[Coronary artery bypass grafting for simultaneous subacute stent thrombosis after sirolimus-eluting stent implantation]

An 82-year-old man developed simultaneous stent thrombosis 11 days after the implantation of a sirolimus-eluting stent (SES) in the proximal left anterior descending artery (LAD) and the proximal right coronary artery (RCA). The patient immediately underwent percutaneous coronary intervention; however, his condition became critical due to the development of recurrent stent thrombosis, and emergent coronary artery bypass grafting with saphenous vein grafts was performed. Postoperative angiography showed good patency of both grafts; thrombus formation in the LAD and RCA was negative. Since the patient had a history of liver dysfunction due to ticlopidine administration, the thienopyridine derivative was not administered; this was believed to be the main cause of subacute stent thrombosis. He was administered aspirin, cilostazol, and sarpogrelate instead. A good postoperative course was achieved only using aspirin. This case demonstrates that simultaneous SES thrombosis in multivessel lesions poses a life-threatening situation.

Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing

Circulation-derived cells play a crucial role in the healing processes of tissue. In early phases of tendon healing processes, circulation-derived cells temporarily exist in the wounded area to initiate the healing process and decrease in number with time. We assumed that a delay of time-dependent decrease in circulation-derived cells could improve the healing of tendons. In this study, we injected platelet-rich plasma (PRP) containing various kinds of growth factors into the wounded area of the patellar tendon, and compared the effects on activation of circulation-derived cells and enhancement of tendon healing with a control group (no PRP injection). To follow the circulation-derived cells, we used a green fluorescent protein (GFP) chimeric rat expressing GFP in the circulating cells and bone marrow cells. In the PRP group, the numbers of GFP-positive cells and heat-shock protein (HSP47; collagen-specific molecular chaperone)-positive cells were significantly higher than in the control group at 3 and 7 days after injury. At the same time, the immunoreactivity for types I and III collagen was higher in the PRP group than in the control group at early phase of tendon healing. These findings suggest that locally injected PRP is useful as an activator of circulation-derived cells for enhancement of the initial tendon healing process.

[Emergent coronary artery bypass grafting in a survivor of out-of-hospital cardiac arrest]

We report a case of emergent coronary artery bypass grafting (CABG) in a survivor of an out-of-hospital cardiac arrest. A 64-year-old male driver lost consciousness and collapsed in a rice paddy field. A bystander placed him in a car and immediately started cardiopulmonary resuscitation after confirming the presence of pulselessness and apnea. Emergency medical service providers performed a defibrillation of ventricular fibrillation by using an automated external defibrillator (AED), and the patient was transferred to the critical care center in our hospital. Coronary angiography revealed a thrombus in the left main trunk (LMT), total occlusion of the left anterior descending artery (LAD) and the right coronary artery (RCA), and 90% stenosis of the left circumflex artery (Cx). Since the patient recovered consciousness 1 hour after admission and did not undergo any critical trauma, an on-pump CABG was performed for 3 vessels. He was discharged on the postoperative day 23, and he resumed a normal life.

Intervertebral Disc Regeneration Using Platelet-Rich Plasma and Biodegradable Gelatin Hydrogel Microspheres

This study evaluated the regenerative effects of platelet-rich plasma (PRP) for the degenerated intervertebral disc (IVD) in vivo. After induction of IVD degeneration in rabbits, we prepared PRP by centrifuging blood obtained from these rabbits. These PRP were injected into the nucleus pulposus (NP) of the degenerated IVDs after impregnation into gelatin hydrogel microspheres that can immobilize PRP growth factors physiochemically and release them in a sustained manner with the degradation of the microspheres. As controls, microspheres impregnated with phosphate-buffered saline (PBS) and PRP without microspheres were similarly injected. Histologically, notable progress in IVD degeneration with time courses was observed in the PBS control, PRP-only, and sham groups. In contrast, progress was remarkably suppressed over the 8-week period in the PRP group. Moreover, in immunohistochemistry, intense immunostaining for proteoglycan in the NP and inner layer of the annulus fibrosus was observed 8 weeks after administration of PRP-impregnated microspheres. Almost all microspheres were indistinct 8 weeks after the injection, and there were no apparent side effects in this study. Our results suggest that the combined administration of PRP and gelatin hydrogel microspheres into the IVD may be a promising therapeutic modality for IVD degeneration.

