[Intraoperative direct angiography for the diminutive central pulmonary artery in a patient with major aortopulmonary collateral arteries].

It can be difficult to judge the degree of arborization of diminutive central pulmonary arteries (cPA) in patients with major aortopulmonary collateral arteries (MAPCA). Even through preoperative cardiac catheterization may not give adequate information. We introduce intra-operative direct angiography of diminutive cPA for patients with MAPCA. This would be one of the good options to judge the degree of arborization of the diminutive cPA, and to decide an initial surgical treatment. In this case, unifocalization of MAPCA without patch augmentation of pulmonary arteries, and an aortopulmonary shunt were performed at the 1st procedure. As enough growth of the cPA was obtained, this patient did not require additional patch augmentation of the pulmonary artery at the time of complete repair.

Immunohistochemical study of pleomorphic adenoma of lacrimal gland.

Immunohistochemical examinations of lacrimal gland specimens were carried out with monoclonal antibodies to S-100 protein and glial fibrillary acidic protein (GFAP) in 3 cases of normal tissue, 2 cases of hypertrophy and 3 cases of pleomorphic adenoma of the lacrimal gland. In specimens of normal lacrimal gland tissue, S-100 protein was identified in myoepithelial cells and ductal epithelia, but GFAP was not identified in any part of the gland. In specimens of lacrimal gland hypertrophy, the findings were identical. In pleomorphic adenoma of the lacrimal gland, asteroid cells in the myxoid and/or chondroid areas were strongly stained by antibodies to both S-100 protein and GFAP. In the solid areas of pleomorphic adenoma specimens, S-100 protein-positive fusiform or round cells and GFAP-positive round cells were observed. It was thought that S-100 protein-positive cells could have originated from myoepithelial cells and that GFAP could be a tumor-associated antigen. These findings agreed with recent immunohistochemical findings in pleomorphic adenoma of the salivary gland. It was speculated that pleomorphic adenoma of the lacrimal gland could cause mesenchymal metaplasia of the myoepithelial cells, as happens in pleomorphic adenoma of the salivary gland.

[A case of localized histiocytosis X of the eyelid].

A case of localized histiocytosis X of the eyelid was reported. The patient was a 33 year-old man who had a tumorous lesion of the right lower eyelid that had not responded to antibiotic treatment. The lesion, accompanied with induration, slightly protruded on the conjunctival side, and the surface of the lesion was smooth and not ulcerative. No abnormal findings were noted by systemic and laboratory examination results. The patient underwent excision of the lesion and its surrounding tissue in the right lid. The specimen was fixed in formalin and embedded in paraffin. Histopathologic examination revealed diffuse infiltrates of many atypical histiocytes, which were immunohistochemically stained with antibodies to S-100 protein, lysozyme and Leu-M1. The diagnosis of localized histiocytosis X of the lid was made. It is possible that these atypical histiocytes may be classified as a category of T-zone histiocyte immunohistochemically. The postoperative course was uneventful and without recurrence.

[Immunohistochemical study of pleomorphic adenoma of the lacrimal gland].

We performed immunohistochemical examinations in 1 hypertrophy and 3 pleomorphic adenomas of the lacrimal glands with monoclonal antibodies to S-100 protein and GFAP (glial fibrillary acidic protein). It was thought that hypertrophy of the lacrimal gland would be cytological equivalent to normal lacrimal gland tissue because of the lack of cytological atypia except when accompanied by lymphoid infiltration. In hypertrophy of lacrimal gland, S-100 protein was identified in myoepithelial cells and parts of the ductal epithelia, but GFAP was not identified in any part. In pleomorphic adenomas of lacrimal glands, asteroid cells of myxoid and/or chondroid areas were strongly stained with both antibodies to S-100 protein and GFAP. In solid areas of pleomorphic adenomas, S-100 protein-positive fusiform or round cells and GFAP-positive round cells were observed. It was thought that S-100 protein-positive cells could have originated from myoepithelial cells and GFAP could be a tumor-associated antigen. The results coincided with recent immunohistochemical findings of pleomorphic adenoma of the salivary gland. It was suspected that pleomorphic adenoma of lacrimal gland could develop from mesenchymal metaplasia of myoepithelial cells as in the case of pleomorphic adenoma of salivary gland.

[A case of orbital hematic cyst].

