activity, and cyclin D1 expression, which were stimulated by HGF and EGF, DNA synthesis was completely inhibited through a marked decrease in cyclin E expression. These results indicate that potent mitogens, such as HGF, TGF-alpha, and HB-EGF, could induce the additive enhancement of liver regeneration cooperatively through an increase in Ras/MAPK activity followed by cyclin D1 expression, and that TGF-beta1 suppresses the growth factor-induced signals between cyclin D1 and cyclin E, resulting in the inhibition of DNA synthesis.

Synthesis of N-linked pentasaccharides with isomeric glycosidic linkage

As part of a program to explore the structural requirement of N-glycans in the carbohydrate-mediated biological interactions, N-linked pentasaccharide core structure was stereochemically modified in terms of glycosidic linkage. Three isomers, alpha-D-Man-(1-->3)-[alpha-D-Man-(1-->6)]-alpha-D-Man-(1-->4)-beta-D-GlcNAc-(1-->4)-beta-D-GlcNAc-L-Asn, alpha-D-Man-(1-->3)-[alpha-D-Man-(1-->6)]-beta-D-Man-(1-->4)-alpha-D-GlcNAc-(1-->4)-beta-D-GlcNAc-L-Asn, and alpha-D-Man-(1-->3)-[alpha-D-man-(1-->6)]-alpha-D-Man-(1-->4)-alpha-D-GlcNAc-(1-->4)-beta-D-GlcNAc-L-Asn, were synthesized. Synthesis of the pentasaccharide with natural linkage is also described.

Visual interactions in the path of apparent motion

When two stationary visual objects appear in alternating sequence, they evoke the perception of a single object moving back and forth between them. This is known as stroboscopic or apparent motion and forms the basis of perceived continuity in, for example, motion pictures. When the spatiotemporal separation between the inducing objects is optimal, the subjective appearance of apparent motion is nearly indistinguishable from that of real motion. Here we report that the detection and identification of a simple visual form in the path of apparent motion is impaired by the illusory perception of an object moving through the empty space between the locations at which the inducing objects are presented. This observation may be a manifestation of perceptual completion or 'filling in' during apparent motion perception. We propose that feedback from higher to lower visual cortical areas activates an explicit neural representation of a moving object, which can then disrupt the representation of visual stimuli in the path of the movement.

3DinSight: an integrated relational database and search tool for the structure, function and properties of biomolecules

MOTIVATION

Although a large amount of information on the structure, function and properties of biomolecules is becoming available, it is difficult to understand the relationship between them. Thus, we have attempted to create an integrated relational database, search and visualization tool, 3DinSight, to help researchers to gain insight into their relationship.

RESULTS

We have gathered data on the structure, function and properties of biomolecules, and implemented them into a relational database system. The structural data contain several subset data such as protein homologues, protein-DNA complex, in order to enable searching within a specific class of data. The functional data include motif sequence and mutation data of proteins. Also, various amino acid properties are implemented as a relational table. The World Wide Web (WWW) interfaces enable users to carry out various kinds of searches among these data. The locations of motif sequences and mutations are automatically mapped on the structure, and visualized in three-dimensional (3D) space by interactive viewers, VRML (Virtual Reality Modeling Language) and RasMol. In the case of VRML, the mapped 3D objects are hyper-linked to the corresponding document data. Also, amino acid properties, linked with structure, functional and mutation sites, can be displayed as graph plots.

AVAILABILITY

3DinSight is freely accessible through the Internet (http://www.rtc.riken.go.jp/3DinSight.h tml).

CONTACT

sarai@rtc.riken.go.jp

Enzyme structure with two catalytic sites for double-sieve selection of substrate

High-fidelity transfers of genetic information in the central dogma can be achieved by a reaction called editing. The crystal structure of an enzyme with editing activity in translation is presented here at 2.5 angstroms resolution. The enzyme, isoleucyl-transfer RNA synthetase, activates not only the cognate substrate L-isoleucine but also the minimally distinct L-valine in the first, aminoacylation step. Then, in a second, "editing" step, the synthetase itself rapidly hydrolyzes only the valylated products. For this two-step substrate selection, a "double-sieve" mechanism has already been proposed. The present crystal structures of the synthetase in complexes with L-isoleucine and L-valine demonstrate that the first sieve is on the aminoacylation domain containing the Rossmann fold, whereas the second, editing sieve exists on a globular beta-barrel domain that protrudes from the aminoacylation domain.

