Evaluation of tumor markers in patients with squamous cell carcinoma in the oral cavity

Serum levels of six tumor markers (carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCCA), immunosuppressive acidic protein (IAP), alpha-fetoprotein (AFP), ferritin (FER), and carbohydrate antigen 19-9 (CA 19-9)) were simultaneously measured in 29 patients with primary squamous cell carcinoma (SCC) of the oral cavity to determine their significance. The positive rates were 34.5% for CEA, 41.4% for SCCA, 51.7% for IAP, 0% for AFP, 10.3% for FER, and 6.9% for CA 19-9 in patients with oral SCC. Therefore, CEA, SCCA, and IAP levels, of which the positive rates were significantly different (P < 0.01) from those of control patients without oral cancer, were considered to be of diagnostic value. The sensitivity (69.0%) and accuracy (90.3%) of the combination assay with these three tumor markers proved to be higher than those obtained with individual markers. A combination assay with CEA, SCCA, and IAP could be useful for the screening of patients with oral cancer.

Tracheal view of vocal fold vibration in excised canine larynxes

The mucosal upheaval where the mucosal wave starts and propagates upward appears on the lower surface of the vocal fold during vibration. We investigated the location of the mucosal upheaval in response to variations in vocal fold tension and mean air flow rate. Twelve excised canine larynxes were used in the experiment. The lower surfaces of the vocal folds were marked with india ink. After cinematography was performed, a small cut wound was made at the mark. This wound served to relate cinematographic findings with the histologically observed position of the mark. The larynx was then fixed, sectioned in the frontal plane, and stained for histologic examination. Horizontal movements of the free edge, mucosal wave, mucosal upheaval, and marks were analyzed. Under a fixed vocal fold tension, the mucosal upheaval appeared more laterally to a limited extent as mean air flow rate increased, but its location on the vocal fold mucosa did not change from its position before the increase of mean air flow rate. The mucosal upheaval appeared more medially when vocal fold tension increased. The position of the mucosal upheaval actually changed medially compared with its original position before the tension increase. Histologic examination indicated that the mucosal upheaval arose on the lower surface of the vocal fold between the free edge and the area where the muscular layer comes in close proximity to the epithelial layer.

Hyperpermeability of abdominal capillary vessels to endothelin-1 in patients with diabetes mellitus

To elucidate the pathophysiologic significance of circulating endothelin-1 (ET-1) to the vascular lesions in diabetic patients, ET-1 levels in plasma and peritoneal dialysis fluid were measured in 11 patients receiving continuous ambulatory peritoneal dialysis (CAPD) [five with diabetic nephropathy (group A); six with chronic renal failure without diabetes mellitus (group B)]. ET-1 levels were determined by a highly sensitive and specific enzymeimmunoassay. Plasma ET-1 levels in group A were not significantly different from those in group B (3.3 +/- 0.9 versus 3.5 +/- 0.9 pg/ml). However, the amounts of ET-1 in peritoneal dialysis fluid in group A were significantly greater than those in group B (19.2 +/- 13.2 versus 10.4 +/- 6.3 ng/day). These results suggest that abdominal capillary vessels in diabetic patients are hyperpermeable to ET-1.

Symmetrical thalamic lesions on CT in influenza A virus infection presenting with or without Reye syndrome

In Reye encephalopathy, diffuse brain swelling is a well known CT finding, but focal CT lesions have not been documented. We report 2 children with Reye encephalopathy and 2 children with non-Reye encephalopathy both associated with influenza A virus infection in whom symmetrical low density lesions of the thalamus and brainstem were detected on CT. These symmetrical low density lesions were present in the acute phase and decreased in size within a few weeks in all, and are still seen 2 years later as clearly defined small round areas in 3 surviving patients. Paired influenza A virus titers in blood showed 4-fold or more increase in all. Myelin basic protein (MBP) in CSF was increased in 2 of the 3 subjects studied. Liver biopsy showed diffuse lipid droplet infiltration in 2, focal infiltration in 1, and normal morphology in 1. The above data suggest that the symmetrical low density lesions were associated with influenza A virus infection, most likely consisting of edema, demyelination, and necrosis. We suspect that there is a continuum of Reye syndrome and virus-associated encephalopathy with significant overlap.

