Step by step protocol for alternative injury models in newt cardiac regeneration

Although the heart is one of the most important organs for animal survival, its regenerative capacity varies among animal species. Notably, adult mammals cannot regenerate their hearts after damage such as acute myocardial infarction. In contrast, some vertebrate animals can regenerate the heart throughout their lives. Cross-species comparative studies are important to understand the full picture of cardiac regeneration in vertebrates. Among the animal species able to regenerate the heart, some urodele amphibians, such as newts, possess a remarkable capacity for this process. Standardized methods of inducing cardiac regeneration in the newt are needed as a platform for studies comparing newts and other animal models. The procedures presented here describe amputation and cryo-injury technique for the induction of cardiac regeneration in Pleurodeles waltl, an emerging model newt. Both procedures consist of simplified steps that require no special equipment. We additionally show some examples of the regenerative process obtained using these procedures. This protocol has been developed for P. waltl. However, these methods also are expected to be applicable to other species of newts and salamanders, facilitating comparative research with other model animals. This article is protected by copyright. All rights reserved.

Cryo-injury procedure-induced cardiac regeneration shows unique gene expression profiles in the newt Pleurodeles waltl

BACKGROUND

Cardiac regeneration in the adult mouse is not substantial. Some vertebrates, such as newts and zebrafish, regenerate the heart throughout their lives. To understand how regenerative abilities differ among animal species, comparative research has been conducted in animals like mouse, zebrafish, and newt. For those purposes, cryo-injury is suitable as an experimental model for the pathological condition of human myocardial infarction. In fact, cryo-injury procedures are common in mouse and zebrafish.

RESULTS

In the present study, we induced cryo-damage on the ventricle in Iberian ribbed newts using a liquid nitrogen-chilled probe. We observed that the injured area recovered within 8 weeks, with remodeling of scar tissue and proliferation of cardiomyocytes. We investigated the subsequent recovery of cryo-injured and amputated tissues by comparative analysis of the gene expression profiles following these two procedures.

CONCLUSION

Notably, we established a cryo-injury procedure for the newt and confirmed that regeneration of the cryo-damaged myocardial tissue is achieved by changes in gene expression that are milder than those observed in the amputation model. Our results suggest that the cryo-injury method is suitable for comparing the process of cardiac regeneration in the newt with that in other animal models. This article is protected by copyright. All rights reserved.

Presence of low voltage area predicts atrial tachyarrhythmia inducibility with atrial burst pacing after pulmonary vein isolation

Background

Induction of atrial fibrillation (AF)/atrial tachycardia (AT) by atrial burst pacing following ablation procedure may reflect the presence of residual substrates in the atria that maintain AF. However, the relation between the inducibility and left atrial low voltage area (LVA) has not been established.

Methods

Fifty-nine patients (65 years old, 43 males) with persistent AF who underwent pulmonary vein isolation (PVI)-based ablation were studied. All patients underwent left atrial voltage mapping during sinus rhythm and atrial burst pacing after PVI. Atrial burst pacing was performed with 30-beat at an amplitude of 10V from the ostium of the coronary sinus; increasing from 240 to 320 ppm in steps of 20 ppm or failure to 1:1 atrial capture. Inducibility was defined as AF/AT lasting more than 5 minutes following burst pacing. Left atrial LVA and other co-variates were analyzed with regard to burst pacing positivity.

Results

AF/AT was induced by burst pacing in 23 patients (39%). Univariate analysis revealed that past history of stroke, CHADS2 score and presence of left atrial LVA were significantly associated with the inducibility of AF/AT. Multivariate analysis revealed that only the presence of LVA was associated with the inducibility (OR 1.5: per 10% increase; p=0.04). We focused on the relationship between the extent of LVA and burst positivity. AF/AT inducibility increased as low voltage area increased, and it was as high as 72.7% when low voltage area was more than 20% (P<0.05). Interestingly, induced arrhythmia type was AT rather than AF when low voltage area was more than 20%.

Conclusions

Presence of left atrial LVA is an independent predictor of atrial tachyarrhythmia inducibility after PVI in patients with persistent AF. A large amount of low voltage area is related to AT inducibility rather than AF.

Extent of LVA and burst positivity

Funding Acknowledgement

Type of funding source: None

Early follow-up visit at outpatient care after discharge improves 2-year heart failure readmission rate and long-term prognosis in patients with decompensated heart failure

Background/Introduction

It has been reported that heart failure (HF) readmission has not declined even with current cardiology practice in the last 10 years. It has been also reported that HF readmission tends to occur shortly after discharge. This may be due to overwork and excessive salt intake after discharge. In other words, it is conceivable that patient factors are largely attributable, which should be intervene for better clinical outcomes.