A case of orbital hematic cyst is reported. The patient was a 3-year-old boy in whom swelling of the left upper lid and left exophthalmos appeared after blunt trauma in the region of the left eye. A hematoma was thought to be present from upper lid to the orbit. The hematoma was absorbed but the swelling of the eyelid and exophthalmos increased though more than seven days elapsed after the trauma. The existence of the cyst located from the upper lid to the orbital deep portion and collection of blood were confirmed during operation. Histopathologically the cyst consisted of thickened fibrogranulomatous tissue and the inner wall lacked endothelial or epithelial lining. The blood collected in the cyst hardly coagulated and was examined hematologically. Extreme delay of activated partial thromboplastin-time and prothrombin time, extreme decrease of fibrinogen and abnormal increase of fibrin degradation products were recognized. This indicated that the blood in the cyst had been in a localized accelerated fibrinolytic state. The results support the hypothesis of the mechanism leading to the enlargement of hematic cyst proposed by Pearson et al.

[c-erbB-2 oncogene product expression in lacrimal gland tumors].

Using a polyclonal antibody to the c-erbB-2 oncogene product (ErbB-2 protein), an immunohistochemical study on the expression of ErbB-2 protein in lacrimal gland tumors was performed. The expression of ErbB-2 protein was observed in 4 (33.3%) of 12 cases of pleomorphic adenoma, but was not in two cases of adenoid cystic carcinoma and one case of normal lacrimal gland. The immunohistochemical reaction was localized in the cell membrane and cytoplasm, and was more intense in the former. There were strongly stained cells in the epithelium of ductal cell lineage and in the solid area, and some of the cells in the myxoid/chondroid areas were weakly stained. The relation ErbB-2 protein with the malignant lacrimal gland tumors in general is not clear, but pleomorphic adenomas of lacrimal gland could have some relation with this protein.

[Venovenous extracorporeal membrane oxygenation in neonatal systemic artery-to-pulmonary artery shunt operations using a double lumen catheter].

The right atrium of the neonate may be too small for direct insertion of 2 venous catheters during intraoperative life support. We inserted a double lumen catheter into the right atrium, and venovenous (V-V) extracorporeal membrane oxygenation (ECMO) was instituted. The patient's arterial oxygen saturation was maintained at 70% to 90%, and hemodynamic stability was obtained during V-V ECMO. V-V ECMO using a double lumen catheter can be easily established in a small neonate, and is an effective support technique for untolerable hypoxemia during systemic-to-pulmonary artery shunt operations.

Identification and characterization of testis specific ornithine decarboxylase antizyme (OAZ-t) gene: expression in haploid germ cells and polyamine-induced frameshifting.

BACKGROUND: Polyamines are known to play important roles in the proliferation and differentiation of many types of cells. However, in the testis, where polyamines such as spermidine and spermine exist in high concentrations, their roles still remains to be elucidated. RESULTS: We have cloned a testis-specific gene encoding an ornithine decarboxylase antizyme known to control intracellular concentrations of polyamines in a feedback manner. The mRNA encoding the protein named ornithine decarboxylase antizyme in testis (OAZ-t) was specifically expressed in haploid germ cells. In contrast, the mRNA level of somatic ornithine decarboxylase antizyme 1 (OAZ1) decreased markedly at the late stages of haploid germ cell differentiation. OAZ-t mRNA was first observed in 23-day-old mice, whereas the OAZ-t protein was detected much later, at 35 days after birth. Further experiments on OAZ-t revealed that polyamines were capable of inducing a frameshifting at the frameshift sequence of OAZ-t mRNA, resulting in the translation of OAZ-t, as was the case with the somatic OAZ1. Transfection of OAZ-t cDNA inactivated the ornithine decarboxylase activity in the HEK293 cells. CONCLUSIONS: Results indicate that the expression of OAZ-t is controlled at both transcriptional and translational levels, and that OAZ-t likely plays a key role in spermatogenesis by regulating the intracellular concentration of polyamines in haploid germ cells.

Identification and characterization of a haploid germ cell-specific nuclear protein kinase (Haspin) in spermatid nuclei and its effects on somatic cells.

We have cloned the entire coding region of a mouse germ cell-specific cDNA encoding a unique protein kinase whose catalytic domain contains only three consensus subdomains (I-III) instead of the normal 12. The protein possesses intrinsic Ser/Thr kinase activity and is exclusively expressed in haploid germ cells, localizing only in their nuclei, and was thus named Haspin (for haploid germ cell-specific nuclear protein kinase). Western blot analysis showed that specific antibodies recognized a protein of Mr 83,000 in the testis. Ectopically expressed Haspin was detected exclusively in the nuclei of cultured somatic cells. Even in the absence of kinase activity, however, Haspin caused cell cycle arrest at G1, resulting in growth arrest of the transfected somatic cells. In a DNA binding experiment, approximately one-half of wild-type Haspin was able to bind to a DNA-cellulose column, whereas the other half was not. In contrast, all of the deletion mutant Haspin that lacked autophosphorylation bound to the DNA column. Thus, the DNA-binding activity of Haspin may, in some way, be associated with its kinase activity. These observations suggest that Haspin has some critical roles in cell cycle cessation and differentiation of haploid germ cells.