Nd3+-activated CaF2 ceramic lasers

Nd,Y:CaF₂ and Nd,La:CaF₂ ceramics featuring good optical quality have been fabricated by reactive sintering and a hot isostatic pressing method. The transmission spectra, emission spectra, and fluorescence decay curves were measured. Lasing at 1064 and 1065 nm was observed in Nd,Y:CaF₂ and Nd,La:CaF₂, respectively, upon quasi-continuous-wave pumping by a diode laser emitting at 791 nm. To the best of our knowledge, this is the first demonstration of Nd³⁺-activated CaF₂ ceramic laser.

Exclusive association of paraoxonase 1 with high-density lipoprotein particles in apolipoprotein A-I deficiency

Paraoxonase1 (PON1) is a high-density lipoprotein (HDL)-associated protein which removes peroxidized lipids from lipoproteins. It has been proposed that apolipoprotein A-I (apoA-I) is an important determinant for its stabilization on HDL. However, little is known about its existence and activity in an apoA-I-deficient state in humans. To characterize the nature of PON1 in apoA-I deficiency, we investigated PON1 in an apoA-I-deficient patient. When serum was analyzed on fast protein liquid chromatography, PON1 protein was distributed almost exclusively on HDL despite the absence of apoA-I; on the other hand, 38.5% of PON1 protein was found in the lipoprotein-free fraction when the lipoproteins were fractionated through ultracentrifugation. The stability of PON1 activity in the patient serum was almost the same as in the normal control sera throughout incubation at 14 degrees C for 7 days. However, when the sera were incubated at 37 degrees C for 24 h, its activity declined more than those in the normal controls (19% versus 4% reduction of the initial values). Our results demonstrated that PON1 protein possesses a preferential association with HDL even in the absence of apoA-I, although apoA-I is a crucial factor for the maximal activity and stabilization of PON1.

Spontaneous recovery from hypopituitarism in a man with lymphocytic hypophysitis: a case report

A 50-year-old man presented with hypopituitarism and a pituitary lesion on magnetic resonance imaging scan. He was diagnosed as having lymphocytic hypophysitis, and replacement therapy with hydrocortisone and thyroxine was started. He regained normal pituitary function after 10 months. Reports of spontaneous recovery from lymphocytic hypophysitis in men are rare. While the natural history of lymphocytic hypophysitis remains elusive and its management is not well established, our report shows that spontaneous resolution may occur with steroid supplementation even in men.

Effect of KMD-3213, an alpha1A-adrenoceptor antagonist, on the prostatic urethral pressure and blood pressure in male decerebrate dogs

BACKGROUND

KMD-3213 is an alpha1A-adrenoceptor-selective antagonist currently being developed for the treatment of urinary outlet obstruction in patients with benign prostatic hyperplasia. In the present study, the uroselectivity of KMD-3213 was evaluated and compared with that of prazosin and tamsulosin in a decerebrate dog model.

METHODS

Intercollicular decerebration was carried out in male mongrel dogs under anesthesia. The inhibitory effects of intravenously and intraduodenally administered compounds on the increase in intraurethral pressure (IUP) induced by electrical stimulation of the hypogastric nerve were estimated. Systemic blood pressure was measured simultaneously.

RESULTS

The alpha1-antagonists tested produced a dose-dependent inhibition of the induced IUP response and decreased mean blood pressure (MBP). The ID50 of KMD-3213, tamsulosin and prazosin for IUP (dose required to inhibit the increase in IUP by 50%) was 3.15, 1.73 and 11.8 microg/kg i.v., respectively, and the ED20 for the hypotensive effect (dose required to reduce MBP by 20%) was 8.03, 0.59 and 2.46 microg/kg i.v., respectively. The data indicate that uroselectivity (ED20/ID50) of KMD-3213 is 12- and 7.5-fold higher than that of prazosin and tamsulosin, respectively. When the drugs were administered intraduodenally, KMD-3213 was sufficiently absorbed from the digestive tract and continued to demonstrate at least 3.8-fold higher uroselectivity than tamsulosin.

CONCLUSION

Based on these findings, KMD-3213 appears to be an effective orally active compound for decreasing urethral resistance during micturition that does not induce any negative cardiovascular effects in patients with benign prostatic hyperplasia.

