The least number of phosphate groups for crosslinking of casein by colloidal calcium phosphate

Artificial casein micelles were formed with whole human casein at 20 mM calcium, 17 mM phosphate, and 10 mM citrate. The casein micelles disaggregated by 6 M urea were separated by high performance gel chromatography on a TSK-GEL G4000SW column into crosslinked and monomeric fractions. When the crosslinked casein fraction was analyzed by high performance ionexchange chromatography on a TSK-GEL DEAE-5PW column, a small peak, representing the 3-P component of human beta-casein, and distinct peaks of the 4-P and 5-P components were found. Artificial casein micelles were formed from mixtures of each purified component of human beta-casein and bovine kappa-casein, disaggregated by urea, and separated on a TSK-GEL G4000SW column. The casein aggregates crosslinked by colloidal calcium phosphate were formed in artificial casein micelles of the 3-P and 4-P components. In contrast, no crosslinkage was formed in artificial micelles of the 1-P and 2-P components. The results indicate that at least three phosphate groups are needed for crosslinking of casein by colloidal calcium phosphate.

Calcitonin release from medullary thyroid carcinoma by thyrotropin-releasing hormone: comparison with calcium injection

The effects of thyrotropin-releasing hormone on the release of calcitonin were investigated in 15 normal subjects and 12 patients with medullary thyroid carcinoma. The present study also compared the effect of TRH stimulation with calcium infusion test on calcitonin release in patients with medullary thyroid carcinoma. In normal subjects, calcitonin increased from a basal value of 7.5 +/- 2.5 pmol/l to a peak value of 9.4 +/- 3.0 pmol/l (p less than 0.01) after iv injection of synthetic TRH (500 micrograms). Basal calcitonin values in patients with medullary thyroid carcinoma were high (1216 +/- 2230 pmol/l, p less than 0.05), and TRH induced a further increase in calcitonin to 1842 +/- 3149 pmol/l in all the patients (p less than 0.05). They had a peak value of 7891 +/- 13,528 pmol/l after the calcium infusion, which was significantly higher than the basal value of 1463 +/- 2630 pmol/l (p less than 0.05). All medullary thyroid carcinoma patients displayed a marked calcitonin increase after TRH and calcium stimulation. Although the increase in serum calcitonin after TRH injection was lower than that after calcium injection (1.6-fold vs 5.4-fold, p less than 0.05), there was no significant difference in mean peak calcitonin value following TRH and calcium injection in patients with medullary thyroid carcinoma. These results indicated that TRH could stimulate calcitonin release from the thyroid C-cells in both normal subjects and patients with medullary thyroid carcinoma.

[Evaluation of halothane induced HPV inhibition with analysis of pressure-flow curve]

We investigated the effect of halothane on the hypoxic pulmonary vasoconstriction using in vivo measurement of the pressure-flow curve of the left lower lobe in the dog. With hypoxic ventilation of the left lower lobe, the pressure-flow curve shifted to the right and the slope of the curve became flatter. Although inhalation of 1 MAC halothane by the left lower lobe during hypoxic ventilation had no effect on the pressure-flow curve configuration, inhalation of 3, 5 MAC made the slope steeper. We analyzed these changes by the distensibility model proposed by W. Mitzner et al, and our data support the hypothesis that hypoxic ventilation decreases the small pulmonary vessels of 1-4 orders and also increases the compliance of the orders of vessel where the constriction has occurred, and halothane antagonizes the HPV response by further increasing the compliance of the constricted vessels. The inhibitory effect of halothane on HPV was weaker in in vivo preparation compared with the effect in in vitro preparation. Some humoral factors in the perfusate could contribute to this effect.

A possible contribution of endogenous atrial natriuretic peptide to proteinuria in patients with chronic renal failure

Plasma levels of immunoreactive atrial natriuretic peptide (IR-ANP) were measured with a specific radioimmunoassay in 19 undialysed patients with chronic renal failure. At the beginning, an extremely high level of plasma hANP (50 fmol/ml) seen in a patient was rejected with Smirnov's test and was excluded from further statistics. The plasma IR-ANP levels in these patients were significantly higher than those of 19 normal subjects matched with age and sex (10.9 +/- 1.6 vs 5.3 +/- 0.6 fmol/ml, mean +/- SEM, p less than 0.01), and positively correlated with mean blood pressure (r = 0.44, p less than 0.05) and the cardiothoracic ratio (r = 0.65, p less than 0.01), but did not correlate with creatinine clearance (r = -0.38, n.s.). Further, a significant correlation was observed between plasma IR-ANP and urinary protein output (r = 0.47, p less than 0.05). On the other hand, urinary protein output did not correlate significantly with variables such as mean blood pressure, the cardiothoracic ratio or creatinine clearance. Since it has been suggested that ANP enhances glomerular capillary permeability, increased ANP responding to volume overload in those patients may play an important role in increasing urinary protein excretion.