Tumoricidal effect of human PBMC following stimulation with OK-432 and its application for locoregional immunotherapy in head and neck cancer patients

Both cell-mediated and cytokine-mediated antitumor activities were induced in peripheral blood mononuclear cells (PBMC) in short-term culture with streptococcal preparation, OK-432. Kinetic analysis of OK-432-activated killer activity (OKAK) showed that it reached a plateau level much faster (by 48 h of culture) than that detected in PBMC stimulated with recombinant interleukin 2 (rIL-2) (lymphokine-activated killer: LAK). We also found that the tumor growth inhibitory factor (TGIF) activity was produced in the culture supernatant (CSN) of the OK-432-activated PBMC (OK-MC) and the activity synchronously increased with augmentation of OKAK activity. The TGIF activity was rarely found in the CSN of rIL-2-stimulated PBMC. The TGIF activity detected in CSN of OK-MC was further characterized as derived from a cytokine different from interferon gamma (IFN gamma), tumor necrosis factor (TNF), or lymphotoxin (LT) by a neutralization test using monoclonal antibodies to these cytokines. These 48-h-cultured-OK-MC were adoptively transferred (adoptive immunotherapy: AIT) into 19 head and neck cancer patients either alone or in combination with chemotherapy and/or radiation therapy, and their therapeutic effects were examined. AIT was performed by intra-arterial or intratumoral administration of OK-MC. There were no significant side effects observed in this treatment. In these patients, approximately 1-10 x 10(7) cells were transferred into the tumor burden. Of the 19 patients, 17 had primary cancer, and in 6 (6/17;35%) of them complete remission (CR) of the tumor was obtained. Partial remission (PR) was attained in 9 of the 17 patients (9/17; 53%), giving the overall response rate of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

[Active tuberculosis in children who received INH chemoprophylaxis]

Twelve children who developed active tuberculosis even after receiving isoniazid (INH) chemoprophylaxis were seen at Tokyo Metropolitan Children's Hospital from 1982 through 1991. All cases received INH more than 9 mg/kg/day, except for one case in which the amount of INH administered at the referring hospital was unknown and Streptomycin was administered together with INH. The age of starting INH prophylaxis ranged from 2 months to 13 years, and the age at which clinical symptoms and/or laboratory evidences of active tuberculosis were first manifested ranged from 4 months to 18 years. Five patients developed active tuberculosis after the completion of chemoprophylaxis and patients during chemoprophylaxis, with the first presentation ranging from primary complex (seven), chronic pulmonary tuberculosis (two), tuberculous meningitis (two), and tuberculous pleuritis (one). None of the Mycobacterium tuberculosis resistant to INH was isolated. Reviewing these patients, eleven cases had at least one of the following factors: (1) age less than two years old (2) infectious sources expectorated more Mycobacterium tuberculosis (3) delay in starting INH. Above factors should be considered in initiating INH chemoprophylaxis and subsequent follow-up of the patients.

Evaluation of the effect of PTCR/PTCA by 99mTc-MIBI myocardial imaging in acute and old myocardial infarction

This study is to clarify the ability of technetium-99m-Hexakis-2-methoxyisobutyl isonitrile(MIBI) myocardial scintigraphy for assessment of the effect of PTCR/PTCA as compared with conventional thallium-201 myocardial scintigraphy (201Tl). 99mTc-MIBI (740-888MBq) was injected before emergency PTCR/PTCA, and the initial imaging was performed immediately after PTCR/PTCA in 4 patients with acute myocardial infarction (AMI). On the other hand, in 2 patients with old myocardial infarction (OMI), 201Tl and MIBI myocardial imagings were performed before and one week after rescue PTCA. The defect area on the follow-up MIBI imaging was smaller than that on the initial MIBI imaging in 2 patients with successful emergency PTCR/PTCA. But in the other 2 AMI patients with unsuccessful reperfusion, the defect area did not significantly decrease after PTCR/PTCA. Reperfusion was successful in one of the two patients with OMI. In both the two patients with OMI, the MIBI defect area did not significantly decrease after rescue PTCA. MIBI myocardial scintigraphy is a useful noninvasive method for evaluating the effect of emergency PTCR/PTCA for myocardial salvage in patients with AMI, because MIBI is a kit type agent, and it does not redistribute.

[Tuberculous meningitis in Japanese children between 1980-1991]

We evaluated the clinical and laboratory findings of tuberculous meningitis admitted to Tokyo Metropolitan Children's Hospital from 1980 through 1991 retrospectively. They consisted of 26 patients (14 boys and 12 girls), and their age ranged from 4 months to 11 years. Seventeen patients were under 3 years of age. Mortality rate was 4% (1/26), and there were 13 patients with sequelae on discharge from the hospital, and 12 patients without any sequelae. The period to recover normal CSF findings was relatively long. Some cases which did not seem to respond well to chemotherapy at the initial stage, recovered from meningitis without sequelae. This suggests that it is not necessary to change the chemotherapy at the initial few weeks of therapy. The risk factors of poor prognosis were; age less than 2 years, decreased level of consciousness on admission, convulsion, CSF protein more than 70 mg/dl, and CSF glucose less than 20 mg/dl. Tryptophan reaction was not always positive. Chloride in CSF was not so important to diagnose tuberculous meningitis in children. For the proper diagnosis of tuberculous meningitis in children one should consider several factors such as tuberculin skin test, family history, chest X-ray findings and CSF study. BCG was inoculated in six children (three patients were under one year old and the rests were older than 4 years). In three patients under one year old BCG was seemed to be inoculated after Mycobacterium tuberculosis infection, and apparently not effective to prevent tuberculosis meningitis. We conclude that BCG vaccination is necessary in early infancy to prevent tuberculous meningitis.