Genetic analysis of phytosterolaemia

Two women with multiple xanthomas, intermittent arthritis and thrombocytopenia were diagnosed as phytosterolaemia, an autosomal-recessive lipid storage disease, based on their increased serum concentrations of beta-sitosterol, campesterol and sitostanol. The gene responsible for this disease is located within a distance of 18 cM between microsatellite markers of D2S 1788 and D2S1352 at chromosome 2p21. We genotyped the patients and their family members with 16 microsatellite markers around this locus. The results from the homozygosity mapping of one family suggested that the gene was located within the distance of 12.6 cM between D2S2328 and D2S1352. We have shortened the genetic distance by 5.4 cM.

Hemoglobin SC disease presenting as acute chest syndrome with ventilation-perfusion mismatches

Acute chest syndrome, characterized by fever, chest pain and pulmonary infiltrates, is a known complication of hemoglobin SC disease. A 41-year-old African male with previously unknown hemoglobinopathy developed an acute episode of fever, chest pain and dyspnea right after surgery for retinal detachment. The patient was suspected of having pulmonary thromboembolism. This was further suggested by a 'high probability' ventilation-perfusion scan. However, a pulmonary angiogram revealed no evidence of thromboembolism. Subsequently, the patient was recognized to have hemoglobin SC disease, with the acute chest syndrome. After appropriate treatment with antibiotics, hydration and exchange transfusion, the patient underwent another surgery without complications.

Hyperthyroidism presenting as dysphagia

A 65-year-old man presented with hyperthyroidism associated with thyrotoxic dysphagia. Treatment with thiamazole improved his symptoms promptly. Although dysphagia is a rare manifestation of thyrotoxicosis, it should be emphasized that the possibility of hyperthyroidism must be discussed in unexplained dysphagia because it is readily treatable.

A new method for right ventricular endomyocardial biopsy via the femoral veins: a novel approach employing a right ventriculography catheter (Nishiya type)

We have devised a new method for right ventricular endomyocardial biopsy, in which the use of a right ventriculography catheter (Nishiya Type) allows us to ensure the introduction of a guiding sheath (Cordis, right-angled long sheath) to the apical portion of the right ventricle by way of the femoral vein. With this method, we have biopsied the endomyocardium in 52 patients during the last 4 years. In each case, it only took us several minutes to complete the biopsy procedure. Neither failed applications nor significant complications were seen. We believe that this technique provides a clinically beneficial means as it enables us to readily and safely achieve right ventricular endomyocardial biopsy.

[Tricuspid valve replacement in a patient with idiopathic tricuspid regurgitation]

Tricuspid regurgitation is often seen but is rarely categorized as "idiopathic". A 66-year-old man suspected of idiopathic tricuspid regurgitation underwent tricuspid valve replacement. With right heart failure over twenty years, his CTR increased to eighty six (86) per cent. During operation, no abnormal findings were observed except for the dilated tricuspid valve ring. Then a stented porcine xenograft (Carpentier-Edwards 33 mm) was inserted in the tricuspid valve annulus. Seven years after replacement, he died. Autopsy demonstrated myocardial hypertrophy of the right ventricle and dilatation of the right heart, supporting the diagnosis of idiopathic tricuspid regurgitation.

[A case of mediastinal teratoma discovered availing of pneumonia]

A 42-year-old woman was admitted to our hospital with hemosputum and an abnormal shadow on chest X-ray. Although her hemosputum disappeared after the treatment of pneumonia, the abnormal shadow was not improved. Chest CT showed a mediastinal mass. She underwent thoracotomy and the tumor, measuring 6 x 5 x 5 cm in size, was resected. Pathological diagnosis was a mature type teratoma with direct invasion to the lung. We have to take mediastinal teratoma into consideration as one of the causes of pneumonia.

Prognosis for patients with pneumonectomy or lesser resections for non-small cell lung cancer based on histologic cell type