[Effects of mecobalamin on testicular dysfunction induced by X-ray irradiation in mice]

Experimental testicular dysfunction were produced by X-ray irradiation to the testes in mice. Mecobalamin (CH3-B12) was orally administered at a daily dose of 0.01, 0.1 or 1 mg/kg six times a week for 8 weeks from the next day after the irradiation. The control mice received physiological saline in the same manner. On 4th- and 6th-week after the irradiation, the weights of testes and epididymides were decreased, although those of the body and accessory sex glands (seminal vesicle, coagulating gland and prostate) were nearly equal to those of non-irradiated mice. At the same time, the diameter of seminiferous tubules decreased and sperm parameters (sperm count, sperm motility and sperm abnormality) deteriorated. When CH3-B12 (1 mg/kg) was administered, the diameter of seminiferous tubules increased and sperm parameters improved as compared to those of the control. The results indicate that CH3-B12 improved the experimental testicular dysfunction in mice induced by the irradiation. These results suggest that CH3-B12 might accelerate testicular function.

[An experimental study to determine the most effective delay procedures on secondary vascularized skin island flaps]

Secondary vascularized flaps made from implanted vascular bundles in the subcutaneous tissues have dominant vascularities. Animal experiments were performed using white rabbits, two types of skin flaps were made on their backs. The first delay procedure was performed on the left side where the vascular bundle had been implanted with an elevation of distally based flap (size 2 cm x 7 cm). 28 out of 32, secondary vascularized skin island flaps survived either partially or completely in the first procedure. Moreover, the first delay method was observed to be efficacious in 15 out of 16 cases (p less than 0.01). The viability of vascular bundles of secondary vascularized flap was thus proved. The first stage of the second delay procedure was performed in bilateral side using the same procedure as the first delay. Two weeks later, two types of delay method were carried out. On the left side, a proximally based flap (size 2 cm x 7 cm) was made at the distal area of the first delay flap. On the right side, a bipedicled flap was made (size 2 cm x 14 cm). These flaps were elevated as secondary vascularized skin island flaps two weeks later. In all cases, the latter procedure produced a longer survival rate compared with the former (p less than 0.01). It was concluded experimentally that the most effective second delay procedure was the bipedicled flap method.

Recombinant human interleukin-1 beta analogue as a regulator of hematopoiesis in patients receiving chemotherapy for urogenital cancers

Ten patients with advanced urologic cancers who were scheduled to receive at least two courses of chemotherapy were enrolled in this trial. Fifty thousand units of recombinant human interleukin-1 (IL-1) beta analogue OCT-43 (Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan) was administered subcutaneously only once or twice when severe neutropenia (less than 500/microliters) continued for 2 consecutive days. In eight patients, OCT-43 was not injected in the first course of chemotherapy as a control, but was injected in the second course. The durations of leukocytopenia (less than 2000/microliters) and neutropenia (less than 1000/microliters) were significantly shortened in the second course compared with those in the first course in those eight patients. Recovery of neutrophil number from the lowest number was also significantly faster in the second course. Thus, OCT-43 was considered to have hematopoietic activities. However, single or double injection of OCT-43 did not affect the numbers of eosinophilic or basophilic granulocytes, monocytes, or platelets. Adverse effects associated with OCT-43 injections were high fever and chills, but they were controlled by indomethacin.

Recombinant human interleukin-1 beta analogue as a regulator of hematopoiesis in patients receiving chemotherapy for urogenital cancers

Ten patients with advanced urologic cancers who were scheduled to receive at least two courses of chemotherapy were enrolled in this trial. Fifty thousand units of recombinant human interleukin-1 (IL-1) beta analogue OCT-43 (Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan) was administered subcutaneously only once or twice when severe neutropenia (less than 500/microliters) continued for 2 consecutive days. In eight patients, OCT-43 was not injected in the first course of chemotherapy as a control, but was injected in the second course. The durations of leukocytopenia (less than 2000/microliters) and neutropenia (less than 1000/microliters) were significantly shortened in the second course compared with those in the first course in those eight patients. Recovery of neutrophil number from the lowest number was also significantly faster in the second course. Thus, OCT-43 was considered to have hematopoietic activities. However, single or double injection of OCT-43 did not affect the numbers of eosinophilic or basophilic granulocytes, monocytes, or platelets. Adverse effects associated with OCT-43 injections were high fever and chills, but they were controlled by indomethacin.