Effects of prolactin and growth hormone on plasma immunoglobulin M levels of hypophysectomized rainbow trout, Oncorhynchus mykiss

Immunoglobulin M (IgM) is a major component of the humoral immune system of teleosts. This study examines the effects of hypophysectomy and subsequent replacement with prolactin (PRL) or growth hormone (GH) upon the plasma IgM levels of the rainbow trout (Oncorhynchus mykiss). Plasma IgM levels of the hypophysectomized fish were decreased to 30% of those in sham-operated fish 1 or 4 weeks after operation. Implantation of a cholesterol pellet containing salmon PRL or GH restored plasma IgM levels of the hypophysectomized fish, suggesting important roles for PRL and GH in the regulation of circulating IgM level in trout.

Molecular cloning of the cDNAs encoding pituitary glycoprotein hormone alpha- and gonadotropin II beta-subunits of the Japanese eel, Anguilla japonica, and increase in their mRNAs during ovarian development induced by injection of chum salmon pituitary homogenate

cDNAs encoding the glycoprotein hormone alpha- and gonadotropin (GTH) II beta-subunits of Japanese eel (Anguilla japonica) pituitary were cloned using the polymerase chain reaction. The nucleotide sequence of the glycoprotein hormone alpha-subunit cDNA was 364 base pairs (bp) long, encoding 117 amino acids, and that of the GTH II beta-subunit cDNA was 433 bp long, encoding 140 amino acids. The deduced amino acid sequence of each mature subunit showed high homology with those of other teleosts, indicating that the structure of GTH subunits has been conserved during the evolution of teleosts. Changes in the expression of these subunit genes during ovarian development induced artificially by the injection of chum salmon pituitary homogenate were examined using Northern blot analysis. Glycoprotein hormone alpha-subunit mRNA increased almost linearly during ovarian development, whereas GTH II beta-subunit mRNA was detected only at the late vitellogenic and migratory nucleus stages. These data indicate that eel GTH II is synthesized mainly at the late vitellogenic and migratory nucleus stages, and suggest that GTH II plays an important role in final oocyte maturation of Japanese eel. Changes in the expression of glycoprotein hormone alpha- and GTH II beta-subunits mRNA correlate with the serum estradiol-17 beta (E(2)) and testosterone profile during ovarian development. The increase in mRNA of both subunits is probably due to positive feedback of E(2) and testosterone produced by ovarian follicles in response to the GTH contained in chum salmon pituitary homogenate.

Monoclonal antibody against an amniotic protein carrying ABH blood group epitopes and its forensic application

A mouse monoclonal antibody against an amniotic protein carrying ABH antigenic epitopes was established. BALB/c mice were immunized by an amniotic protein of molecular weight over 200 kDa, which had proved to be the carrier protein of ABH blood group epitopes by analysis with SDS-PAGE and immunoblotting. The antibody, ASP-1, was directed to the amniotic carrier protein without affecting the ABH blood group antigenicity, and did not cross-react with other body fluids which included blood, saliva, semen, urine or vaginal secretion. The immunoglobulin class of ASP-1 was IgG1 with a titer of 1 : 1,600. ASP-1 was used to detect the ABH blood group of amniotic fluid by the sandwich ELISA in which wells of plates were coated with ASP-1, and the ABH blood group of the captured protein was detected with mouse IgM anti-A and -B antibodies and enzyme conjugated anti-mouse IgM. The sandwich ELISA could successfully detect the blood group of amniotic fluid in mixed body fluids.

Molecular biologic analyses of tetragametic chimerism in a true hermaphrodite with 46,XX/46,XY

OBJECTIVE

To investigate the mechanism of the formation of a tetragametic chimera with true hermaphroditism (46,XX/46,XY).

DESIGN

Molecular biologic analyses.

SETTING

Outpatient clinic and laboratories of a university hospital.