Contrary results have been reported regarding prognosis by histologic cell type in surgical treatment for lung cancer. To evaluate whether histologic cell type has influence on prognosis, we separately analyzed the prognostic outcome of patients who had undergone pneumonectomy (n=119) and lesser resections (n=124) for non-small cell lung cancer (NSCLC) between January, 1985 and March, 1996. The pneumonectomy group included 87 (73%) squamous cell carcinoma (Sq), 25 (21%) adenocarcinoma (Ad) and 7 other types with 10 (8%) patients in postoperative stage I of the disease, 29 (24%) stage II, 74 (62%) stage III and 6 in stage IV. The lesser resection group included 45 (36%) Sq, 63 (51%) Ad and 16 other types with 71 (57%) patients in stage I, 9 (7%) stage II, 32 (26%) stage III and 12 stage IV. In patients with stages I-III, the 5-year survival rate was 42.8% for the Sq group and 41.1% for the Ad group in the case of lesser resections and 37.1% for the Sq group and 0% for the Ad group (p<0.05) in the case of pneumonectomy. The poorer prognosis for patients with Ad in the case of pneumonectomy was suspected to be due to the N factor; the percentage of patients with N0-1 was significantly lower in the Ad group than for the Sq group (28 vs 62%, p<0.005). Histologic cell type can be a prognostic factor for patients undergoing surgical treatments for NSCLC. One possible reason for the contrary results on prognosis by histologic cell type among investigators may be due to the mixed results of pneumonectomy and lesser resections.

Effect of high concentrations of bile acids on cultured hepatocytes

High concentrations of bile acids have been reported as injurious to hepatocytes. We report the influence of various combinations of bile acids on the liver-specific function of cultured rat hepatocytes. Using 4 bile acids (glycocholate [GC], taurocholate [TC], glycohenodeoxycholate [GCDC], and taurochenodeoxycholate [TCDC]), we obtained 6 bile-acid mixtures, each containing equal amounts of 2 bile acids (total bile acids [TBA], 2 mM). Changes in gluconeogenesis, ureagenesis, DNA contents, medium alanine aminotransferase, and morphologies were compared among the paired bile acid compositions by measuring the C/CDC ratio ([GC + TC]/[GCDC + TCDC]) of each. In terms of their relative impairments of ureagenesis from greatest to least, the acids were GCDC, TCDC, and GC, which was almost the same as TC. When the C/CDC ratio was 0, the values of all parameters measured deteriorated. When the C/CDC ratio was 1 in the presence of 1 mM GCDC, only the rate of ureagenesis was diminished. When the C/CDC ratio was infinite, no hepatocellular injury was observed. GCDC and TCDC, together or separately, showed significant hepatocellular injury when the TBA concentration was 2 mM.

Results of pneumonectomy for non-small cell lung cancer: appropriateness of the new TNM staging system

In the new TNM staging system for lung cancer in 1997, stage T3N0M0 was revised from stage IIIA to stage IIB. Therefore, we initiated a study to assess the appropriateness of this revision. One hundred and nineteen patients who had undergone pneumonectomy for non-small cell lung cancer (NSCLC) between January 1985 and March 1996 were analyzed. They included 87 squamous cell carcinoma (sq), 25 adenocarcinoma (ad), 4 large cell carcinoma (la), and 3 adenosquamous cell carcinoma (ad-sq), with 10 patients in postoperative stage I (3 IA + 7 IB), 29 stage II (1 IIA + 28 IIB), 74 stage III (39 IIIA + 35 IIIB) and 6 in stage IV of the disease. Stage IIB included 14 patients with T3N0M0 (12 sq, 1 ad, 1 la). The 5-year survival rate for patients with T3N0M0 was 69.6%, which was superior to that (55.7%) for patients with stage II (T1-2N1M0) of the previous system. According to the new TNM staging system, the 5-year survival rate was 40% in stage I, 66.2% in stage II, 24% in stage IIIA, 0% in stages IIIB and IV (stage I vs stage II, NS; stage II vs stage IIIA, p<0.01; stage IIIA vs stage IIIB, p<0.01; stage IIIB vs stage IV, p<0.01). A significant prognostic difference between stage II and stage IIIA was observed, which had not been observed in the previous system. Our results show that the revision of T3N0M0 from stage IIIA to stage II in the new TNM staging system seems appropriate with regard to the pneumonectomy group.

Results of pneumonectomy for non-small cell lung cancer

To assess the role of pneumonectomy for lung cancer and the factors affecting the prognosis, 107 patients who had undergone pneumonectomy for non-small cell lung cancer (NSCLC) between January, 1985 and March, 1996, were analyzed. They included 81 squamous cell carcinoma, 22 adenocarcinoma, 3 large cell carcinoma, and one adenosquamous cell carcinoma, with 8 patients in post-operative stage I, 15 in stage II, 51 in stage IIIA, and 33 in stage IIIB of the disease. The 5-year survival rate was 54.7% in stages I + II, 38.0% in stage IIIA, and <4% in stage IIIB. In stages I-IIIA, the patients with squamous cell carcinoma showed a significantly better prognosis than those with adenocarcinoma (50.6 vs. 0%, p < 0.01). The prognosis was also better, but not statistically significant, for patients with central type compared with those with peripheral type in both all histologic types (58.0 vs. 8.4%) and only squamous cell type (59.3 vs. 18.8%). A better prognosis observed in squamous histologic type or central type seemed to be related to a better N factor. Pneumonectomy remains the treatment of choice for lung cancer, but seems not to be justified for patients with stage IIIB due to their poor prognosis.