Salt sensitivity and central dopaminergic activity in patients with essential hypertension

The pathophysiological role of the central dopaminergic mechanism in human essential hypertension (EHT) is still unknown, so we investigated a possible relationship between the central dopaminergic activity and salt sensitivity to blood pressure in patients with EHT. We divided 22 inpatients with EHT into salt-sensitive (SS, n = 11) and non-salt-sensitive (NSS, n = 11) groups according to an 8% increase of mean blood pressure (MBP) when dietary salt intake was increased from 2 g/day to 20 g/day for two periods of 7 days each. The change of central dopaminergic activity by salt load was evaluated as the percentage change of plasma prolactin (PRL) response to a small dose (25 micrograms) of thyrotropin-releasing hormone (TRH) administered intravenously. The mean percentage change of PRL response by salt load in the SS group was -9.4 +/- 8.5% (mean +/- SEM), which was remarkably lower than the 26.8 +/- 5.5% in the NSS group (P less than .01). There was a significant negative correlation between the percentage change of PRL response and that of MBP by salt load (r = -0.456, P less than .05). These results suggest that a lack of activation of the central dopaminergic system by salt load may contribute in part to a rise in blood pressure in SS patients with EHT.

A new method of hernioplasty for adult groin hernias centering on repair of the transversalis fascia

A new method of hernioplasty for adult groin hernias centering on repair of the transversalis fascia was assessed by a questionnaire conducted every five years on adult patients who had received the above operation. The efficacy of this method was evaluated in terms of the postoperative quality of life and prevention of recurrence of groin hernias. Over the last 9 years, 834 adult patients with 921 groin hernias, including bilateral lesions, have undergone the above procedure and overall, favorable results were obtained, with only one case of recurrence (0.1 per cent) being reported. Contralateral herniation, which has been often reported following Bassini's or Hatakoshi's method, was found in only one of our patients although the number of patients who complained of pain in the operated region was comparatively high, being 51 cases or 11.4 per cent.

[Clinical study of renal cell carcinoma as incidental finding]

Reports on renal cell carcinoma (RCC) as an incidental finding have been increasing in recent years as the imaging modalities including ultrasonography (US) and computerized tomography (CT) scan have gained popularity in clinical medicine. Because effective treatment in RCC is only surgical removal of the involved kidney even at present, it is imperative for urologists to find and to diagnose the RCC in early stage. Whether RCC found incidentally is in early stage cancer is not determined at present. To determine if the RCC found incidentally is in early stage cancer and if the survival rate is better than that of the RCC found with symptoms, we undertook the following study. Between December 1972 and March 1990, 65 patients with RCC were registered at the Department of Urology, Teikyo University Hospital. Of 65 patients 20 with RCC as an incidental finding were subjected to this study. 34 patients with RCC found with symptoms including hematuria were subjected to control group. Causes of the diagnosis in 20 patients included workup for non-urological diseases in 11 patients (55.0%), workup for urological disease other than RCC in 5 patients (25.0%) and routine medical checkup in 4 patients (20.0%). First-line imaging modalities for the diagnosis was US in 9 patients (45.0%), DIP in 6 patients (30.0%) and CT in 5 patients (25.0%). Size of the tumor, pathological stage (pT) and grade in these 20 patients were tended to be smaller and lower, respectively, but these results were not significant as compared to those of the control group. Incidence of the remote metastasis, at the time of diagnosis, however, was significantly lesser than that of the control group (p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

[Magneto-optical disk filing system for oral diagnostic reports and their synchronized images]

The rewritable and compact media of magneto-optical disk (MOD) is firstly applied to store medical images with spoken reporting. The MOD has multi-media function of communication and filing. Our system is optimized in terms of recording length of speech based upon our clinical research. The results will have influences over the future PACS. One of their examples is possibility of multimedia PACS with images, speeches and demographic data. Another example is prevention of dispersion of images which have no interpretations by radiologists. Our next step is to recognize filed speech in background processing for printing reports.

