[Reoperation through right thoracotomy for mitral regurgitation after coronary artery bypass grafting; report of a case].

A 53-year-old male patient developed severe mitral regurgitation 6 years after coronary artery bypass grafting (CABG) with a left internal thoracic artery and 2 saphenous veins. The left ventriculography showed severe mitral regurgitation and slight decrease in left ventricular function. The coronary arteriography showed all grafts being patent. The median re-sternotomy was avoided because of the risk for injury of bypass grafts, and the right anterolateral thoracotomy was chosen. Mitral valve replacement was performed under moderate hypothermia and ventricular fibrillation without aortic cross clamping. The postoperative course was uneventful. Right anterolateral thoracotomy is considered to be a superior approach to the mitral valve surgery in the patients with previous CABG.

[Exposure for harvesting internal mammary artery grafts].

Inflated lungs often disturb the harvesting of internal mammary artery grafts. We employ a Universal Stabilizer Arm and Aortic Valve Assistant (Estech Corporation, Danville) to push the mediastinal pleura and the lung away from the upper part of the mediastinum. This system can be attached to any type of retractor and has excellent flexibility. Its use provides good exposure for harvesting the internal mammary artery.

Direct action of parathyroid hormone-related peptide to enhance corticosterone production stimulated by adrenocorticotropic hormone in adrenocortical cells of hens.

The presence of receptor for chicken parathyroid hormone-related peptide (cPTHrP) in the cortical cells of the adrenal gland of the hen was demonstrated by radioligand binding assays. When the cortical cells were incubated in vitro with chicken adrenocorticotropic hormone (cACTH) in the presence of cPTHrP, greater production of corticosterone was observed than when incubated with cACTH alone. The results suggest that PTHrP may act directly on the adrenocortical cells via its receptor binding and increase the response to ACTH for corticosterone secretion in the hen.

[Ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade: report of a case].

A 67-year-old female was sent into our hospital for ruptured thoracic aneurysm with hemorrhagic cardiac tamponade. Computed tomography (CT) showed pericardial effusion and ruptured aortic arch aneurysm. We performed urgent graft replacement of the aortic arch using selective cerebral perfusion under mild hypothermia. Postoperative course was uneventful.

Enterobacterial repetitive intergenic consensus sequence-based PCR (ERIC-PCR); its ability to differentiate Streptococcus pyogenes strains and applicability to the study of outbreaks of streptococcal infection.

We evaluated the ability of enterobacterial repetitive intergenic consensus sequence-based PCR (ERIC-PCR) to differentiate 95 Streptococcus pyogenes strains with M or T serotypes isolated from sporadic streptococcal infections as compared with M or T serotypings and pulsed-field gel electrophoresis (PFGE). Although the ERIC-PCR had less discriminatory power, defined as the ability to divide the strains with the same serotypes into the different sub-types, than PFGE, it consistently classified the strains into 16 patterns with a high correlation with M or T serotyping. The PCR method further discriminated 4 M or T serotypes into sub-types. The application of ERIC-PCR to 5 outbreaks of streptococcal infection produced the results that agreed closely with those of T serotyping and PFGE. ERIC-PCR has sufficient discriminatory power and is a quick and relatively easy technique, making it useful for routine epidemiological investigations.

Medium-chain triglyceride-rich enteral nutrition is more effective than low-fat enteral nutrition in rat colitis, but is equal in enteritis.

BACKGROUND: Although enteral nutrition (EN) therapy for Crohn's disease has been confirmed to be as effective as steroid therapy, the precise mechanism responsible for the effects of EN remains unclear, although some of the therapeutic effects of EN are believed to be due to a low dietary fat content. In order to elucidate the influence of fat in EN, it is important to investigate not only the quantity of fat, but also the source of the fat. METHODS: We compared two enteral nutritional formulae: Elental (Ajinomoto) (elemental diet; ED), which contains only 1.5% fat, provided as long-chain triglycerides (LCT), versus Twinline (Snow Brand Milk Products) (TL), which contains a high percentage of fat (20.4%), provided mainly as medium-chain triglycerides (MCT). These formulae were tested on rat enteritis and rat colitis induced by trinitrobenzene sulfonic acid (TNBS). RESULTS: Both ED and TL reduced the manifestations of enteritis. TL had a stronger anti-inflammatory effect than ED for colitis. TL also had nutritional advantages as compared with ED, as shown by the total serum protein in the TL group being significantly higher than that in the ED group. CONCLUSION: The results indicate that intraluminal MCT is suitable as a fat energy source during intestinal inflammation in rats. We suggest that Twinline may be more useful to improve nutritional status and to reduce the mucosal inflammation in rat colitis, but that Twinline is equal in effect to Elental for rat enteritis.