Purpose

We hypothesized and investigated whether an early follow-up visit at outpatient care within 2 weeks after discharge affects the re-admission rate and prognosis in patients with decompensated HF.

Methods

We retrospectively investigated consecutive 407 hospitalized patients due to decompensated HF. After exclusion of 99 patients with in-hospital death, transfer to another hospital and readmission within 2 weeks after discharge, consecutive 308 out of 407 patients were investigated. Two-year clinical outcomes after discharge were collected and analyzed. An early follow-up was defined as an outpatient care visit within 2 weeks after discharge with the adjustment of drugs and/or the lifestyle guidance, if necessary. A setting of early follow-up in each patient was according to a physician's discretion.

Results

One hundred-twenty eight patients underwent early follow-up visits and other 180 patients were without it. An univariate analysis showed that the early follow-up was significantly associated with a lower HF readmission rate during 2 years (17.1% in the early follow-up group, 34.4% in the control group, p≤0.001, OR=0.397, 95% CI=0.230–0.685, Figure) and a 2-year composite adverse outcome (all cause death and HF readmission; 18.7% vs. 40.5%, p<0.001, OR=0.332, 95% CI=0.196–0.563, Figure). To exclude possible relationships of other co-variable factors, we performed a multivariate analysis about the association with HF readmission rate and the 2-year composite adverse outcome (co-variate factors as follows are included; factors of which p-value was less than 0.1 and general confounding factors). The multivariate analysis showed that the early follow-up was independently associated with HF readmission during 2 years (p=0.002, OR=0.376, 95% CI=0.197–0.716) and the 2-year composite outcome (p<0.001, OR=0.343, 95% CI=0.182–0.648). Finally, we characterized the practical interventions at outpatient care after discharge. Lifestyle guidance was done in all patients. However, medication adjustments were done in only 36.7% patients. Interestingly, whether or not a medication adjustment was done at the early follow-up visit was not associated with the HF readmissions (p=0.781).

Conclusions

The present study suggests that an early follow-up approach after discharge in decompensated HF patients may improve the long-term prognosis. These results were not dependent on whether a medication adjustment was performed or not. An early follow-up may help improve patient factors of HF worsening.

Main results

Funding Acknowledgement

Type of funding source: None

Thin film growth of CaAgAs by molecular beam epitaxy

We have grown thin films of CaAgAs by molecular beam epitaxy, which was theoretically proposed to be a topological insulator. The temperature dependence of resistivity and the carrier concentration at 4 K were similar to the reported results of bulk samples. However, the magnetoresistance exhibited a steep increase at low magnetic fields, a behavior not observed for bulk samples. This steep increase of resistivity is ascribable to the weak antilocalization effect and provides clues to the nature of the topological surface state of CaAgAs.

Selective mass enhancement close to the quantum critical point in BaFe2(As1-x P x )2

A quantum critical point (QCP) is currently being conjectured for the BaFe₂(As_1-x P _x )₂ system at the critical value x _c  ≈ 0.3. In the proximity of a QCP, all thermodynamic and transport properties are expected to scale with a single characteristic energy, given by the quantum fluctuations. Such a universal behavior has not, however, been found in the superconducting upper critical field H _c2. Here we report H _c2 data for epitaxial thin films extracted from the electrical resistance measured in very high magnetic fields up to 67 Tesla. Using a multi-band analysis we find that H _c2 is sensitive to the QCP, implying a significant charge carrier effective mass enhancement at the doping-induced QCP that is essentially band-dependent. Our results point to two qualitatively different groups of electrons in BaFe₂(As_1-x P _x )₂. The first one (possibly associated to hot spots or whole Fermi sheets) has a strong mass enhancement at the QCP, and the second one is insensitive to the QCP. The observed duality could also be present in many other quantum critical systems.