Survival and prognosis after pneumonectomy for lung cancer in the elderly

BACKGROUND

The number of elderly patients with lung cancer is increasing. This study was undertaken to assess the validity of pneumonectomy for the treatment of lung cancer in this patient group.

METHODS

Twenty-seven patients 70 years old or older (elderly group) and 95 patients younger than 70 years (younger group) who underwent pneumonectomy between January 1985 and March 1996 formed the study group. In the elderly group, 22 patients had squamous cell carcinoma, 2 had adenocarcinoma and 3, small cell carcinoma; 1 patient was in postoperative stage I, 4 patients were in stage II, 14 in stage IIIA, 5 in stage IIIB, and 3 in stage IV of the disease. The only significant differences in patient characteristics between the two groups were the percentage of patients undergoing right pneumonectomy and the percentage of patients receiving chemotherapy or radiotherapy within 3 months before or after operation or both times.

RESULTS

The prognosis for the elderly group was comparable to that of the younger group for all stages of the disease; the overall 5-year survival rate was 30.5% for the younger group and 11.5% for the elderly group. However, operation-associated mortality was significantly higher in the elderly group (22.2% versus 3.2%; p < 0.005). The prognosis was better for patients with a centrally located tumor than a peripheral tumor in both groups [13.5% versus 2.0% in the elderly group and 46.7% versus 5.2% (p < 0.01) in the younger group] and significantly better for patients having a left pneumonectomy than a right pneumonectomy in the younger group (46.7% versus 5.2%; p < 0.01) but not in the elderly group (13.7% versus 22.2%). Adjuvant treatment did not have any beneficial effect on the prognosis in either group.

CONCLUSIONS

Pneumonectomy for lung cancer in elderly patients appears to be justified because the outcome in our study was comparable with that for the younger patients. However, it should be performed only in carefully selected patients because of the increased operative risk.

[A case of anastomotic aneurysm-enteric fistula]

We successfully performed circulation reconstructive surgery and repair of a small intestine resection, primarily at an anatomical position, for perforation of a pseudoaneurysm in the small intestine, which occurred in an anastomosis site of the right leg of a Y graft of an artificial blood vessel and internal iliac artery graft on a patient, at the remote time of 18 years after she had received a Y-type artificial blood vessel. The patient's life was saved. The results suggest that it is important to make a definitive diagnosis quickly after the occurrence of symptoms and to select an appropriate surgical technique according to the findings of infection adjacent to the perforation site.

Cytotoxic T lymphocytes derived from bone marrow mononuclear cells of multiple myeloma patients recognize an underglycosylated form of MUC1 mucin

MUC1 is a highly immunogenic epithelial mucin and serves as a tumor-associated antigen in breast, pancreatic and ovarian carcinomas. We previously reported the expression of MUC1 on myeloma cells and the establishment of an HLA-unrestricted cytotoxic T lymphocyte (CTL) line TN that recognized MUC1 from peripheral blood mononuclear cells in a multiple myeloma patient. In this study, we attempted to induce such CTL from six other multiple myeloma patients consecutively in order to show that the induction of the CTL line TN had not resulted from some idiosyncrasy of the first patient. Bone marrow mononuclear cells were used to induce CTL, because they contain myeloma cells that might stimulate the autologous lymphocytes. Bulk CTL lines were induced from two out of six patients. The CTL line TS was CD8+ cell dominant and KY was CD4+ cell dominant. Both CTL lines lysed MUC1+ myeloma and breast carcinoma cell lines. The cytotoxicity of the CTL lines was inhibited by anti-CD3, anti-alpha beta TCR and anti-MUC1 mAb. It was also inhibited by a MUC1 transfectant, but not by a mock transfectant in cold target inhibition assays. MUC1 was transfected into a human colonic carcinoma cell line. The reactivity of anti-MUC1 core protein mAb and the cytotoxicity of the CTL against the transfectant was enhanced by the treatment of the cells with an O-glycosylation inhibitor. Thus it is generally accepted that the HLA-unrestricted CTL which directly recognize the underglycosylated from of MUC1 using their TCR could be induced from a certain proportion (approximately 30%) of untreated multiple myeloma patients.