[High speed cinematographic analysis of subglottal mucosal vibration during experimentally induced phonation in excised larynges]

Twenty-seven excised canine larynges and two excised human larynges fixed on a wall of a specially constructed glass box, were blown on and the subglottal mucosal vibrations were photographed using high speed cinematography from the tracheal side. Each film was repeatedly projected at normal speed and analyzed frame by frame. Mucosal upheaval appeared between the anterior commissure and the vocal process. The mucosal wave or "traveling wave" started from the mucosal upheaval and propagated medially and upward. The mucosal upheaval vibrated with a small amplitude and with an earlier phase than any other portion of the vocal fold. Increase of air flow resulted in increased amplitude of the free edge excursion. The mucosal upheaval seemed to shift more laterally after the increase of air flow. But judging from the positional relations between the mucosal upheaval and markers, the origin of the mucosal upheaval was the same despite the increase of air flow. After the increase of vocal fold tension by cricothyroid approximation, the mucosal wave occurred within the limited area near the vocal edge. The mucosal upheaval was located more medially as compared to the original position. The mucosal upheaval appeared on what was actually the superior portion of the vocal fold. Direct electrical stimulation of the thyroarytenoid muscle (TA) bulged the lower surface of the vocal fold medially, and narrowed the subglottic area surrounded by bilateral mucosal upheavals during vibration. The mucosal upheaval seemed to shift more medially after stimulation of TA, but combined with the movements of the marker, the mucosal upheaval appeared on a more inferior portion of the vocal fold compared to its position before the stimulation. Thus, a more dynamic mucosal wave appeared in the vertical direction. Histological examination revealed that the mucosal upheaval arose on the lower surface of the vocal fold, slightly above the area where the muscular layer came close to the epithelial layer. After the cricothyroid approximation, the mucosal upheaval occurred in a more upward area where the lamina propria was thicker. In addition, after stimulation of the TA, the mucosal upheaval was located in the area where the muscular layer was thick under the epithelial layer.

Evaluation of cardiac motion and function by cine magnetic resonance imaging

Cardiac cine magnetic resonance imaging (MRI) was studied to evaluated the cardiac motion and function, and a water-stream phantom study was performed to clarify whether it was possible to quantitatively assess the valvular regurgitation flow by the size of the flow void. In normal subjects, the left ventricular (LV) epicardial apex swung up to the base only a few millimeters, and the mitral annulus ring moved about 14 mm as mean value toward the apex during systole. Those motions of mitral annulus ring may contribute to the left atrial filling. The LV longitudinal shortening and torsions were shown by the tagging method. This tagging method was the best method for estimating cardiac motions. Cardiac cine MRI using software including a modified Simpson's method program and a wall motion analysis program was useful for routine LV volumetry and wall motion analysis because it was a simple and reliable method. Our water-stream phantom studies demonstrated that it might be difficult to perform quantitative evaluation of valvular regurgitation flow by using only the size of the flow void without acquiring information relating to the orifice area.

Long-term haemodynamic effects of a 4-week regimen of nipradilol, a new beta-blocker with nitrovasodilating properties, in patients with portal hypertension due to cirrhosis. A comparative study with propranolol

To study the long-term effects of pharmacological combination therapy, a comparison was made of the haemodynamic changes in patients with cirrhosis and portal hypertension following a 4-week treatment of propranolol or nipradilol, a new nonselective beta-blocker with nitrovasodilating effect. Nipradilol (12 mg/dag, n = 12) significantly diminished wedged hepatic venous pressure (WHVP, 25 +/- 16%), the hepatic venous pressure gradient (HVPG, 20 +/- 12%), and estimated hepatic blood flow (EHBF, 18 +/- 16%). Propranolol (30 mg/day, n = 11) also caused a significant reduction in WHVP (22 +/- 21%) and HVPG (24 +/- 21%), but not in EHBF. The percentage of portal pressure reduction and the frequency of nonresponders did not differ between the nipradilol and propranolol groups. Both agents reduced heart rate by approx. 20%. Nipradilol, however, did not cause a significant reduction in cardiac index (CI) versus a 14% reduction by propranolol. Pulmonary capillary wedge pressure and central venous pressure, an index of preload, were decreased slightly in the nipradilol group. When nonresponders were excluded, there was a significant correlation of the percentage of reduction between WHVP and CI or systemic vascular resistance, in the nipradilol group. These results indicate that nipradilol may have potent hypotensive effects on portal hypertension, similar but not superior to propranolol. Nipradilol, at the dosage used in the present study, did not appear to exert a nitrovasodilating effect to enhance the portal pressure reduction induced by beta-blocking action.