[A case of corticobasal degeneration of which movemental disturbances were improved by administration of amantadine].

Corticobasal degeneration(CBD) is a neurodegenerative disorder characterised clinically by apraxia, cortical sensory loss, alien limb, dementia, oculomotor abnormalities, dysarthria, postural instability, akinesia, rigidity, and pyramidal signs. Brain imaging may demonstrate greater abnormalities contralateral to the more affected side. We reported a case of corticobasal degeneration of which praxic impairments were improved by administration of amantadine. The patient was a 63-year-old right-handed woman. She showed marked dysfunction including rigidity, limb kinetic apraxia, cortical sensory loss, ideomotor apraxia, and dressing apraxia. A brain MRI scan revealed bilateral cortical atrophy centered in the postcentral gyrus, more pronounced in the left hemisphere than the right. A SPECT scan showed a decrease in blood flow in the temporo-parieto-occipital regions, more pronounced in the left hemisphere than the right. An EEG showed a diffuse slowness. L-dopa had no effect on the symptoms of rigidity, limb kinetic apraxia, cortical sensory loss, ideomotor apraxia, and dressing apraxia. By administration of amantadine, rigidity and cortical sensory loss did not improve, but some praxic impairments, such as dressing apraxia and ideomotor apraxia, and the EEG improved. Upon withdrawal of amantadine, the improved symptoms deteriorated. Amitriptyline did not improve the deteriorated symptoms. After amantadine was re-administered, the same praxic impairments and the EEG improved again. This suggested that administration of amantadine had some effect on certain praxic impairments and the EEG.

Developmental changes of parathyroid hormone/parathyroid hormone-related peptide and calcitonin receptor binding properties in the chicken calvaria and kidney.

The equilibrium dissociation constant (Kd) and the maximum binding capacity (Bmax) of receptors for parathyroid hormone (PTH)/parathyroid hormone-related peptide (PTHrP) and calcitonin (CT) in the membrane fraction of the calvaria and the kidney of chickens were examined from 1 d after the hatch up to 24 wk of age by the use of radioligand binding assays. The Kd values of the PTH/PTHrP receptor in both tissues were decreased at 10 and 24 wk in female birds, whereas the values were increased at 24 wk in male birds. The Bmax values of the PTH/PTHrP receptor in both tissues were decreased at 10 wk and returned to baseline at 24 wk in female birds. The values were increased at 24 wk in male birds. The Kd and Bmax values of CT receptors in the both tissues were constant during the experimental period in female and male birds. The results suggest that the binding properties of PTH/PTHrP receptor and of CT receptor may be influenced by gonadal hormones relating to sexual maturation.

Relationship between blood flow kinetics and severity of Alzheimer's disease: assessment of severity using a questionnaire-type examination, Alzheimer's disease assessment scale, cognitive sub-scale (ADAS(cog)).

We assessed hemokinetics associated with changes in Alzheimer's disease (AD) severity in 90 AD patients by researching the relationship between AD Assessment Scale, cognitive sub-scale (ADAS(cog)) scores and regional cerebral blood flow (rCBF). In the present study, we employed the questionnaire-type ADAS(cog) examination to accurately assess the severity of AD. Between five groups classified on the basis of ADAS(cog) score, significant differences were observed in parietal, lateral temporal and superior frontal rCBF. In addition, in parietal and lateral temporal regions, significant correlations were also observed between ADAS(cog) score and rCBF. In superior frontal rCBF, significant differences were noted only between group 5 (> or =40 ADAS(cog) points) and each of the other groups; there was no significant correlation between rCBF and ADAS(cog) score. Thus, we propose the following mechanism for blood flow kinetics associated with changed severity: In an early stage of AD, blood flow in the medial temporal cortex is impaired, and gradually involves the temporoparietal regions. While the medial temporal impairment of blood flow reaches a plateau, temporoparietal blood flow continues to be impaired well into a severe stage, at which point blood flow impairment in the frontal region is initiated.