Clinical study on thymoma: assessment of prognostic factors

In order to define the clinical features of thymoma, we reviewed 51 thymoma patients in our departments from 1980 to 1995. Of 146 mediastinal tumors, 51 (35%) had thymoma, the most frequent tumor, and 21 (14%) had neurinoma. Twenty-one patients had non-invasive thymoma (Masaoka staging = stage I) and 30 had invasive thymoma (stages II-IV). In the non-invasive group, the male to female ratio was 0.8 (9/12) and the majority were of mixed histologic type (13/21 = 62%). Conversely in the invasive group, the male to female ratio was 1.7 (19/11), and the occurrence of the epithelial type (12 = 40%) was as frequent as the mixed type (13 = 43%). Patients with non-invasive thymoma were all treated with surgery only, and those with invasive thymoma were treated with multimodalities except for one. The 5-year survival rate was 100% for the non-invasive group, and 67% for the invasive group. Patients with accompanying myasthenia gravis (MG) showed a better prognosis than the non-MG patients (P < 0.05). The lymphocytic type also showed a better prognosis than the epithelial type, but this was not statistically significant. The prognosis for patients with thymoma was much better than for those with thymic cancer (n = 9). Thymoma showed a variety of clinical features depending on histologic type and association with myasthenia gravis.

Capsaicin does not inhibit the intracellular calcium handling process in rat ventricular papillary muscle

1. We studied the effects of capsaicin, a pungent agent extracted from red pepper, on rested-state contraction (RSC) of isolated rat ventricular papillary muscles. 2. The RSC was induced by stimulation, after a rest interval of 5 sec to 10 min, after the twitch tension of the muscle preparation stimulated at the regular stimulus frequency of cycle lengths of 5, 1 or 0.2 sec attained the steady state. 3. Drug effects were evaluated on the RSC in the presence of capsaicin 10(-5) M, caffeine 10(-2) M or ryanodine 10(-7) M, respectively. 4. All drugs inhibited the RSC but to different degrees. Ryanodine was the most effective in inhibiting RSC, followed by caffeine and capsaicin, in that order. However, the inhibitory mode varied, depending on the drugs. 5. These findings suggest that capsaicin may not inhibit the function of intracellular Ca2+ store in rat cardiac muscle.

The retrospective assessment of surgical resection in the management of small cell carcinoma of the lung

Role of surgical resection for small cell lung carcinoma (SCLC) was retrospectively assessed in 16 patients with pTNM-stage I and 13 with pTNM-stages II and IIIA. The 3-year and 5-year survival rates in patients with stage I were 61% and 45%, respectively, and the median survival time (MST) was 23.5 months. On the other hand, the 3-year survival rate for the 13 surgical patients with stages II and IIIA was 28% (MST=19 m), which showed no statistical difference between that of 21% (MST=10 m) for the 16 non-surgical patients with clinical stages II acid IIIA. These results suggest that resection is desirable for patients with stage I, but is of no benefit for patients with stages II and IIIA.

Inhibition of contractile tension by capsaicin in isolated rat papillary muscle

1. We examined effects of capsaicin (10(-9) - 10(-5) M), a pungent agent extracted from red pepper, on the contractile tension of rat ventricular papillary muscles stimulated at various cycle lengths (0.2, 0.5, 1, 2 and 5 sec). 2. Capsaicin produced a marked concentration-dependent decrease in the amplitude, the rate of rise (dp/dt) and the rate of relaxation (dr/dt) of the tension. 3. However, the half relaxation time and the time to peak tension of the tension were slightly affected by the agent. 4. The negative inotropic effect of capsaicin was stimulus cycle length (CL) dependent. In particular, IC50 (50% inhibitive concentration) of the agent in the amplitude of the tension was stimulus CL dependent. That is, the values of IC50 were around 10(-7) M at longer CLs (1, 2 and 5 sec), and the value of IC50 at CL 0.2 sec was 4 x 10(-6) M. 5. These capsaicin-induced negative inotropic effects were reversible. Other studies from our laboratory show that the negative inotropic effects may be largely due to a decrease in Ca2+ current.