Comparison between the gelsolin and adseverin domain structure

Adseverin (74-kDa protein, scinderin) is a calcium- and phospholipid-modulated actin-binding protein that promotes actin polymerization, severs actin filaments, and caps the barbed end of the actin filament, with its NH2-terminal half retaining these properties (Sakurai, T., Kurokawa, H., and Nonomura, Y. (1991) J. Biol. Chem. 266, 4581-4585). Further proteolysis of this NH2-terminal half generated five fragments, and two of them (Mr 15,000 and 31,000) showed Ca(2+)-dependent binding to monomeric actin. The Mr 31,000 fragment especially caused actin filament fragmentation, although its severing activity was also inhibited by several acidic phospholipids as was found in adseverin and its NH2-terminal half. Amino acid sequencing demonstrated that the two fragments' NH2 terminus were blocked in the same manner as the NH2 terminus of adseverin, and thus these two fragments are possibly located at the NH2-terminal of the adseverin molecule. This would then indicate that NH2-terminal fragments had a Ca(2+)-sensitive actin-binding function that relates to actin severing. The other two fragments' NH2-terminal sequencing showed a similar homology to the amino acid sequences of gelsolin and villin. Based on these observations, we propose that adseverin has a functional domain structure similar to that of the gelsolin and villin core.

[Dose estimation of Tc-99m-DTPA-galactosyl-human serum albumin (Tc-99m-GSA) in the blood with nonlinear regression method]

Tc-99m-DTPA-galactosyl-human serum albumin (Tc-99m-GSA) was applied as an agent for receptor-binding hepatic scintigraphy. A single dose of 3-10 mg/185 MBq (5 mCi) Tc-99m-GSA per body was administered in four healthy volunteers and three patients. Time-activity curves for 60 (40) min after injection were obtained from the regions-of-interest over the heart and lung (back-ground). Exponential regression curve was generated from the heart curve during 2-60 (40) min after background subtraction with nonlinear least squares method. Regression curve was well fitted to the heart curve and a significant correlation coefficient of 0.997 +/- 0.003 was obtained between these two curves. Absolute dose of GSA in the blood was decided on the assumption that extrapolated value of regression curve at time 0 represented the total injected dose. The absolute dose differences between sample blood and regression curve were 1.4-4.3% (mean). Nonlinear regression analysis is useful for estimating quantitative dose of GSA in blood without any blood samples.

The Ca2(+)-dependent actin filament-severing activity of 74-kDa protein (adseverin) resides in its NH2-terminal half

Calcium sensitive actin severing protein, adseverin, with Mr 74,000, was cleaved into two fragments of Mr 42,000 and Mr 39,000 by V8 protease and trypsin, and both fragments were purified by high performance (pressure) liquid chromatography ion-exchange column chromatography. To understand how adseverin can sever actin filaments, we identified the actin-binding domains. The NH2 termini of native adseverin and the Mr 42,000 fragment were confirmed to be blocked by amino acid sequencing. Twelve amino acids of the Mr 39,000 fragment were sequenced from the NH2 terminus; the sequence of this part had a homology to the hinge region between segments 3 and 4 of gelsolin and villin. Thus, the Mr 42,000 fragment is the NH2-terminal half (N42), and the Mr 39,000 fragment is the COOH-terminal half (C39). Each fragment was examined for actin-severing, -nucleating, -capping, and phospholipid binding activities with and without calcium. N42 contained a calcium-dependent actin-severing activity regulated by phospholipid. C39 bound to G-actin in a calcium-dependent manner, but had no severing activity. The sequence homology and similar functional domain structure suggest a common structural basis for the calcium- and phospholipid-regulated actin-severing properties shared by adseverin, gelsolin, and villin.

Evaluation of the serum level of immunosuppressive substance in oral cancer patients

The serum level of immunosuppressive substance (IS) was studied in 40 patients with primary oral cancer and in 79 patients without cancer. Its usefulness was evaluated as a parameter for monitoring therapy as well as recurrence of the tumors. Mean values for serum IS in patients with cancer and patients without were 687 +/- 284 micrograms/mL and 464 +/- 153 micrograms/mL, respectively. Normal healthy controls had a mean value of 431 +/- 105 micrograms/mL, with the cutoff value set at 641 micrograms/mL (mean +2 SD). Patients without cancer who had a severe infectious disease showed conspicuously high serum IS levels, and these values were closely correlated with their C-reactive protein values. The positive rate of IS increased in all patients with oral cancer was 58%. The mean level of serum IS in cancer patients was significantly higher than that of the controls (P less than .01), and the level was found to be more elevated as the stage of the disease advanced (stage I to III, 48%; stage IV, 68%). Histologic analysis of the tumor cells in patients with squamous cell carcinoma (SCC) showed that the mean serum IS level of those who had poorly differentiated SCC was much higher (937 +/- 181 micrograms/mL) than that of patients with well-differentiated SCC (616 +/- 159 micrograms/mL). Patients who had recurrent or metastatic cancer, or those who died from the cancer exhibited marked elevation of the serum IS levels, whereas patients who remained free of cancer in the follow-up period showed significantly lower serum IS levels. The rise and fall of the serum IS level was closely correlated with the disease progression and/or remission. These data strongly suggest that serum IS is a useful parameter for monitoring the disease stage as well as the effect of therapy on patients with oral cancer.