Continuous monitoring of unbound flomoxef levels in rat blood using microdialysis and its new pharmacokinetic analysis

Microdialysis sampling method coupled to high-performance liquid chromatography with UV detection was applied to continuous monitoring of in vivo unbound flomoxef concentration in rat blood. By comparison with ultrafiltration method, it was demonstrated that it gave reliable results for the unbound drug monitoring in blood. Furthermore, a new method was presented for the calculation of pharmacokinetic parameters from the data obtained by the microdialysis method.

Renal sodium handling and sodium transport inhibitor in salt-sensitive essential hypertension

To investigate the mechanism whereby blood pressure rises with NaCl loading in salt-sensitive essential hypertension, salt-sensitivity index was determined along with sodium and lithium clearances, plasma Na+,K(+)-ATPase inhibitor and intra-erythrocyte sodium and potassium concentrations. Salt-sensitivity index was defined as the percentage of change in mean blood pressure when NaCl intake was changed from low (34 mmol/day) to high (342 mmol/day). Salt-sensitivity index was inversely correlated with fractional excretion of lithium both on the low and high NaCl diets (r = -0.721, P less than 0.01 and r = -0.591, P less than 0.02, respectively; n = 16), but not with fractional excretion of sodium. The change of plasma Na+,K(+)-ATPase inhibition with NaCl loading had a direct correlation with salt-sensitivity index (r = 0.704, P less than 0.01; n = 16). Either intra-erythrocyte sodium and potassium concentrations or the ratio of these two values did not change significantly with an increase of dietary NaCl intake. These results suggest that an enhancement of proximal tubular sodium reabsorption stimulates secretion of plasma Na+,K(+)-ATPase inhibitor which may be involved in a rise in blood pressure with sodium loading. They also suggest that lithium clearance is a determinant which can predict salt sensitivity without actual NaCl loading.

Surgical method for treatment of syndactyly with osseous fusion of the distal phalanges

For the interdigital space plasty to correct a syndactyly with fusion of the distal phalanges, we adopted a new operative procedure, covering the exposed distal bone with local rectangular flaps designed transversely on both dorsal and volar surfaces. A full-thickness skin graft from the groin region covers the remaining raw surface. The procedure was performed in six patients, and the flaps measured 6 mm (width) x 12 to 16 mm (length) in four patients, 5 x 15 mm in one patient, and 5 x 18 mm in one patient. Partial necrosis was observed in only one patient, in whom a narrow flap of 5 x 18 mm was used. In the other five patients, however, the results were satisfactory on both external appearance and function during the follow-up period of 3 to 6 years.

Analysis of eight Sipple's syndrome patients and review of eighty-two cases from the Japanese literature

Eight Sipple's syndrome patients from four families have been reviewed. One family had the largest number of members with pheochromocytoma and/or medullary thyroid carcinoma. A total of 82 cases (47 females and 35 males) collected from the Japanese literature during the period 1960-1989, are also reviewed. The ages ranged from 22 to 73 (median 41) years, 13%, being over the age of 60 years (elderly patients). Pheochromocytoma occurred bilaterally in 72% of cases. With Sipple's syndrome, a relatively high urinary excretion of the epinephrine fraction and a high content of epinephrine in the tumor tissues were thought to be characteristic. Seventy-three patients underwent adrenalectomy with a successful outcome for 62 (85%). There needs to be careful periodic follow-up after unilateral adrenalectomy. Medullary thyroid carcinoma (MTC) also occurred bilaterally and was multicentric in 66% of cases, and was often found to be metastasized to the cervical lymph nodes at the time of surgery (35%). Parathyroid disease was found in 22% of cases: parathyroid adenoma in nine, hyperplasia in 10. Fourteen patients (17%) died of surgical complications, hypertensive crisis caused by excessive catecholamine release and/or widespread MTC metastases.

[Urothelial tumor in dialysis patients; report of four cases]

Four cases of urothelial tumors diagnosed during hemodialysis were reported. Patients' ages ranged from 43 to 74 years old. One case was female and others were male. Durations of dialysis at the time of diagnosis were 13 to 24 months. Chief complaints of these four cases were gross hematuria. One case with bladder tumor underwent emergency operation because of repeated bladder tamponade. Partial cystectomy was performed on this case. Other two cases with bladder tumor were treated with endoscopic method. Simple nephrectomy was done in the case with renal pelvic tumor. Post operative course in all four cases were uneventful without major complications.