Evidence of two dimensionality in quasi-one-dimensional cobalt oxides

The quasi-one-dimensional (Q1D) cobalt oxides A(N + 2)Co(n + 1)O(3n + 3) (A = Ca, Sr, and Ba, n = 1 - infinity) were investigated by muon-spin spectroscopy under applied pressures of up to 1.1 GPa. The relationship between the onset Néel temperature T(on)(N) and the interchain distance (d(ic)), which increases monotonically with n, is well fitted by the formula T(N)/T(N,0) = (1 - d(ic)/d(ic,o)(beta), here for T(on)(N) approximately 100 K for Ca(3)Co(2)O(6) (n = 1) and approximately 15 for BaCoCoO(3) (n = infinity at ambient P. The T(on)(N) - d(ic) curve also predicts a large dependence of Y(N) for the compounds with n > or = 5, i.e., in the vicinity of , while the compounds show only a very small effect. Indeed, our high-pressure mu(+) results show that of BaCoO(3) is enhanced by with a slope of 2.2 K(Gpa), whereas no detectable changes by P for both Ca(3)Co(2)O(6) and Sr(4)Co(3)O(9) (n = 2). This clearly confirms the role of the 2D-antiferromagnetic interaction on T(on)(N) in the Q1D cobalt oxides.

Three-dimensional fermi-liquid ground state in the quasi-one-dimensional cuprate PrBa(2)Cu(4)O(8)

The interchain resistivity of PrBa(2)Cu(4)O(8) has been measured in high magnetic fields up to 30 T. Co-herent interchain transport at low temperatures is destroyed by a large magnetic field applied perpendicular to the CuO chains. Comparisons with quasiclassical transport theory provide strong experimental support for a three-dimensional Fermi-liquid ground state in PrBa(2)Cu(4)O(8), despite extreme anisotropy in its electronic properties and the presence of strong electron correlations.

Combined trisomy 9P and Shprintzen syndrome resulting from a paternal t(9;22)

The authors report on a female infant with partial trisomy 9 (pter-->q12) together with partial monosomy 22 (pter-->q11.23) that included DiGeorge critical region (DGCR), as a result of adjacent-2 disjunction. In addition to the clinical features characteristic of trisomy 9p syndrome, the patient had Truncus arteriosus type A2, bilateral hydronephrosis, palatal anomaly, retrognathia, and laryngeal hypotonia, which are likely to be attributed to 22q11.2 deletion. This patient appears to be the first reported case with such unbalanced translocation resulting from a paternal reciprocal translocation. For live birth, the risk for male carrier is 8.7-17.4%. It is important to consider this higher risk when counseling. Precise study concerning the presence of the DGCR can facilitate in the better understanding of the condition.

Squalene synthase inhibitors reduce plasma triglyceride through a low-density lipoprotein receptor-independent mechanism

Inhibitors of squalene synthase are considered to be candidate drugs to reduce both plasma cholesterol and triglyceride. However, little is known about the mechanism of squalene synthase inhibitor-specific effect on plasma triglyceride. In this study, we confirmed the triglyceride-lowering effect of ER-27856, a potent squalene synthase inhibitor prodrug, in rhesus monkeys. To determine the role of low-density lipoprotein (LDL) receptor in the triglyceride-lowering effect of squalene synthase inhibitors, we intravenously administered ER-28448, the active form of ER-27856, to Watanabe heritable hyperlipidemic (WHHL) rabbits for 4 days. In heterozygotes, ER-28448 reduced plasma cholesterol and triglyceride by 52% and 37%, respectively. In homozygous rabbits, in contrast, ER-28448 lowered plasma triglyceride by 40% but did not lower plasma cholesterol. Orally administered ER-27856 reduced plasma triglyceride in homozygous animals but atorvastatin and bezafibrate did not. In hepatocytes isolated from homozygous WHHL rabbits, squalene synthase inhibitors but not atorvastatin reduced triglyceride biosynthesis. These data demonstrate that squalene synthase inhibitors reduced plasma triglyceride through an LDL receptor-independent mechanism, which was distinct from that of the triglyceride-lowering action of atorvastatin or bezafibrate. The reduction of hepatic triglyceride biosynthesis may play an important role in the hypotrigyceridemic action of squalene synthase inhibitors.