Genetic analysis of variation in the number of primary spermatocytes per cyst in Drosophila virilis

Two experiments were performed with the aim of clarifying the genetic basis of variation in the number of primary spermatocytes per cyst in the B12 strain of Drosophila virilis and identifying the chromosome responsible for the variation. First, crosses between B12, showing a mean cell number of 11.81, and strain TK with a mean of 7.91, were performed. From the results obtained, it was considered that there were two factors, i.e., a recessive gene and certain modifiers, which shifted the cell number toward a higher value in B12. Second, chromosomal analysis with a marker strain and the B12 strain revealed that the third chromosome of B12 was responsible for the major effect of changing the primary spermatocyte number, although this chromosome did not exert a sufficient effect alone, and furthermore that at least one of the modifiers located on the second chromosome.

Beta-actinin is equivalent to Cap Z protein

Chicken skeletal muscle beta-actinin, previously reported to bind the slow-exchanging (pointed) ends of actin filaments was purified to homogeneity. By two dimensional gel electrophoresis, it consists of two subunits, beta I (35 kDa) and beta II (32 kDa), and each subunit has two isoforms. The amino acid sequences of V8 protease-digested peptides of beta I were nearly identical with those of portions of the muscle barbed end-blocking protein Cap Z alpha, although several amino acids were different from those deduced from cDNA sequences (Casella, J.F., Casella, S.J., Hollands, J.A., Caldwell, J.E., and Cooper, J.A. (1989) Proc. Natl. Acad. Sci. U.S.A. 86, 5800-5804). The amino acid sequences of two peptides from beta II were completely identical with portions of Cap Z beta deduced from cDNA sequences (Caldwell, J.E., Waddle, J.A., Cooper, J.A., Hollands, J.A., Casella, S.J., and Casella, J.F. (1989) J. Biol. Chem. 264, 12648-12652). beta-Actinin capped the barbed end of an actin filament as evidenced by actin assembly of myosin S1-decorated filaments and specifically its impairment of growth in the "barbed" direction. Thus it is concluded that highly purified beta-actinin is identical with the more recently described Cap Z, an actin barbed-end capping protein of chicken skeletal muscle.

Simple and rapid purification of brevin

Brevin or plasma gelsolin, a calcium dependent actin-binding and actin-severing protein, was purified from bovine plasma by a very rapid and simple procedure; ammonium sulfate fractionation and only one step of anion exchange column chromatography by a convenient use. It takes only 24 hrs to complete all the procedure. The purity of brevin prepared by this method was more than 95% on SDS-PAGE and total recovery was much better than previous preparation methods. This brevin preparation has about 8 isomers on 2-D PAGE and strong severing activity on F-actin under electron microscopic observation.

Distribution of a gelsolin-like 74,000 mol. wt protein in neural and endocrine tissues

A Ca2(+)-dependent actin binding protein with a molecular weight of 74,000, was purified from bovine adrenal medulla by using deoxyribonuclease I affinity chromatography followed by ion-exchange chromatography and gel filtration. This protein broke actin filaments into fragments and promoted nucleation of actin polymerization in a Ca2(+)-dependent manner as effectively as gelsolin. Proteolytic and immunological comparison with gelsolin which is widely distributed actin-severing protein, indicated that the 74,000 mol. wt protein is a distinct protein, but its domain structure resembles that of gelsolin. Immunoblotting using antibody against this protein showed a tissue-specific distribution. The protein was detected in various endocrine, neuroendocrine and nervous tissues, but not in muscle tissues and plasma which contained relatively large amounts of cytoplasmic and plasma gelsolin. This fact might indicate that this actin-severing protein is involved in the regulation of the secretory process of endocrine and nervous tissues. In the exocytotic process regulated by Ca2+, this protein probably plays a role to free secretory organelles like vesicles from the cytoskeletal network, mainly F-actin, which prevents the movement of secretory vesicles in the resting state.