Plasma atrial natriuretic peptide in patients with Graves' disease

In order to clarify the effect of thyroid hormone on the plasma atrial natriuretic peptide (ANP) concentration, 14 patients with Graves' disease and 6 normal control subjects were studied. They were all under constant sodium intake because dietary sodium is known to affect the amount of plasma ANP. Sodium intake remained constant at 171 mEq daily for five consecutive days at which time the ANP concentration was measured. Graves' disease patients were tested both before and after surgery. The preoperative, hyperthyroid ANP level concentration in Graves' disease patients was 6.7 +/- 2.3 fmol/ml compared to a significantly lower level of 4.2 +/- 1.4 fmol/in normal control subjects. Seven days after surgery when Graves' disease patients became euthyroid their ANP markedly decreased to 4.2 +/- 2.9 fmol/ml. In the present study we were able to confirm that under a constant sodium diet, high plasma ANP in patients with Graves' disease was reduced after surgery when they became euthyroid. Results also suggest that high circulating ANP might play an important role in sodium and water metabolism and hemodynamic changes in hyperthyroidism.

Combined reserpine and pituitary irradiation therapy for Cushing's disease patients following unsuccessful transsphenoidal microsurgery

The effectiveness of treatment with reserpine and pituitary irradiation, and with reserpine alone was evaluated in three female patients with Cushing's disease whose transsphenoidal pituitary microsurgery (TPM) had been unsuccessful. In these patients, endocrinological examination after the surgery demonstrated a recurrence of the disease although the microadenomas had apparently been curetted out from the pituitary in all patients. The first patient therefore received 1.0-2.0 mg/day of reserpine with 60 Gy x-ray irradiation, and there was complete remission within 3 months and the patient remained asymptomatic even when reserpine was reduced to 0.1 mg/day 10 years later. The second case was treated with low dose x-ray (20 Gy) and reserpine (0.5-2.0 mg/day), which were also effective. However, 2 weeks discontinuation of the drug caused urinary 17-hydroxycorticosteroids (17-OHCS) and serum cortisol to increase abnormally again, but these were finally re-normalized by an additional administration of reserpine. The third case was given reserpine alone (1.0-2.0 mg/day). She also had a remission in 3 months and the treatment was continued for one year, requiring no further treatment. These results suggest that additional treatment with reserpine and pituitary irradiation or with reserpine alone after unsuccessful TPM may be an effective alternative for patients with Cushing's disease.

[A case of long surviving gastric cancer with an malignant acanthosis nigricans]

Reported the case of a 73 year old female who was diagnosed as having a gastric cancer with malignant acanthosis nigricans and had a long survival, totaling about 8 years 6 months after operation. Further, her skin lesion completely disappeared. In general, a gastric cancer with malignant acanthosis nigricans is said to have a very poor prognosis and an analysis of recent cases has indicated that the average survival is about 10 months. The reason for such a bad prognosis is thought to be that the diagnosis of a gastric cancer with malignant acanthosis nigricans is usually determined only after the cancer is far advanced.

[Case report of a saccular aneurysm of the thoracic aorta in childhood]

A five-year-old boy with a large saccular aneurysm of the thoracic descending aorta extending rightward in the mediastinum underwent operation. Through a left thoracotomy descending aorta was clamped during partial femoro-femoral bypass and a examination of somatosensory evoked potential of the spinal cord. Placing a vertical incision on the aorta, a orifice of the aneurysm was closed with a xenograft pericardial patch. The aneurysm was left untouched. Nine months after operation the aneurysm was not recognized on chest X-ray and computed tomography. Etiology was unknown.

Spermicidal activity of menfegol-coated condom

The spermicidal activity of menfegol-coated condoms was investigated. Menfegol (P-menthanyl-phenyl-polyxyethylene [8,8] ether) showed strong spermicidal activity at 0.5 mg/ml and higher concentrations. Semen was ejaculated directly into menfegol-coated condoms (20 mg/condom) or uncoated condoms. Immediately after ejaculation, sperm motility and viability were examined. In the menfegol-coated condoms, sperm motility was completely suppressed and no viable sperm were observed. In the uncoated condoms, most of the sperm were alive, although their motility was almost suppressed. These results indicate that the menfegol-coated condom represents a new birth control method in which the contraceptive efficacy of the condom is enhanced by the spermicidal activity of menfegol.