Improved glucose tolerance via enhanced glucose-dependent insulin secretion in dipeptidyl peptidase IV-deficient Fischer rats

Glucagon-like peptide-1 (GLP-1) is an incretin, which induces glucose-dependent insulin secretion. GLP-1 is rapidly degraded by dipeptidyl peptidase IV (DPPIV) after its release. We investigated whether DPPIV-deficient F344/DuCrj rats show improved glucose tolerance when compared with DPPIV-positive F344/Jcl rats. Oral glucose tolerance test indicated improved glucose tolerance in F344/DuCrj rats, but blood glucose levels of the two strains were almost the same 120 min after the glucose bolus. Valine-pyrrolidide, a DPPIV inhibitor, had no effect on the glucose tolerance of F344/DuCrj rats, but improved that of F344/Jcl rats. Enhanced insulin secretion and high plasma active GLP-1 levels were detected in an intraduodenal glucose tolerance test. Glucose tolerance is improved in DPPIV-deficient F344/DuCrj rats via enhanced insulin release mediated by high active GLP-1 levels. Our results suggest that DPPIV inhibition is a rational strategy to treat diabetic patients by improving glucose tolerance with low risk of hypoglycemia.

Anisotropic optical spectra of PrBa2Cu4O8: possible Tomonaga-Luttinger liquid response of the quasi-one-dimensional metallic CuO double chains

The optical spectra of PrBa2Cu4O8 show large in-plane anisotropy. For the a polarization (E perpendicular chain), the spectrum is characterized by a gap of 1.4 eV, indicating the charge-transfer insulating nature of the CuO2 planes. For the metallic chain direction (E // b), the spectrum deviates from a simple Drude response; reflectivity R(b)(omega) shows a sharp edge at approximately 1 eV but it also shows a dip at approximately 15 meV, which splits the conductivity spectrum into two parts--a zero-energy mode with small weight and a pronounced 40 meV mode. These features are discussed in terms of a Tomonaga-Luttinger liquid in a doped 1D Mott insulator and compared with 1D Bechgaard salts.

Experimental study on paratumoral injection of cisplatin-loaded microspheres for gastric cancer

Microspheres from glycolide-L-lactide copolymers incorporating cisplatin (CDDP-MS) were prepared to evaluate the sustained release and anticancer effect by paratumoral injection on the gastric cancer with regional lymphnode metastases induced by VX2 tumor in rabbits. In the first set of experiment, the rabbits were divided into three groups subjected to treatment and compared the tissue cisplatin distribution. In the first group (CDDP-MS pt group), 1 mg/kg of cisplatin was administered by the method of paratumoral injection in the form of CDDP-MS. In the second group (CDDP solution pt group), the same dose was given in the form of CDDP aqueous solution in the same way and in the third group (CDDP solution i.v. group), the same dose was intravenously administered. In the second set of experiment, after twice of each therapy the anticancer effects were compared between CDDP-MS pt and CDDP solution i.v. groups. In results, the platinum concentrations of the tumor and regional lymphnodes were 3.14 +/- 6.22, 0.65 +/- 0.79 micrograms/g in the first group, 0.43 +/- 0.39, 0.16 +/- 0.16 microgram/g in the second group and 0.03 +/- 0.01, 0.07 +/- 0.05 microgram/g in the third group, respectively.

Complete agenesis of the dorsal pancreas

Pancreatic anomalies are occasionally reported, but complete agenesis of the dorsal pancreas is extremely rare. We report a 47-year-old woman with complete agenesis of the dorsal pancreas. This patient initially presented with jaundice. Computed tomography did not reveal the pancreatic corpus or tail. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography did not visualize the dorsal pancreatic duct. Choledochojejunostomy was performed because she had obstructive jaundice. At laparotomy, there was an enlarged pancreatic head, but no distal pancreas was seen. Histological examination of the pancreatic biopsy specimen showed scattered islets of Langerhans in diffuse fibrosis, with destruction of the glandular parenchyma. This case was diagnosed as complete agenesis of the dorsal pancreas.

Clinicopathological features of esophageal cancer simultaneously associated with gastric cancer

BACKGROUND AND OBJECTIVES

We usually use the stomach for esophageal substitution in the surgical treatment of esophageal cancer, although it is often associated with gastric cancer. In order to improve the likelihood of safe and curative surgery of esophageal cancer, we investigated the clinicopathological characteristics of synchronous esophageal and gastric cancer.

METHODS

Among 288 patients with primary esophageal cancer who had undergone esophageal resection, this cancer was associated with gastric cancer in 11 cases, and 1,416 gastric cancer patients operated on during the same period, were analyzed. The clinicopathological characteristics and surgical procedures of the 11 patients were compared with those of the other esophageal cancer patients and with those with the gastric cancer only.

RESULTS

There were significant differences between the synchronous double cancer and the gastric cancer only in sex (P < 0.01) and location of the gastric cancer (P < 0.05). All of the patients with the synchronous double cancer were men, and the incidence of patients with cardiac cancer was high.