[Clinical use of castable ceramics (OCC) crown]

The new ceramics material (OCC) was developed for the purpose of aesthetic restration which can be fabricated by an usual lost wax process and it produces accurate marginal fit. OCC possesses mechanical, chemical, and physical properties. This article is discussed utility and security of OCC complete crown on the clinical application from Dec, 1986 to Jun, 1989. The results may be summarized as follows: 1) 2 of 69 cases were broken down in the period from Dec, 1986 to Jun, 1989. These reasons are caused by the lack of occlusal thickness and unsuitable fit of crown. 2) Although 4 of 69 cases are stained by tobacco tar and 5 of 69 cases are suffered from plaque accumulation, these staining and plaque accumulation are improved by plaque control. 3) An allergic reaction or an abnormality of oral tissues haven't been recognized during test period of clinical use. Consequently OCC crown showed itself about safety and usefulness.

Vibratory patterns of normal and microscopically operated larynges. Observation of lower surface of vocal fold in dogs

The authors investigated the effect of microsurgical intervention involving the canine larynx on vocal fold vibration. In normal cases both lower lips and free edges vibrated symmetrically. The lower lip coincided with the free edge and collided with that of the other side at the midline. Immediately after the collision, the lower lip rapidly retracted laterally at the beginning of a closed phase. It stayed in the most lateral position for the rest of the closed phase until the free edge started to move away laterally. The lower lip then began to move medially to occlude again with the other side. In cases subjected to microsurgery, a part of the mucosal layer of either the upper or the lower surface of the vocal fold was removed. Several weeks after the procedure, vibration was observed. In either case, vibration of the free edge of the operated vocal fold diminished in amplitude and often became earlier in phase than that of the contralateral fold. Usually the lower lip of the operated vocal fold moved away more slowly. In addition, when the extent of epithelial removal was large, the lower lip itself was not elicited.

[Massive intracerebral hemorrhage due to convexity meningioma]

Intracranial meningioma usually present with the typical symptomatology of a progressive neurological deficit. Sudden spontaneous intracerebral hemorrhage from an asymptomatic meningioma is exceedingly rare. A case of 81-year-old woman with convexity meningioma manifested suddenly by massive intracerebral hemorrhage is reported with the findings of computed tomography and angiography.

[Pharmacokinetic and clinical studies on sulbactam/ampicillin in children]

Laboratory and clinical studies of sulbactam/ampicillin (SBT/ABPC) in children have been carried out, and the following results were obtained. 1. Antibacterial effect MICs of SBT/ABPC were only one-tube less than or similar to those of ABPC against susceptible organisms. Against ABPC-resistant organisms at the inoculum size of 10(8) cells/ml however, SBT/ABPC was superior to ABPC when evaluated in terms of their MIC values. When MICs of SBT/ABPC were compared to those of ABPC against organisms with high beta-lactamase producing activities, it was found that many of ABPC-resistant organisms were much susceptible to SBT/ABPC. 2. Absorption and urinary excretion In 2 cases to which 50 mg/kg and 20 mg/kg SBT/ABPC were respectively given over 30 minutes by drip infusion, peak serum levels were obtained at the end of the drip infusion with peak levels of SBT of 45.5 micrograms/ml, 12.5 micrograms/ml, respectively and those of ABPC of 83.0 micrograms/ml, 22.9 micrograms/ml, respectively. The half-lives of SBT and ABPC were 0.94 hour and 0.98 hour, respectively. The mean urinary excretion rates in the first 6 hours after the end of administration were 84.4% for SBT and 63.1% for ABPC. 3. Clinical results Clinical efficacies were evaluated in 24 cases including 9 cases of pneumonia, 2 cases of upper respiratory infection, 7 cases of urinary tract infection and 1 case each of bronchopneumonia, pyothorax, tonsillitis, streptococcal infection, ++ phlegmon and staphylococcal scalded skin syndrome. Clinical efficacies were excellent or good in 19 cases with an overall efficacy rate of 86.4%. Adverse effect was found in 1 case with nausea and vomiting, and abnormal laboratory test values observed were 2 cases each of eosinophilia, slight elevation of GOT and GPT and elevation of LDH, but they were not serious.

Exocytotic features of rat specific atrial granules

To clarify the mode of secretion of specific atrial granules, rat atrial muscle cells were examined by transmission electron microscopy. Atrial granule formation and exocytotic features of granules were clearly seen. Abrupt breaks in the unit membrane structure of mature granules were observed in thin sections, but these breaks were not detected in freeze-fracture replicas. These findings support the concept that the granule contents are released to the extracellular space by exocytosis.

Ecchordosis physaliphora arising from the cervical vertebra, the CT and MRI appearance

The authors report a rare case of ecchordosis physaliphora arising from C2, manifested with clinical symptoms, with the findings of CT scans and MRI.