Studies on clinicopathological features of lung cancer patients with K-ras/p53 gene alterations: comparison between younger and older groups

In order to define the roles of the K-ras and p53 genes in the development of lung cancer, especially in young adults, we compared the clinicopathological features of the patients between younger (< or = 45 years, n = 47) and older (< 55 years, n = 50) groups. The gene alterations were examined by the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) method. The K-ras gene alterations were detected only in adenocarcinomas, and the p53 gene alterations in all histologic types of lung cancer. There were no significant differences in the frequency of both K-ras and p53 gene alterations between the younger and older groups (9 vs. 11%, 36 vs. 32%). In the younger group, but not in the older one, the percentage for smokers was significantly higher in the p53 gene alteration-positive group than for the negative group (65 vs. 30%). As to the prognosis, there were no significant differences between the p53 gene alteration-positive and -negative cases in both the younger and older groups as well as in all subjects, while a tendency of poorer prognosis was observed in K-ras gene alteration-positive cases than for the -negative ones with adenocarcinomas. These results suggest that (1) the K-ras and p53 gene alterations would have no special roles in terms of the lung carcinogenesis in young adults; (2) a positive relationship between smoking and p53 gene alteration would exist in young adults with lung cancer, and (3) K-ras gene alteration would become a prognostic factor in lung cancer.

[Cavernostomy and muscle plombage with the pedicled latissimus dorsi and serratus anterior flap for recurrent large bullae with infection: a case report]

A 70-year-old male, who suffered from infection by MRSA and Aspergillus of the recurrent large bullae, was operated on cavernostomy for space sterilization. About three months later he underwent muscle plombage with the pedicled latissimus dorsi and serratus anterior flap. These muscles are ideal to place in open wound in the thorax because of the following reasons: These have the ability to eliminate local infection, a sufficient length and volume to obliterate an open cavity. And transposition of these muscles cause minimal functional upper extremity disability. Therefore, we considered that this technic was useful for the case of an infectious intrathoracic cavity with many bronchial fistulas.

Severe hyponatremia and hyperkalemia induced by trimethoprim-sulfamethoxazole in patients with Pneumocystis carinii pneumonia

An antimicrobial agent trimethoprim-sulfamethoxazole (Tmp-Smx) does not usually cause electrolyte disturbances at regular doses, and few cases of Tmp-Smx-induced electrolyte imbalance have been reported in the English-language literature to date. Recently, however, we treated two patients with Pneumocystis carinii pneumonia who developed severe hyponatremia and hyperkalemia on administration of high-dose Tmp-Smx. These electrolyte disturbances were attributable to the direct effect of Tmp-Smx on the renal distal tubules, were reversible, and corrected by infusion of a sodium-enriched and potassium-free liquid. Therefore, it is suggested that even after electrolyte disturbances have occurred, high-dose Tmp-Smx therapy may be continued for severe infectious diseases under appropriate electrolyte correction.

Evaluation of prognostic-significance of p53 gene alterations in patients with surgically resected lung-cancer

Clinical significance of p53 gene alterations, as a prognostic factor, was assessed in 69 patients with surgically resected lung cancer. The p53 gene alterations (exon 5-9) were examined by the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) method of genomic DNA. The p53 gene alterations were detected in all histological types of lung cancer, with a positive rate of 45% (31/69). In the alteration-positive group, patients in the advanced stages of III and IV were seen more frequently than in the negative group (58% vs. 21%, p<0.05). Such a difference was not observed in other parameters such as age, gender, histological type and smoking habit. The prognosis was, on a whole, poorer in the alteration-positive group than for the -negative one (5-year survival rate: 19.3% vs. 40.6%, MST: 17 months vs. 36 months), but the difference did not reach statistical significance. However, in the case of females (p<0.05), adenocarcinoma (p<0.01), early stages of I and II (p<0.05) and non-smokers (p<0.005), a significantly poorer prognosis was observed in the gene alteration-positive group than for the -negative one. These results suggest that the p53 gene alteration may be a useful prognostic factor in certain subgroups with lung resected for cancer.