CONCLUSIONS

Our findings suggest that, in cases of synchronous esophageal and gastric cancer, an adequate surgical procedure must be chosen in terms of the stage, location, and operative burden.

A case of esophagectomy for corrosive esophageal stricture caused by swallowing strong alkali. A case report

We report herein the case of a 22-year old woman who underwent esophagectomy for corrosive esophageal stricture. This patient with mental disturbance swallowed a strong alkali in a suicide attempt and suffered from esophageal stenosis instead of steroid therapy. Because the stiffness and stricture of the esophagus proved to be refractory, transhiatal esophagectomy by blunt finger with gastroesophagostomy was performed four months after injury. Operative findings revealed severe stiffness and inflammation of the esophagus which had spread to the adjacent organs, especially the carina. As for pathological findings, most of the esophageal mucosa showed defects resulting from infiltration of inflammatory cells and capillary vascularization from the lamina propria to the extra-esophageal wall. The postoperative course was uneventful and perioperative psychological state had been stable leading to a decrease in tranquilizer dosage. This experience indicates that esophagectomy is the treatment of choice for such mental disturbed patients with severe stenosis.

Surgical treatment of patients with psychiatric disorders: a review of 21 patients

Between January 1985 and September 1994, 21 patients with psychiatric disorders underwent various forms of surgery at our hospital. There were 12 men and 9 women with an average age of 57.6 years. The coexisting psychiatric disorders were schizophrenia in 15 patients, depression in 2, dementia in 2, mental retardation with epilepsy in 1, and Parkinson's disease in 1. All the patients had been receiving neuroleptic medications for a long period. The indications for surgery were: cholelithiasis in 6 patients, acute appendicitis in 4, perforation of the small intestine in 3, incarceration of an inguinal hernia in 2, and esophageal cancer, stomach cancer, bleeding from a gastric ulcer, perforation of a duodenal ulcer, strangulating ileus, and burns in 1 patient each, respectively. All of the patients who underwent elective surgery were given epidural anesthesia with or without general anesthesia. Antipsychotic medications were given until just prior to surgery and recommenced concurrent with the first meal. Abnormal behavior was observed in 11 patients (52.4%) postoperatively, but all the patients were discharged in accordance with recovery from their surgical disorder. Intra- and postoperative hypotension resistant to intravenous catecholamine administration was recognized in 9 patients (42.9%), and this peculiar complication should be borne in mind when patients with psychiatric disorders require surgical management.

A study of patients having survived curative operation for esophageal cancer for five years or more

In order to analyze the prognostic factors for curatively resected esophageal cancer, 42 patients who had survived their operation more than 5 years (long-term survivors) were compared for clinicopathologic items with 30 recurrent patients who had died within 5 years postoperatively (recurrent cases). Moreover, to estimate the prognosis for the current survivors, we investigated the cause of death of long-term survivors who had died. This comparison showed that the rate of lymphatic invasion was 36.4% and of blood vessel invasion 19.4% for the survivors, much lower than those of the recurrent cases which were respectively 62.1% and 31.0%. It was found that the significantly unfavorable prognosis-determinant factors was lymphatic invasion (p < 0.05). Ten out of 12 n (+) survivors (83.3%) had single metastasing region, one in the neck, three in the mediastinum and six in the abdomen. This was not significantly different from the recurrent cases, of whom, ten out of 14 n (+) cases had a single metastasing region, six in in the mediastinum and four in the abdomen. As for the number of metastatic lymph nodes, nine out of 12 n (+) survivors (75%) had only one matastatic lymph node, and none of them had more than three. On the other hand, two of the recurrent cases had more than three. Of the 42 long-term survivors, 21 patients are still alive (current survivors' average age: 70.1 +/- 7.9) and 21 have died. The cause of death was recurrence in six cases, metachronous primary malignant tumor in three, other disease in six and unknown in six. The average age of death was 62.1 +/- 10.3 in cases of recurrence or double cancer, and 71.8 +/- 9.5 in others. The former were thus significantly younger than the latter (p < 0.05).