[A case of bronchial carcinoma showing regression upon intratumoral administration of OK-432]

A 38-year-old female suffering from chronic respiratory symptoms due to lung cancer occupying the left main bronchus was treated by frequent intratumoral injections of OK-432. The immune-modifying therapy was performed as follows; 0.2 KE of OK-432 was injected intracutaneously once a week, then the dose was gradually increased to 3.0 KE once a week. Following immunization, intratumoral injection was done under endoscopy at a dose of 3.0 KE every two weeks. Three months later, the tumor showed remarkable regression, and clinical symptoms were diminished. In conclusion, intratumoral injection of OK-432 was considered to be very beneficial in lung cancer.

Purification of a novel 30,000 Da calcium-binding protein from bovine cerebellum

A novel very acidic calcium-binding protein (CaBP) was purified from bovine cerebellum, using 45Ca autoradiography as a marker, through a preparative procedure involving salting out with a very high concentration of ammonium sulfate, DE52 column chromatography, RNAase treatment, and HPLC gel filtration. This protein showed a molecular weight of 30,0000 dalton (Da) on sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and of 120,000 on in gel filtration chromatography analysis under physiological ionic strength. The calcium binding activity of this 30,000 Da CaBP was monitored on the basis of calcium-dependent changes in tyrosine fluorescence (Kd = 3.0 microM).

[Regional cerebral blood flow in the acute stage with ischemic cerebrovascular disease studied by xenon-133 inhalation and single photon emission computerized tomography]

The papers about cerebral blood flow (CBF) in patients with cerebrovascular diseases have been already reported by positron emission computerized tomography (PET), single photon emission computerized tomography (SPECT), Xray CT (CT) using cold Xe, and so on. However the literature about the CBF changes in acute stage is few. We studied CBF in 68 patients with ischemic cerebrovascular disease within 48 hours after the onsets from February 1984 through February 1985. CBF was measured by a rapidly rotating single photon emission computerized tomography (SPECT) using non-invasive Xenon-133 inhalation method. Our subjects included 51 cases with cerebral infarction (male 37, female 14, average 62.9 years) and 17 cases with TIA (male 13, female 4, average 60.5 years), the patients who had a past history of stroke were excluded from the subjects. The SPECT was performed with use of Tomomatic 64 developed by Dr. Lassen, et al, SPECT and carotid arteriography were simultaneously performed within 48 hours in all cases. CT we used were GE CT 9800 scanner and Hitachi HF CT. The following results have been obtained: 1) SPECT clearly showed an ischemic focus correlated with clinical symptom after the attack rather than CT, the positive finding by SPECT was 92.2% and that by CT was 62.7% within 48 hours after the onset. 2) The remote effect phenomenon so-called crossed cerebellar diaschisis was demonstrated in 7 of 14 cases (50%) with cerebral infarction due to internal carotid artery occlusion and in 9 of 26 cases (34.6%) with that due to middle cerebral artery occlusion. 3) SPECT and CT were performed within 8 hours after the onset in 20 cases with cerebral infarction. SPECT showed decreased CBF in all cases whereas the positive finding by CT was 40.0%. The area of decreased CBF was always larger than the low density area that CT demonstrated. Mean CBF value of the cerebral hemisphere in the cases with ICA occlusion within 8 hours after the onsets was 31.0 (ml/100 g/min), and that of MCA occlusion was 36.0 (ml/100 g/min), and that of MCA occlusion was 36.0 (ml/100 g/min). 4) The positive finding by SPECT on TIA cases was 47% and that by CT was 41.1%, SPECT usually did not demonstrate a small ischemic focus especially at the deep region (ie, basal ganglia region). 5) SPECT using Xe-123 inhalation was useful and non-invasive method for the diagnosis in acute stage with ischemic cerebrovascular disease.(ABSTRACT TRUNCATED AT 400 WORDS)

Vapor compression distiller and membrane technology for water revitalization

Water revitalization for a space station can consist of membrane filtration processes and a distillation process. Water recycling equipment using membrane filtration processes was manufactured for ground testing. It was assembled using commercially available components. Two systems for the distillation are studied; one is an absorption type thermopervaporation cell and the other is a vapor compression distiller. Absorption type thermopervaporation able to easily produce condensed water under zero gravity was investigated experimentally and through simulated calculation. The vapor compression distiller was studied experimentally and it offers significant energy savings for evaporation of water.