Gene cloning and overproduction of low-specificity D-threonine aldolase from Alcaligenes xylosoxidans and its application for production of a key intermediate for parkinsonism drug.

The dtaAX gene encoding a pyridoxal 5'-phosphate (pyridoxal-P)-dependent low-specificity D-threonine aldolase was cloned from the chromosomal DNA of Alcaligenes xylosoxidans IFO 12669. It contains an open reading frame consisting of 1,134 nucleotides corresponding to 377 amino acid residues. The predicted amino acid sequence displayed 54% identity with that of D-threonine aldolase from gram-positive bacteria Arthrobacter sp. DK-38, but showed no significant similarity with those of other known pyridoxal-P enzymes. This gram-negative bacterial enzyme was highly overproduced in recombinant Escherichia coli cells, and the specific activity of the enzyme in the cell extract was as high as 18 U/mg (purified enzyme 38.6 U/mg), which was 6,000 times higher than that from the wild-type Alcaligenes cell extract. The recombinant enzyme was thus feasibly purified to homogeneity by ammonium sulfate fractionation and DEAE-Toyopearl chromatography steps. The recombinant low-specificity D-threonine aldolase was shown to be an efficient biocatalyst for resolution of L-beta-3,4-methylenedioxyphenylserine, an intermediate for production of a therapeutic drug for Parkinson's disease.

Parathyroid hormone receptor binding property in the shell gland of oviduct of the guineafowl during an oviposition cycle.

Parathyroid hormone (PTH) receptor binding property in the membrane fraction of the endometrium of the shell gland (uterus) of the guineafowl was analyzed by the use of [125I]PTH-related peptide (PTHrP) binding assays. Specificity, reversibility, and saturation of binding were demonstrated. Scatchard plots revealed a single class of binding sites. The equilibrium dissociation constant (Kd) was 0.50 to 1.15 nM in laying birds and 1.07 to 1.16 nM in nonlaying birds. The maximum binding capacity (Bmax) per milligram of membrane protein was 65.2 to 110.9 femtomoles (fmol) in laying birds and 105.8 to 120.6 fmol in nonlaying birds. Both Kd and Bmax values changed within the above range during an oviposition cycle in laying birds, showing a decrease during the period of eggshell formation. No change was found in nonlaying birds. The results suggest that PTH/PTHrP receptors are present in the shell gland of the guineafowl, and their binding may be related to eggshell formation.

Effect of estrogen replacement on temporomandibular joint remodeling in ovariectomized rats.

PURPOSE: The investigation was performed to elucidate the effect of estrogen on the temporomandibular joint (TMJ) and to evaluate the therapeutic effect of 17beta-estradiol replacement in growing rats. MATERIALS AND METHODS: Thirty 4-week-old female albino Wistar rats were divided into 3 groups. Ten rats were ovariectomized followed by intramuscular administration of 17beta-estradiol for hormone replacement (OVX + E2), 10 were sham operated (CTL), and 10 were ovariectomized without hormone replacement (OVX). Five rats from each group were killed at 1 and 2 weeks postoperatively, and the serum estrogen was determined to verify the adequacy of replacement. The temporomandibular joints of the age-matched sham-operated control and ovariectomized groups were histomorphometrically evaluated at the same periods. RESULTS: In OVX animals, the thickness of the articular soft tissue was increased by a concomitant increase of the transitional and cartilage zones in the anterior and posterior portions at 1 and 2 weeks postoperatively. However, the bone volume was decreased in the anterior and posterior portions at 2 weeks after the surgery and the condyle was flattened. Replacement with 17beta-estradiol restored most of the histomorphometric parameters. The thickness of articular soft tissue was increased in the anterior portion by an increase in the cartilage zone in the OVX + E2 group at 2 weeks postoperatively. Increase of bone volume was found at 2 weeks after hormone replacement with a corresponding increased osteoid surface and decreased quiescent surface in the central portion at 1 week postoperatively. A flattened condyle was still noted at 2 weeks postoperatively in the OVX + E2 animals despite the hormone replacement. CONCLUSIONS: Estrogen in a physiologic concentration may play an important role in TMJ remodeling. Progesterone may be indispensable for remodeling, particularly contributing to morphogenesis.