SUBJECTS

A true hermaphrodite with 46,XX/46,XY and the parents. MAIN OUTCOME ANALYSIS: Restriction fragment length polymorphism (RFLP) of the pseudoautosomal region on sex chromosomes.

RESULTS

Whereas a normal diploid individual showed two bands, the true hermaphrodite showed four bands in the RFLP analyses. Evaluation of the molecular weights of the bands revealed two of them to be of maternal origin and the other two to be of paternal origin.

CONCLUSION

The two cell lineages composing the true hermaphrodite are heterogeneous because those originated from the fertilization of two genetically different maternal haploid cells by two different spermatozoa.

The effect of cortisol administration on blood plasma immunoglobulin M (IgM) concentrations in masu salmon (Oncorhynchus masou)

Immunoglobulin M (IgM) is known as a main factor in the humoral immune system of teleosts. In the present study, the effect of cortisol on plasma IgM concentrations was investigated using a specific antibody to IgM in masu salmon (Oncorhynchus masou). Cortisol was orally administered each day for 2 weeks at a dose of 1 mg g(-1) in the diet, and for the following week the fish were fed a non-treated diet. Blood plasma samples were collected at 0, 1, 2 and 3 weeks after the initiation of treatment. Oral administration of cortisol elevated plasma cortisol concentrations to about 40 ng/ml for 2 weeks after administration and slightly reduced plasma IgM concentration; the suppression was statistically significant one week after the period of hormone administration. However, treatment with cortisol did not affect plasma concentrations of total protein or α1-protein, one of the major serum proteins, during the experimental period. These results indicate that cortisol specifically suppresses plasma IgM concentrations.

[Two unusual cases of half-sibling test with DNA polymorphism]

In usual paternity cases, the putative man and the mother-child couple are alive. However, there are some cases in which putative man and mother were deceased and only children were available for analyses. It is difficult to determine the presence or absence of half-sibling relationship from analyses of conventional blood group markers (CBGM). In this study, five kinds of single locus DNA probes were applied to 2 half-sibling cases. To decide usefulness of single locus DNA probes, we defined likelihood ratio of half-sibling (LRHS) based on the likelihood ratio of paternity (LRP) and also investigated the distribution curves of log10 LRHS in cases of unrelated combinations and half-sibling combinations. Distribution curves of log10 LRHS from DNA analyses in the cases of unrelated combinations and half-sibling combinations is more clearly separated than from CBGM. Single locus DNA probes are considered to be more informative for half-sibling cases.

Na(+)-H+ exchange inhibitors decrease neointimal formation after rat carotid injury. Effects on smooth muscle cell migration and proliferation

The presence of multiple growth stimuli at the sites of vascular injury following angioplasty suggests that therapies targeted toward common growth pathways will be more effective than therapies that inhibit only a single growth factor. We tested this hypothesis using amiloride and ethyl isopropyl amiloride (EIPA), which are inhibitors of the Na(+)-H+ exchanger, whose activity is required in many cells for proliferation and migration. In the rat carotid injury model, EIPA (100 micrograms/h for 15 days) significantly decreased intimal area and the ratio of intimal to medial area, whereas amiloride (25 micrograms/h) showed an inhibitory trend that was similar to that observed for captopril (80 mg/kg per day) and heparin (25 U/h). EIPA and amiloride inhibited rat vascular smooth muscle cell DNA synthesis, with IC50 values of 8.8 and 82.2 microM, respectively. Using platelet-derived growth factor as a chemoattractant, EIPA caused a concentration-dependent inhibition of migration (IC50, approximately 60 microM). Because amiloride and EIPA have nonspecific effects on cellular function (especially inhibition of tyrosine kinases), we sought to characterize the specific role of the Na(+)-H+ exchanger in vascular smooth muscle cell proliferation and migration. We generated a Na(+)-H+ exchanger-deficient mutant cell line [RNHE(-)]. Studies with these cells suggested that the inhibitory effects of EIPA and amiloride were mediated only in part via Na(+)-H+ exchange because (1) RNHE(-) cells grew well at pH 6.8 to 7.5 in bicarbonate-containing medium, and (2) there was no difference in migration in response to platelet-derived growth factor in the RHNE(-) cells. In summary, these data indicate that amiloride and EIPA inhibit neointimal formation in the rat carotid after injury. However, the mechanism of inhibition is likely to involve cellular events other than Na(+)-H+ exchange, such as an effect on tyrosine kinases.