Serum levels of eosinophil cationic protein reflect the state of in vitro degranulation of blood hypodense eosinophils in atopic dermatitis

In patients with atopic dermatitis (AD), serum levels of eosinophil cationic protein (ECP) have been shown to be a good reflector of disease severity. To elucidate what serum levels of ECP actually reflect, ECP levels in serum and plasma and cytological aspects of blood eosinophils were examined in AD patients (n = 27) and compared to healthy subjects (n = 12). Significantly elevated levels of serum ECP were noted in AD patients, while plasma ECP were uniformly recorded at nadir levels in both AD patients and normal subjects. In addition to blood eosinophilia, AD patients had significantly increased numbers of hypodense eosinophils (HEo) with morphological characteristics consistent with an activated state. Serum ECP levels strongly correlated with HEo numbers rather than with total eosinophil counts. These results indicate that elevated levels of serum ECP may be a consequence of in vitro degranulation of "activated" HEo, not of ECP supplementation from lesional skin. In addition, the dynamic correlations of eosinophil-associated parameters (total eosinophil counts, HEo numbers, and serum ECP levels) with AD severity suggest that inflammatory events in lesional skin may be involved in causing not only eosinophilopoiesis in bone marrow, but also development of HEo in the periphery, whose degree in turn may be mirrored in the levels of serum ECP in vitro.

Retinal complications during interferon therapy for chronic hepatitis C

OBJECTIVES

Various side effects of interferon (IFN) therapy have been reported. In this study, we examined retinal change during IFN therapy.

METHODS

We performed ophthalmological examinations before, during, and after therapy on 63 patients with chronic hepatitis C who were receiving either natural IFA-alpha or recombinant IFN-alpha 2a or 2b.

RESULTS

No retinal lesion was detected before IFN therapy, but, during therapy, retinal abnormality or retinopathy developed in 36 (57.1%) of 63 patients, including retinal hemorrhage in 25 patients and cotton-wool spots in 28 patients. They were noted early in the course of IFN therapy, within the first 4 wk in 67% (24/36) and within 8 wk in 86% (31/36). The incidence was not influenced by the type of IFN but was higher among diabetic (11/12, 92%, p < 0.05) or hypertensive patients (4/5, 80%, not significant) than among patients without either diabetes or hypertension (24/49, 49%). There was no relation between the incidence of retinopathy and the level of ALT activity or white blood cell or platelet counts. However, retinopathy occurred in most patients receiving IFN therapy after white blood cell count and platelet count reached a nadir. The levels of LDL-cholesterol and the atherosclerotic index in patients with retinopathy were slightly higher than those in the patients without retinopathy.

CONCLUSIONS

These results suggest that retinopathy often occurs in patients with chronic hepatitis C who are receiving IFN and that we should closely monitor patients for retinal complications during IFN therapy.

Purification of human blood eosinophils by a combination method using anti-CD16 monoclonal antibody, immunobeads, and Nycodenz density gradient

A simple method is described for the procurement of human blood eosinophil phenotypes by combining an anti-CD16 monoclonal antibody, immunobeads, and a non-toxic and non-ionic density gradient medium, Nycodenz. The purification depends on the removal of mononuclear cells using a 1.076/1.102 g/ml Nycodenz density gradient, partial removal of neutrophils based on different binding to plastic dishes, interaction of residual neutrophils with immunobeads via an anti-CD16 monoclonal antibody and, finally, extraction of eosinophil phenotypes by sifting the immunobeads-loaded neutrophils through an 1.080/1.102 g/ml Nycodenz density gradient. This method permits simultaneous preparation of highly purified normodense (> 1.080 g/ml) and hypodense eosinophils (< 1.080 g/ml) with reasonable chemiluminescence responses to opsonized zymosans and helminthotoxic activity to opsonized schistosomula corresponding to their own immunocytological properties.

Relationships between eosinophil-associated parameters and disease severity in atopic dermatitis

This study demonstrated not only the presence of house dust mite antigen (HDM)-specific IgE and IgG antibodies in the sera of 27 patients with atopic dermatitis (AD), but also considerably increased levels of serum eosinophil cationic protein (ECP) and uniformly nadir levels of plasma ECP, which provides evidence for ECP release from eosinophils in vitro. Besides blood eosinophilia, AD patients had an increased number of CD32+ eosinophils and EG2+ "activated" eosinophils; both of which, especially the latter, were significantly correlated with elevated levels of serum ECP. AD-source eosinophils had enhanced sensitivity for IgG-immune complexes corresponding to their increased expression of CD32, whereas neither HDM alone nor IgE/HDM-immune complex induced eosinophil activation. There were no gamma globulin-bearing cells in AD-source eosinophils, indicating that serum ECP levels may be dependent on EG2+ eosinophil numbers rather than the state of CD32-mediated eosinophil degranulation, as shown in vitro. Since HDM can cause an eczematous skin reaction accompanying the eosinophil accumulation and degranulation in sensitized AD, increased numbers of both CD32+ and EG2+ eosinophils according to the extent of AD severity indicates that these eosinophil in vivo generations and their subsequent functioning in the lesional skin may be regulated through HDM-initiated dermatitis events, and then, may form a vicious circle as the AD lesions spread.