Changes in parathyroid hormone-related peptide receptor binding in the shell gland of laying hens (Gallus domesticus) during the oviposition cycle.

In this study, parathyroid hormone (PTH) receptor binding was examined in the membrane fraction of the endometrium of the shell gland of laying and nonlaying hens by the use of (125)I-PTH-related peptide (PTHrP) binding assays. Specific (125)I-PTHrP binding was found in the endometrium of the shell gland and increased during the first 1 h of incubation and then reached a plateau. Specific (125)I-PTHrP binding increased in line with an increase in protein concentration from 10 to 80 microg. The membrane fraction had specific binding to (125)I-PTHrP. The Scatchard plot analysis revealed a linear profile that indicated the presence of one type of receptor. The equilibrium dissociation constant (K(d)) and the maximum binding capacity (B(max)) in the shell gland decreased 19 h before oviposition in egg-laying hens and remained low for about 20 h during the period of calcification. In contrast, the K(d) and the B(max) in nonlaying hens were constant throughout a 24-h period. These results suggest that PTH acts on the endometrium of the shell gland during the eggshell calcification.

Prostaglandin F concentration in serum of hens and cocks.

Prostaglandin F (PGF) concentrations in the serum of laying and nonlaying hens and of cocks at various times during a day were measured by radioimmunoassay. The serum concentration of PGF was higher in laying hens than in nonlaying hens or cocks without regard to time of day. In all birds, the concentration showed a peak at 2 h after onset of light (0700 h). In laying hens on the day of laying the fourth egg of a sequence, two peaks were found: one at 2 h after onset of light and another at the time immediately after oviposition. The results suggest that the serum concentration of PGF in both male and female chickens shows a daily change and that in laying hens it also shows a change associating with oviposition.

Identification of an androgen receptor within the uterus of the domestic fowl.

Cytosolic and nuclear fractions of the uterus (shell gland) of the hen's oviduct were found to contain a specific [17alpha-methyl-3H]-methyltrienolone ([3H]R1881; a synthetic androgen) binding component having properties of an androgen receptor; i.e., binding specificity, high affinity, and limited capacity. The value of the equilibrium dissociation constant (Kd) was of the order of 10(-9), and did not differ between laying and nonlaying hens. The maximum binding capacity (Bmax) per gram of tissue of both fractions was greater in laying hens than in nonlaying hens. When 5alpha-dihydrotestosterone was administered exogenously, the Bmax of the cytosolic fraction decreased and that of the nuclear fraction increased without any change in Kd. The specific binding in both fractions was at an increased level from 4 to 11 h before oviposition, suggesting that androgen binding may be related to certain events during an early stage of shell formation in the uterus of laying hens.

Arginine vasotocin receptor in the vagina of the oviduct of the hen.

The presence of receptor for arginine vasotocin (AVT) in the vagina of the oviduct of the hen was demonstrated by the use of radioligand binding assays on membrane fractions of the tissue. The binding to [125I]AVT was highly competitive with unlabeled AVT. Scatchard analysis revealed that the binding sites are of a single class. The equilibrium dissociation constant (Kd) was 0.48+/-0.05 nM (x+/-SEM; n = 6) in laying hens holding a hard-shelled egg in the uterus (shell gland) and 1.01+/-0.02 nM (n = 6) in nonlaying hens. The maximum binding capacity (Bmax) was 0.41+/-0.04 pmol/mg protein (n = 6) in laying hens and 0.81+/-0.01 pmol/mg protein (n = 6) in nonlaying hens. The Kd value of the laying hens varied from 0.39 to 1.20 nM during an oviposition cycle, showing an increase just prior to oviposition, and the Bmax value also varied from 0.30 to 0.66 pmol/mg protein, showing a gradual increase after 6 h prior to oviposition. In the nonlaying hen, both values were almost constant during a 24-h day. The changes in the binding affinity and capacity of AVT receptor of the vagina may be related to oviposition in the hen.