[Myocardial infarction due to thrombi in coronary aneurysms in a young woman with systemic lupus erythematosus]

Acute myocardial infarction (AMI) is relatively rare in systemic lupus erythematosus (SLE), although other cardiac complications, such as pericarditis and myocarditis, occur frequently in this disease. A 20-year-old woman with documented SLE experienced a transmural anterior AMI due to thrombi in saccular aneurysms of the left main coronary artery and the proximal portion of the left anterior descending coronary artery. There were also saccular and fusiform aneurysms in the right coronary artery, but thrombi were not observed in them. Aorto-coronary bypass surgery was performed to salvage the viable myocardium and to prevent recurrent myocardial infarction and rupture or infection of these coronary aneurysms. Postoperative coronary angiography revealed a new small saccular aneurysm in the mid-portion of the right coronary artery. During this period, there was no immunological evidence of active SLE. It is important to ascertain whether such coronary aneurysms resulted from atherosclerosis or arteritis, because of the choice of the different therapeutic interventions. In this case, however, it was difficult to determine. It was speculated that these coronary aneurysms arose from an arteritic process, because the saccular aneurysm in the mid-portion of the right coronary artery was formed in less than three months, there were no coronary risk factors, and any microscopic evidence of atherosclerosis was not obtained in the aortic specimen during aortocoronary bypass surgery. Serial coronary angiographic studies are necessary for accurately diagnosing coronary artery disease. Anticoagulant therapy and antiinflammatory medication may be necessary to prevent myocardial infarction in patients with SLE, even if there is no immunological evidence of active SLE.

[Left axis deviation investigated by body surface mapping and phase image analysis]

Relationship between left axis deviation and left anterior fascicular block (LAFB) was investigated by estimating the ventricular excitation and contraction sequence using body surface potential mapping and phase image analysis by radionuclide ventriculography. This study included seven normal persons, eight patients with complete right bundle branch block (RBBB) without left axis deviation (LAD), twelve with RBBB and unblocked axis (determined by the first half of the QRS complex) of 0 degrees or farther deviated to the left (RBBB with LAD), and three with isolated LAD. The isochrone ventricular activation maps (VAT maps) were obtained by body surface mapping technique. Planar phase images in the left anterior oblique projection and short-axis ventricular tomographic phase images using a seven-pinhole collimator were constructed by ECG-gated equilibrium blood pool scintigrams. On the VAT maps of RBBB, there was a markedly delayed conduction to the right ventricle, however, in the left ventricle, the excitation was initiated in the anterior paraseptal region, and it proceeded rapidly toward the lateral and posterior walls, and in the same direction as normal. The VAT maps of RBBB with LAD were categorized in three types according to the activation sequence in the left ventricle. Type I, the same as maps of RBBB, consisted of three cases. Type II, four cases, showed excitation starting from the apex and ascending in the anterior wall. There were five cases of type III, which showed the earliest excitation in the basal posteroparaseptal region, proceeding toward the apex and ascending in the anterior wall. Type II was considered compatible with block of the left anterosuperior fascicle, and type III was that of left anterosuperior and midseptal fascicles. In types II and III, the phase delay in the left anterior wall was recognized in tomographic phase images, and the difference between right and left ventricular mean phase angles in planar phase images was significantly smaller than in cases of isolated RBBB, These were thought to support the existence of LAFB. The range of the unblocked axis of RBBB with LAD was -3 degrees approximately 13 degrees (-7.7 +/- 5.0 degrees) in type I, -8 degrees approximately -30 degrees (-19.8 +/- 9.1 degrees) in type II, and -33 degrees approximately -60 degrees (-51.0 +/- 10.9 degrees) in type III. All cases with left axis deviation beyond -30 degrees were of type III, and suspected to have extensive damage, including the midseptal fascicle.(ABSTRACT TRUNCATED AT 400 WORDS)

Nanosecond fluorescence studies of noncovalent interaction of monomeric and dimeric intercalators with DNA

The noncovalent interaction of 2-aminodipyrido[1,2-a:3',2'-d]imidazole (Glu-P-2) and its derivatives, which are potent mutagens isolated from L-glutamic acid pyrolysate, with calf thymus DNA was studied by steady-state and nanosecond fluorescence spectroscopies. The fluorescence of these compounds exhibits static quenching by noncovalent interaction with DNA. Fluorescence lifetimes of the free and intercalated states of these compounds were determined to be 9-10 and 0.5-1 ns, respectively. The bisintercalative effect of the dimeric analogue of Glu-P-2, bis(Glu-P-2)spermine (2GP-SP), to DNA was also investigated. This 2GP-SP, which has two Glu-P-2 moieties at each end of spermine, indicates a strong intramolecular interaction exhibiting remarkable quenching of fluorescence spectrum and lifetime (tau = 3.5 ns) in the absence of DNA. In the presence of DNA, however, the 3.5-ns lifetime component of fluorescence disappeared, and a two-exponential decay of fluorescence (t = approximately 10 and 1.5 ns) was observed at a DNA concentration of more than approximately 0.001 mM P, while the solution containing a very dilute DNA concentration (less than or equal to 0.001 mM P) exhibits a three-component decay of fluorescence (1.5, 3.5, and approximately 10 ns). The potent bis intercalation of two moieties in 2GP-SP with an identical DNA molecule was suggested by the DNA-concentration dependence of these fluorescence lifetimes and their intensity.