Sex differences in clinicopathological features of peripheral T1 adenocarcinoma of the lung

Clinicopathological features of surgically-treated peripheral T1 adenocarcinoma of the lung were compared between 30 females and 26 males, and the following sex differences were observed; 1) Females were younger than males, 2) There was a higher percentage of smokers among males, 3) The acinar histologic subtype was less frequently found in females, 4) Well differentiated tumors were more frequently found in females, 5) K-ras gene mutations were observed only in males, 6) Prognosis was slightly better in females. As to other factors such as N-factor, tumor ploidy or central fibrosis, there was no statistical difference between the two groups. Although we were not able to explain the causes for the above sex differences, it was speculated that smoking was mainly responsible for them.

Analysis of prognostic factors in patients with resected peripheral T1 adenocarcinoma of the lung

Prognostic factors in patients with surgically-treated peripheral T1 (< or = 3 cm in greatest diameter) adenocarcinoma of the lung were analyzed in 45 cases. Statistical difference in survival was observed between stages I + II and III + IV (p < 0.05). However, neither sex, age, location of tumor, histological subtype, histological grade, tumor ploidy, nor presence of central fibrosis was of prognostic determinance. Our results suggest that only clinical stage is of prognostic importance in surgically-treated peripheral T1 adenocarcinoma of the lung.

Immunologic considerations in the use of cultured porcine hepatocytes as a hybrid artificial liver. Anti-porcine hepatocyte human serum

Cultured porcine hepatocytes with reasonable metabolic functions are a promising bioreactor for a hybrid artificial liver in the treatment of liver failure. A cytotoxic human serum (t-serum) against cultured porcine hepatocytes was accidentally discovered during preliminary experiments, however, which prompted the authors to study the mechanism of the cytotoxicity and the frequency of occurrence of the cytotoxic sera. Among 103 individual sera examined, seven (6.8%) sera showed cytotoxicity to cultured porcine hepatocytes. T-serum heated at 56 degrees C for 30 min completely lost its cytotoxic activity, but the inactivated cytotoxicity was restored by the addition of rabbit complement to the inactivated t-serum. IgM-depleted t-serum produced by 2-mercaptoethanol treatment abolished the cytotoxicity to porcine hepatocytes. The cytotoxic reactions were therefore thought to be mediated by IgM capable of complement activation. Although IgM binding to porcine hepatocytes was also seen in nontoxic sera, the IgM did not activate complement. This implies differences in hepatocyte surface antigens recognized by IgM from t- and nontoxic sera. Before clinical application of a hybrid artificial liver using cultured porcine hepatocytes, detection of cytotoxic human IgM against porcine hepatocytes is necessary, and the means of eliminating the cytotoxic IgM from the hybrid artificial liver system, or of inactivating complement in the system, will be desirable in cases positive for cytotoxic IgM.

[Case report of congenital bronchial cyst in the subsuperior segment of the right lung]

A fifty-five-year-old man revealed abnormal shadow on chest X-P. Congenital Bronchial Cyst (CBC) is believed to be caused by the abnormal budding process during the early development of the foregut and after born result in formation of noninfected cysts in the lung. In this case, CBC was lined by columnarciliated epithelium and contained cartilages and bronchial mucous glands in their wall. They were located along the tracheobronchial tree and cystgraphy presented dumbbell-like change of cysts that were seen during the development stage. These findings support the past reports radiographically that CBC may result from occlusion of the proximal side of bronchus during the early development by unknown mechanism.

Effect of methylene blue on the vesicourethral function in the rats

The bladder and urethral activities during the rhythmic bladder contractions were evaluated before and after the intraarterial administration of methylene blue, which prevents the activation of soluble guanylate cyclase. The methylene blue produced an increase in the bladder activity and a decrease in the urethral smooth muscle relaxant response induced with bladder contraction. The L-arginine/nitric oxide pathway seems to modulate the vesicourethral function.

[Vesical ultrasonography and internal examination of female patients with urethral syndrome]

Transabdominal ultrasonography of the bladder and internal examination were performed in 80 female patients without pyuria. They were divided into 3 groups: urethral syndrome with trigonitis (49 cases), asymptomatic trigonitis (16 cases) and normal bladder (15 cases) by cystoscopy. Ultrasonography of trigonitis with or without symptoms showed focal dilation of the submucosal low echo zone and mucosal irregularity around the bladder neck. On the sagittal view, the thicknesses from the surface of mucosa to that of muscle layer within 2 cm from the bladder neck were 4 +/- 1 mm (mean +/- standard deviation) in the group with urethral syndrome and in that with asymptomatic trigonitis, and 3 +/- 1 mm in the normal bladder group. Mucosa of the trigonitis with or without symptom is patients with significantly thicker than that of those with normal bladder (p less than 0.01). On internal examination, tenderness at the upper frontal wall of the vagina was present in 10 of 11 cases (91%) with urethral syndrome, in 2 of 8 cases (25%) with asymptomatic trigonitis and in one of 9 cases (11%) with normal bladder. There was a significant difference (p less than 0.005) between the degree of inflammation and the number of cases with tenderness at the frontal wall of the vagina. From these results, transabdominal ultrasonographic measurement of mucosal thickness around the bladder neck and internal examination for tenderness at the frontal wall of vagina are thought to be useful methods for diagnosis and follow-up of urethral syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