A case report of serologically diagnosed pulmonary anisakiasis with pleural effusion and multiple lesions

The second known human case of pulmonary anisakiasis is reported. A 22-years-old man living in Hyuga City, Miyazaki Prefecture, Japan, developed high fever, respiratory distress, and pleural effusion after consumption of raw fish. Although his total white blood cell count increased to approximately 10,000-20,000/mm3, eosinophilia was not observed. The total IgE level in his serum markedly increased up to 3,599 IU/ml. Since the patient was suspected to have a parasitic disease, immunoserologic tests were carried out. Screening tests using a multiple dot-enzyme-linked immunosorbent assay (ELISA) and an Ouchterlony double-diffusion test showed that his serum and pleural effusion had the strongest reactivity against crude antigen of Anisakis type I larvae, together with weak cross-reactivity against several other nematode antigens. Since extragastrointestinal anisakiasis was strongly suspected, this diagnosis was confirmed by a microplate-ELISA and Western blot analysis using a monoclonal antibody.

Eosinophilic cellulitis (Wells' syndrome) associated with ascariasis

A case of eosinophilic cellulitis (Wells' syndrome) in association with ascariasis is described. The clinical and histopathologic features of the patient responded well to an oral anthelminthic drug. According to our search, this association has not previously been reported.

[A case report of successful open valvotomy in neonate with critical aortic stenosis]

Open valvotomy was successfully performed in neonate with critical aortic stenosis using cardiopulmonary bypass. The baby was referred to our hospital at the age of 24 days with very grave state, and needed intensive care including endotracheal intubation and inotropic support. Critical valvular aortic stenosis was confirmed by echocardiography. Poststenotic dilatation and enough size of short axis LV dimension were reported, and aortic annulus was measured 6 mm in diameter. Without catheterization and angiography, open valvotomy was performed with moderate hypothermia and ischemic arrest using single dose of cold cardioplegia at the age of 29 days. Bicuspid aortic valve was thick and dysplastic with thick gelatinous cusp edge, however commissurotomy was applicable in two direction. The diameter of aortic opening was enlarged from 2 mm to 7 mm. Total bypass and aortic cross clamp time were 78 and 28 minutes respectively. The baby recovered uneventfully and there was no evidence of significant AS or aortic regurgitation in echocardiography 7 months after surgery. Sorts of reoperation for restenosis or regurgitation were reported. The results of reoperation for regurgitation were reported to be poor, especially in young infants who should be performed aortic valve replacement. However, residual AS could be manipulated with re-valvotomy, PVB, apico-aortic conduit or AVR. As the choice of first relief of critical AS without other anatomical disadvantages including hypoplastic left ventricle, endocardial fibroelastosis, and mitral stenosis, it would be crucial for late results to prevent progression of aortic regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Eosinophil phenotypes in bullous pemphigoid

Eosinophil phenotypes were investigated in peripheral blood and skin lesions from eight patients with bullous pemphigoid (BP). By Nycodenz density gradients fractionation, blood eosinophils were divided into two phenotypes; normodense (greater than 1.080 g/ml) and hypodense (less than or equal to 1.080 g/ml). Increased numbers of hypodense eosinophils were observed in the blood from all patients with BP. Immunocytochemical observations, using an EG2 monoclonal antibody to react with the secretion form of eosinophil cationic protein (ECP), revealed that EG2 was expressed in 86 +/- 3% of hypodense phenotypes and 3 +/- 2% of normodense phenotypes. Ultrastructurally, hypodense eosinophils were characterized by numerous spheroidal granules, each with a lytic crystalloid core. These indicate that the hypodense phenotype represents a cell in an activated state. Only eosinophils with immunocytochemical and morphological characteristics similar to hypodense phenotypes infiltrated around the basement membrane zone in involved skin of BP. Furthermore, direct adherence of eosinophils associated with degranulation into basal keratinocytes was seen at the sites of blistering lesions. Bullous fluids contained higher concentrations of ECP than sera as determined by a radioimmunosorbent assay; thus hypodense (activated) eosinophils may directly damage the basal keratinocytes by releasing their granule proteins, subsequently leading to dermo-epidermal separation.