Lenńox-Gastaut syndrome associated with leukoencephalopathy

We report a 13-year-old boy with Lennox-Gastaut syndrome (LGS) associated with leukoencephalopathy. He was diagnosed with unclassified acute lymphocytic leukemia at the age of 3 years. After initial chemotherapy, he received intravenous methotrexate (total dosage 1,035 mg), intrathecal methotrexate (total dosage 221 mg), and whole brain irradiation (2,400 cGy). From about the age of 8 years, he developed slurred speech, hyperactivity, and mental deterioration. Cranial CT revealed calcification of the subcortical white matter. At age 9 years, he exhibited tonic seizures and atonic seizures. EEG showed diffuse slow spike-wave discharges, which are characteristic of LGS. Although multiple antiepileptic drugs have been prescribed, the frequency of seizures remains unchanged and his mental state is becoming progressively worse.

Bone scintigraphy in detection of bone invasion by oral carcinoma

Detecting osseous involvement is clinically important in the management of oral carcinoma. Thirty-one patients with osseous involvement due to oral carcinoma who underwent panoramic radiography and bone scintigraphy were evaluated retrospectively. Bone scintigraphy confirmed osseous involvement in all 31 (100%) of these patients. In 27 (87%) of 31 patients with osseous involvement, both the panoramic radiogram and bone scintigram were positive. In the remaining four patients (13%), bone scintigram was positive for mandibular or maxillary invasion, while panoramic radiogram was negative. There were no instances of an abnormal radiogram with a normal bone scintigram. These findings strongly suggest that bone scintigraphy is more sensitive than panoramic radiography in detecting osseous involvement of the mandible and maxilla due to oral carcinoma. Furthermore, bone scintigraphy was a critical pre-surgical in determining the extent of the osseous involvement.

[A case of gastric cancer with multiple liver metastasis responding to combined therapy with UFT and mitomycin C]

A 66-year-old female was admitted to our hospital with the complaint of anorexia and epigastric pain. Examination of the gastrointestinal tract revealed Borrmann III type gastric carcinoma, 5 cm x 5 cm in size, in the lesser curvature of the stomach. Multiple liver metastases were detected on abdominal computed tomography. In January 1993, she underwent subtotal gastrectomy as a palliative therapy. Pathological diagnosis of the resected specimen was poorly differentiated adenocarcinoma. Two weeks after operation, administration of UFT (300-450 mg/day, orally) and mitomycin C (12 mg/three months, intravenously) was started. This chemotherapy had to be discontinued within six months because of its severe side effects, such as leukopenia and acral erythema. However, a marked reduction in the size of the metastatic liver tumors was observed on abdominal computed tomogram, and the patient is now (15 months after operation) alive without local recurrence or re-growth of liver metastatic tumors.

Magnetic resonance imaging for aspirated peanut in the bronchus

Peanut inhalation in the right main bronchus of a 15-month-old boy was diagnosed using a T1-weighted image produced by magnetic resonance imaging (MRI) because of the high fat content of the peanut. The T1-weighted MRI image may also be useful in diagnosing other kinds of aspirated nuts with high lipid content as well as peanuts. This method does not involve any X-ray exposure.

[An experimental study on radiotherapy for esophageal cancer using intraluminal administration of radiosensitizer]

This study was undertaken to evaluate the efficacy of intraluminal administration of 5-bromo-2'-deoxyuridine (BUdR) as a radiosensitizer during radiotherapy for esophageal cancer. Lipid-surfactant mixed micelles (MM) was used as an absorption promoter. VX2 carcinoma cells were endoscopically injected into the esophageal wall of rabbits. Two weeks after tumor inoculation, BUdR (100 mg/body) with MM was administered into the esophageal lumen and kept for 3 hours. Subsequently, animals were irradiated with 60Co at dosages of either 5 or 10 Gy. Twelve days after, animals were sacrificed to determine tumor diameter and to evaluate histological effect of radiation. BUdR uptake rates of tumor tissue were determined two weeks after tumor inoculation. Tumor diameters in control animals and those treated with simple irradiation at a dose of 5 Gy were similar. In contrast, irradiation at a dose of 5 Gy significantly reduced tumor diameters when combined with intraluminal administration of BUdR with MM. In cancer bearing animals receiving irradiation under intraluminal injection of BUdR with MM, the histological effect were apparently enhanced as compared to animals receiving simple irradiation. BUdR uptake rates of primary tumors showed a significant increase in animals with the intraluminal administration of the drug as compared the those with intravenous one shot bolus and intravenous drip infusion. Based on those results, we conclude that preoperative radiotherapy combined with intraluminal administration of radiosensitizer could be an effective method.