[Comparative study on nephrotoxicity of ionic and non-ionic contrast agents for drip infused urography]

The effects on renal function of an ionic and hyperosmolaric contrast agent (diatrizoate) and a non-ionic and slightly hypertonic agent (iohexol) for drip infused urography were compared on 60 patients with normal renal function. Urine samples were collected before and 30 minutes after drip infusion of contrast agent, and analyzed for albumin (ALB), gamma-glutamyl transpeptidase (gamma-GTP), N-acetyl-beta-glucosaminidase (NAG), beta 2 microglobulin (beta 2MG) and creatinine (CRE). The urinary excretion of proteins and enzymes was compared with urinary CRE. gamma-GTP, NAG and beta 2MG increased significantly after infusion of diatrizoate. gamma-GTP and beta 2MG increased significantly after infusion of iohexol. Excretion of ALB, gamma-GTP, NAG and beta 2MG was significantly higher after infusion of diatrizoate than after iohexol. The urinary concentration of CRE was significantly lower after infusion of diatrizoate than after iohexol. The degree of renal damage after urography was no related to the appearance of allergy to the contrast agent or age of patient. Therefore, the non-ionic and slightly hyperosmolaric iohexol may be less toxic to the kidneys than the ionic and hypertonic diatrizoate. This nephrotoxicity after drip infused urography is thought to be related mainly to the osmolarity of contrast agent.

Does a porcine hepatocyte hybrid artificial liver prolong the survival time of anhepatic rabbits?

To examine cultured porcine hepatocytes as a bioreactor of a hybrid artificial liver (HAL) in rabbits, a small version of a multiplated HAL was manufactured. In vitro and ex vivo studies were performed to evaluate the small HAL. The HAL consisted of 50 glass plates (10 x 5 x 0.04 cm each) on which porcine hepatocytes were cultured in a monolayer at confluent cell density. After 2 days of standard cultivation, the glass plates with hepatocytes were placed in the module and were used for studies. The module contains about 5 grams of hepatocytes (1/10 of 2 kg.bw rabbit liver). After undergoing perfusion culture for 5 days, the HAL showed satisfactory hepatic function. Glucose and urea were synthesized at the rate of 4.06 +/- 0.7 mg/module/hr and 0.62 +/- 0.09 mg/module/hr, respectively, and loaded ammonia was metabolized at the rate of 1.29 +/- 0.26 mg/module/hr. Ex vivo extracorporeal plasma perfusion studies revealed that the module with cultured porcine hepatocytes, which were heterogeneous to rabbits, showed a tendency to prolong the survival time of anhepatic rabbits. These results indicate that the HAL system, using multiplated porcine hepatocyte monolayers, is a promising artificial liver support system for clinical cases.

[Effects of Tsumura Chorei-to and Tsumura Chorei-to-go-shimotsu-to on patients with urethral syndrome]

Tsumura Chorei-to or Tsumura Chorei-to-go-shimotsu-to, was administered to 71 female patients with urethral syndrome 2.5 g three times a day for four weeks. Total efficacy rate of Tsumura Chorei-to in 34 cases was 71%. Tsumura Chorei-to was effective against pollakisuria, miction pain or discomfort, sense of residual urine and lower abdominal discomfort. Total efficacy rate of Tsumura Chorei-to-go-shimotsu-to in 37 cases was 57%. Tsumura Chorei-to-go-shimotsu-to was effective against dysuria, sense of residual urine and lower abdominal discomfort. Uutoward effect rates of Tsumura Chorei-to and Tsumura Chorei-to-go-shimotsu-to were 6% and 14%, respectively. Many of the untoward effects of these two drugs were epigastral discomfort. These two drugs are thought to be effective on patients with urethral syndrome.