[Surgical treatment of acute ascending dissection--a simplified operative method]

Primary anastomosis for acute ascending aortic dissection was performed in 8 patients. Primary anastomosis included resection of the intimal tear where applicable, a circumferential suture line in the ascending aorta at the site of the tear, and wrapping of the anastomosis of the ascending aorta with Dacron vascular prosthesis. The aortic valve was resuspended in 1 of 6 patients associated with aortic regurgitation. In 4 patients, aortic regurgitation disappeared postoperatively. Two patients show minor non-progressive valve regurgitation. Two of 8 patients died early postoperatively. There was no late death and dilatation of the aortic root in the follow-up period of mean 27 months. On the basis of these results, we believe that primary anastomosis is a simpler and safer operative method for acute dissection of the ascending aorta.

Primary anastomosis for acute ascending aortic dissection

Intimal tear resection and primary anastomosis of the aorta were used for the treatment of eight patients with DeBakey I and II type acute aortic dissection. Five patients were of DeBakey I type, and three patients were of the II type. Moderate or severe aortic regurgitation (AR) was observed in six of eight patients. The site of the intimal tear was diagnosed by intraoperative echocardiography, and the adventitia corresponding to the intimal tear was transversely opened under total cardiopulmonary bypass. While resuspension of the aortic valve was performed on only one of six patients, AR disappeared in four, postoperatively. Two of eight patients died early postoperatively. The cause of death was postoperative cardiac tamponade in one patient and cerebral herniation in the remaining one. The other six patients have been observed for a mean period of 27 months. There is no late death, and they show no dilatation of the aortic root and deterioration of AR. We believe that this operative method is a simple and safe emergency procedure for DeBakey I and II type acute aortic dissection.

Ultrasonographic findings and management of intrahepatic biliary tract abnormalities after portoenterostomy

Ultrasonographic examinations was made in 24 children who had undergone a portenterostomy to correct extrahepatic biliary atresia. Abnormalities were observed in six patients. These were the result of ongoing inflammatory reactions because all had been suffering from cholangitis after surgery, and the size of the biliary tract structure changed in accordance with the occurrence and subsidence of the cholangitis. Ultrasonographic examination showed dilation of the intrahepatic bile duct in one patient and cystic lesions in five patients. Treatment included percutaneous transhepatic bile drainage for dilated bile ducts, alcohol injections for intrahepatic cysts, and reoperation for cysts in the porta hepatis. Treatment was not required for cysts in controllable cholangitis. The results of these approaches were excellent, indicating that they were of benefit in treatment intrahepatic abnormalities occurring after portoenterostomy.

[Surgery for aortic aneurysms with coronary disease]

Between 1981 and 1988, 52 patients with dissecting aneurysms were operated and four of them (7.7%) had right coronary dissections that were repaired by Bentall's method with or without right coronary bypass grafting (CABG). Three (8.5%) of 35 patients with thoracic aneurysms had coronary disease. Among them, two had one vessel disease (1VD) and one had 2VD; two underwent temporary axillofemoral bypass grafting (AFBG) without CABG and one underwent extracorporeal circulation with CABG. Eight (5.6%) of 142 patients with abdominal aneurysms had coronary disease. They consisted of three patients with 1VD, two with 2VD and three with 3VD; their ejection fraction rates were 0.46 to 0.75. Three of them underwent temporary AFBG and one first underwent CABG but later underwent abdominal aortic graft replacement. In conclusion, patients with good coronary distal run-off and a low ejection fraction rate (under 0.5) should initially undergo CABG, but for those with poor run-off, temporary AFBG is better to prevent cardiac afterload.

A monoclonal antibody against dentin phosphophoryn recognizes a bone protein(s) appearing at the beginning of ossification

Decalcified and nondecalcified sections of fetal bovine tibia were stained immunohistochemically with a monoclonal antibody against dentin phosphophoryn. In the epiphyseal portion of the long bone, osteoblasts, osteocytes and the bone matrix were stained, but chondrocytes and the cartilage matrix were not. Similar staining was observed in the epiphyseal and diaphyseal portions of bones. These findings suggest that a protein(s) with the same epitope as phosphophoryn may be synthesized and secreted by osteoblasts at the beginning of ossification and may be involved in mineralization of bone tissue. On Western blots of proteins extracted from fetal bovine bone, the antibody reacted with two bands of molecular weights of about 71,000 and 63,000. These proteins and antibody(s) to the proteins may be useful for detection of the phenotype of osteogenesis.