Simple and sensitive quantitation method for mevalonic acid in plasma using gas chromatography/mass spectrometry

The combination of gas chromatography and mass spectrometry using a polar capillary column and isobutane chemical ionization made it possible to determine mevalonic acid (MVA) as the lactone at subnanogram levels using 1 mL of plasma. The pretreatment procedure consisted of only three steps, namely lactonization, washing with chloroform and liquid/liquid extraction. This simple, rapid and sensitive method, having good precision and accuracy, is useful for evaluating the change of plasma MVA, which is well correlated with whole-body cholesterol biosynthesis.

Second cutaneous neoplasms after acute lymphoblastic leukemia in childhood

Two cases of second cutaneous neoplasms, one with adenoid cystic carcinoma of the skin and the other with basal cell carcinoma, both occurring 7 years after treatment for childhood acute lymphoblastic leukemia (ALL) are reported. Although such cutaneous neoplasms are generally reported in patients over 40 years of age, our cases, which were diagnosed at the ages of 9 and 14, are the first report of the occurrence of such cutaneous neoplasms following ALL. The neoplasms arose from the scalp of two patients who had received cranial irradiation for central nervous system prophylaxis. The possible link between leukemia therapy incorporating irradiation and the pathogenesis of second cutaneous neoplasms in the scalp is discussed.

The use of autologous blood in the surgical treatment of spinal disorders

A program of autologous blood transfusion in 101 patients who underwent spinal surgery was analyzed. Autologous transfusion was achieved by intraoperative blood salvage using a cell saver and with predeposited blood. The techniques of predeposition of blood included freezing the blood and using a storage solution. Forty-eight patients had scoliosis and received mainly cryopreserved autologous blood and 53 patients had other spinal diseases. Surgery was performed using only autologous blood transfusion in more than 90% of all patients cases. The program was well tolerated by the patients and easily managed by the blood center staff. There were no severe complications associated with this program. The use of instrumentation and extensive spinal fusion were found to be factors associated with increased intraoperative blood loss. This finding suggests that instrumentation surgery and extensive spinal fusion are indications for autologous blood transfusion. Cryopreserved autologous blood transfusion is an effective method for storing a sufficient volume of blood for scoliosis surgery without affecting the patients' preoperative hemodynamic status.

[A case of complete remission of lymph nodes metastasis from esophageal cancer with combination treatment of UFT and radiation]

A 65 year old female patient, who had developed left atelectasis because of mediastinal lymph nodes metastasis after esophageal resection for esophageal cancer, underwent the combination treatment with UFT (300 mg/day) and radiation (1.5 Gy/day, total dosage: 70.2 Gy). The symptoms soon subsided, and mediastinal CT and bronchoscopy revealed a complete disappearance of metastatic lymph nodes after one month. During one year of CR she enjoyed her daily life, however the relapse occurred. It is suggested that the combination treatment is an effective and safe way even in a patient who went through a lot of invasive surgeries.

A new method of myocardial revascularization by laser

There are some problems in surgical treatment for those patients with small branches or diffuse stenotic lesions of the coronary arteries, for whom coronary artery bypass grafting can not be carried out at all. To resolve these problems, we have planned to supply arterial blood from the left ventricle into the ischemic myocardium through holes cut into the myocardium by laser. It was clearly recognized that arterial blood could be hemodynamically supplied from the left ventricle into the ischemic myocardium. In trials on dogs laser holes 0.2 mm in diameter have been shown microscopically to be patent even 3 years after their creation, thus this procedure could be used as a new method of myocardial revascularization. Consequently, myocardial revascularization by laser was employed in a 55-year-old male patient with severe angina pectoris who had undergone pericardiectomy 2 years before. He is doing well 5 years and 3 months after surgery.

[Experimental and clinical studies on the laser application in the cardiovascular surgery; analysis of clinical experience of 112 patients]

Since 1980, we have applied lasers experimentally in the following three categories in the fields of cardiovascular surgery. That is, Group 1: New myocardial revascularization in the patients whose coronary arteries are too small or diffuse due to atherosclerosis, Group 2: Laser vascular anastomosis especially for small-caliber vessels, such as coronary artery bypass grafting, Group 3: Laser angioplasty for obstructive arterial disease. Subsequently, efficacy of laser application could be obviously recognized in these fields. On the basis of excellent results of our experimental studies, laser was clinically employed for 112 patients with anginal pain, intermittent claudication and renal failure. They consisted of new myocardial revascularization in one case and vascular anastomosis in 89 cases including 7 cases (LIMA-LAD2, SVG-LAD5) of the coronary artery bypass grafting and laser angioplasty in 22 cases including 5 cases (LAD3, RCA2) of intraoperative laser coronary angioplasty. Optimal conditions of vascular anastomosis were 20-40mW in output and 6-12sec/mm in irradiation time. On the other hand, optimal conditions for laser angioplasty were 6 watts in output and 3sec in irradiation time for each shot. Laser irradiation was carefully repeated according to the grade of atherosclerotic changes. These patients are doing well without any complications throughout laser. Our experimental and clinical experiences of laser application in the fields of the cardiovascular surgery were presented in detail.