Effects of thyroid hormone on gonadotropin-induced steroid production in medaka, Oryzias latipes, ovarian follicles

Blood and ovarian samples were collected at intervals of 4h prior to spawning time from medaka (Oryzias latipes) that were maturationally synchronized with artificial photoperiod (14h light: 10h dark). Plasma estradiol-17β (E2) levels increased rapidly from 16h before spawning and peaked at 8h before spawning. Follicle-enclosed oocytes (ovarian follicles) at different stages of development were isolated from the ovaries and used to study the in vitro effects of thyroid hormone (triiodothyronine; T3) on pregnant mare serum gonadotropin (GTH)-induced E2 production. GTH at a concentration of 100 IU/ml stimulated E2 production by ovarian follicles collected between 32 and 16h before spawning. At 32h before spawning, T3 (5 ng/ml) administered along with GTH (100 IU/ml) resulted in a 3.5 fold increase in E2 production, compared with GTH administered alone. These results suggest that T3 can act on ovarian follicles directly to modulate GTH-stimulated E2 production in the medaka.

Prenatal paternity testing with DNA analyses

Two PCR amplified loci and 3 single locus DNA probes were applied in a paternity case in which a married woman became pregnant after being raped. DNA analysis were performed using samples from the woman, her husband and amniotic fluid cells taken during the 16th week of pregnancy. The combined probability of paternity for her husband was calculated as 0.999997107. The application of PCR analyses and single locus DNA probes were considered to be extremely informative in prenatal paternity testing.

Blood grouping of minute samples using monoclonal anti-A,B antibody

The availability of a monoclonal anti-A,B antibody (AB-E6E2) for blood grouping of blood and saliva stains was investigated. The antibody, which was reacted with A, B and AB antigens but not with O antigen, was produced from BALB/c mouse-mouse hybridoma raised to group AB red blood cells. AB-E6E2 had heat-elutability enough to detect ABO antigens in blood and saliva stains by absorption-elution test, whereas it had extremely weak double combining potency in mixed agglutination test. Application of elution-ELISA method will enable the detection of smaller amount of ABH antigens. The antibody, therefore, would be useful to segregate group O minute samples from the other blood group ones.

Impact of influenza virus infection as a cause of pediatric hospitalization

From winter 1989 to spring 1990, a severe epidemic caused by influenza A (H3N2) and B viruses developed in Japan. During the epidemic (December 1989 to February 1990), 244 children were admitted to the pediatric ward of Nippon Kokan Hospital: 53 (21.7%) were hospitalized with influenza virus infection, 22 (9.0%) with rotavirus gastroenteritis, and 17 (7.0%) with respiratory syncytial virus infection. Among those with influenza, 24 had type A and 29 had type B. Most were young healthy children without underlying illnesses (mean age, 4.8 +/- 3.4 years). The impact of the influenza epidemic on pediatric hospitalization is probably much greater than generally thought when a severe epidemic occurs.

[Study of the profiles of prolactin and other hormones in both maternal plasma and amniotic fluid during labor]

The effects of a dopamine antagonist and stress of labor on prolactin (PRL) concentrations were studied in maternal plasma and amniotic fluid during term delivery. In procedure 1, maternal blood and amniotic fluid samples were obtained from 5 normal full-term deliveries at 20-minute intervals for 180 minutes after the intravenous bolus of 10 mg metoclopramide (MCP) during labor just before delivery. Amniotic fluid samples were drawn through a transcervical intrauterine pressure catheter to avoid contamination with maternal blood. PRL, 17 beta-estradiol (E2), progesterone (P) and cortisol were measured by means of radioimmunoassay (RIA), and free MCP concentrations were measured by high pressure liquid chromatography. In procedure 2, maternal blood and amniotic fluid samples were obtained from 12 full-term pregnancies with spontaneous delivery and 10 cases of elective cesarean section when birth was imminent. The amniotic fluid was obtained by direct sampling from the forewaters in spontaneous delivery and by means of a syringe inserted through amniotic membrane after the uterine wall had been incised in cesarean section. PRL, beta-endorphin (beta-EP) and cortisol were measured by RIA. The PRL levels in maternal plasma increased significantly (p less than 0.01) after the MCP injection. The peak value of PRL net increase (delta PRL) was 676.5 +/- 189.6 ng/ml. However, the PRL levels in amniotic fluid did not change significantly after the administration of this drug. Although the delta PRL levels in maternal plasma were significantly (p less than 0.001) correlated with MCP concentrations (r = 0.812) after the MCP injection, there was no correlation between delta PRL and MCP concentrations in amniotic fluid. No significant changes in E2, P and cortisol levels in both samples were observed after the MCP injection. The plasma PRL levels in vaginal delivery cases were significantly (p less than 0.05) lower than those in elective cesarean section cases (123.3 +/- 15.8 ng/ml vs. 181.0 +/- 22.2 ng/ml), and the plasma beta-EP and cortisol levels in vaginal delivery cases were significantly (p less than 0.01, p less than 0.001) higher than those in elective cesarean section cases respectively (beta-EP: 134.8 +/- 25.6 pg/ml vs. 49.7 +/- 12.3 pg/ml, cortisol: 79.4 +/- 5.8 micrograms/dl vs. 30.2 +/- 3.3 micrograms/dl). Therefore, a significant reduction in plasma PRL levels was accompanied by a marked rise in plasma beta-EP and cortisol levels during labor. In amniotic fluid, however, there were no significant differences of PRL, beta-EP and cortisol levels in vaginal delivery cases and elective cesarean cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Prolactin-releasing system in maternal, fetal, and amniotic compartments during labor

The effect of a dopamine antagonist on prolactin concentrations was studied in maternal, fetal plasma, and amniotic fluid in term gestation. Twenty-three women with normal full-term pregnancies received 10 mg metoclopramide intravenously during labor. The prolactin levels in maternal plasma increased significantly after metoclopramide. However, the prolactin levels in amniotic fluid and fetal plasma did not change significantly after administration of this drug. Although the increased values of prolactin in maternal plasma were significantly correlated with metoclopramide concentrations after metoclopramide injection, there was no correlation between these two values in amniotic fluid. The authors conclude that the prolactin-releasing system in amniotic fluid is independent of the maternal hypothalamopituitary axis.

Developmental changes in contractile protein adenosine 5'-triphosphatase in the rabbit heart

This study was designed to investigate developmental changes in contractile protein adenosine 5'-triphosphatase in the rabbit heart. Myofibrils and myosin were isolated from ventricular muscles from the fetal, newborn, and adult rabbits. Actin and troponin-tropomyosin complex were isolated from the adult skeletal muscle. Myofibrillar (actomyosin) adenosine 5'-triphosphatase measured at low ionic strength increased with development. In contrast, myofibrillar calcium adenosine 5'-triphosphatase at high ionic strength was the greatest in the newborn and the lowest in the adult. Myosin calcium adenosine 5'-triphosphatase and actin-activated myosin adenosine 5'-triphosphatase were also the greatest in the newborn and the lowest in the adult. The relative proportion of myosin isozyme V1 was the greatest in the newborn and the lowest in the adult. The addition of troponin-tropomyosin complex stimulated myosin adenosine 5'-triphosphatase in the presence of calcium in the adult, but not in the newborn and fetus. As a result, actin-activated myosin adenosine 5'-triphosphatase in the presence of troponin-tropomyosin complex was the greatest in the adult, followed by the newborn and fetus. These data suggest that the low myofibrillar adenosine 5'-triphosphatase activity at low ionic strength in the premature heart may be due to the age-related difference in the interaction of myosin with troponin-tropomyosin. Developmental change in myosin calcium adenosine 5'-triphosphatase (which is determined by the relative proportion of isomyosin V1 and V3) may not be directionally identical to that of the physiologically important myofibrillar adenosine 5'-triphosphatase.