On the external carotid artery and its branches in hens

The external carotid artery and its branches were investigated in hens by an acrylic plastic injection method. The common carotid artery of hens bifurcated into the internal and external carotid arteries at the level of the second cervical vertebra. The external carotid artery advanced antero-superiorly within the platysma, stylohyoid, and occipitomandibular muscles at the postero-lateral side of the pharynx. Thereafter, it bifurcated into the anterior palatine and facial arteries between the pharynx and capitis rectus muscle at the posterior side of the medial mandibular process of the articular bone. The external carotid artery sent out the following branches: the occipital, hyomandibular, anterior temporal, sublingual, anterior palatine, and facial arteries.

Salivary gland uptake of gallium-67 citrate after sialography

Sialography may cause greatly increased Ga-67 activity within otherwise normal salivary glands. Five patients are presented in whom sialography with oily contrast material injected 8-26 days before Ga-67 imaging produced strongly positive examinations. In each patient it appears that sialography rather than pre-existing pathologic conditions accounted for the increased activity. Sialography-induced subclinical sialadenitis may be the mechanism for the phenomenon.

Synthesis and antiinflammatory activities of 3-(3,5-di-tert-butyl-4-hydroxybenzylidene)pyrrolidin-2-ones

A series of 3-(3,5-di-tert-butyl-4-hydroxybenzylidene)pyrrolidin-2-ones was synthesized and evaluated as candidate antiinflammatory/analgesic agents as well as dual inhibitors of prostaglandin and leukotriene synthesis. Some compounds that showed dual inhibitory activity were found to possess equipotent antiinflammatory activities to indomethacin, with reduced ulcerogenic effects. One of the compounds, N-methoxy-3-(3,5-di-tert-butyl-4-hydroxybenzylidene)pyrrolidin-2-o ne, was found to have a wider safety margin than indomethacin or piroxicam, and was selected for detailed evaluation as a candidate drug for clinical application.

[The difference between the mechanism of 67Ga accumulation and 59Fe accumulation in cultured tumor cells]

It is well known that the mechanism of 67Ga accumulation into tumor cells is mediated with transferrin receptor as well as iron. The present study was designed to explore the difference between the mechanism of gallium accumulation and that of iron by using mouse leukemic cell line L5178Y. When monensin which inhibits the recycle of transferrin receptor was added to the incubated system, accumulation of 59Fe and 67Ga was clearly diminished compared with that of control. However, inhibition of 59Fe accumulation was more remarkable than that of 67Ga. Furthermore, monensin has a action of Na+ ionophore which decreases Na+ gradient between the inside and the outside of the plasma membrane. Following administration of monensin, 67Ga accumulation was diminished according to the loss of the Na+ gradient. On the other hand, following administration of valinomycin, 67Ga accumulation was not affected by the loss of the K+ gradient. From these results, it was suggested that the mechanism of 67Ga accumulation into tumor cells differed from that of 59Fe and transferrin receptor and Na+ gradient of tumor cells played an important role on 67Ga accumulation into tumor cells.

Identification of Warthin's tumor with technetium-99m pertechnetate

Salivary gland imaging with Tc-99m pertechnetate is a useful procedure for evaluating the functional status of salivary glands. The only neoplasms of salivary glands known to consistently concentrate Tc-99m pertechnetate are Warthin's tumor and oncocytoma. In the five cases presented, increased concentration of Tc-99m pertechnetate was seen in these tumors of the parotid glands. This finding was useful for preoperative identification of Warthin's tumor. During this investigation, the concentration of Tc-99m pertechnetate in Warthin's tumor varied by histologic type. Thus, a dynamic study may be helpful in evaluating the accumulation rate of Tc-99m pertechnetate into this tumor type. Because the retention of Tc-99m pertechnetate in tumor following stimulation is useful for the diagnosis of Warthin's tumor, a washout image is of importance in establishing this diagnosis.