Evidence for a Square-Square Vortex Lattice Transition in a High-T_{c} Cuprate Superconductor.

Using sound velocity and attenuation measurements in high magnetic fields, we identify a new transition in the vortex lattice state of La_{2-x}Sr_{x}CuO_{4}. The transition, observed in magnetic fields exceeding 35 T and temperatures far below zero field T_{c}, is detected in the compression modulus of the vortex lattice, at a doping level of x=p=0.17. Our theoretical analysis based on Eilenberger's theory of the vortex lattice shows that the transition corresponds to the long-sought 45° rotation of the square vortex lattice, predicted to occur in d-wave superconductors near a van Hove singularity.

Anisotropy of the superconducting state in Sr2RuO4.

Despite intense studies the exact nature of the order parameter in superconducting Sr2RuO4 remains unresolved. We have used small-angle neutron scattering to study the vortex lattice in Sr2RuO4 with the field applied close to the basal plane, taking advantage of the transverse magnetization. We measured the intrinsic superconducting anisotropy between the c axis and the Ru-O basal plane (~60), which greatly exceeds the upper critical field anisotropy (~20). Our result imposes significant constraints on possible models of triplet pairing in Sr2RuO4 and raises questions concerning the direction of the zero spin projection axis.

Sign reversal of field-angle resolved heat capacity oscillations in a heavy Fermion superconductor CeCoIn5 and d{x{2}-y{2}} pairing symmetry.

To identify the superconducting gap symmetry in CeCoIn5 (T{c}=2.3 K), we measured the angle-resolved specific heat (C{phi}) in a field rotated around the c axis down to a very low temperature, 0.05T{c}, and made detailed theoretical calculations. In a field of 1 T, a sign reversal of the fourfold angular oscillation in C{phi} was observed at T approximately 0.1T{c} upon entering a quasiclassical regime where the maximum of C{phi} corresponds to the antinodal direction, coinciding with the angle-resolved density of states (ADOS) calculation. The C{phi} behavior, which exhibits minima along the [110] directions, unambiguously allows us to conclude d{x{2}-y{2}} symmetry of this system. The ADOS-quasiclassical region is confined to a narrow T and H domain within T/T{c} approximately 0.1 and 1.5 T (0.13H{c2}).

Expression of connexin32 and connexin43 gap junction proteins and E-cadherin in human lung cancer.

We used immunohistochemical staining to examine the expression of the gap junction proteins connexin32 and connexin43 and of the intercellular adhesion molecule, E-cadherin, that is thought to be a prerequisite for gap junctional intercellular communication (GJIC), in 24 specimens of human lung cancer. Connexin32 was not found in cancer tissue and there were significantly fewer spots of connexin43 in the poorly differentiated versus the well differentiated (P = 0.0005) and moderately differentiated (P = 0.0002) adenocarcinomas and in the poorly differentiated versus the well differentiated (P = 0.0182) and moderately differentiated (P = 0.004) squamous cell carcinomas of the lung. E-Cadherin was expressed in all but three cases of poorly differentiated non-small cell lung cancer that showed a heterogeneously decreased expression of E-cadherin. These findings suggest that GJIC is decreased in poorly differentiated non-small cell lung cancer.

Protein, cell, and LTB4 concentrations of lung edema fluid produced by high capillary pressures in rabbit.

We previously demonstrated disruptions of the pulmonary capillary endothelium and alveolar epithelium at transmural pressures (Ptm) of 52.5 cmH2O in rabbit by electron microscopy. In the present study, we determined the characteristics of the alveolar edema fluid in this condition by carrying out bronchoalveolar lavage after blood perfusion for 10 min at Ptm of 12.5 (low), 32.5 (intermediate), and 52.5 cmH2O (high). At low Ptm, where our previous studies showed no ultrastructural changes, the volume of alveolar fluid obtained by urea dilution was very small, and the concentrations of proteins, cells, and leukotriene B4 (LTB4) in the bronchoalveolar lavage fluid (BALF) were low. However, at high Ptm the volume of alveolar fluid and the concentrations of total protein and cells in the BALF were greatly increased. The amount of LTB4 in the BALF also increased substantially from 6.0 to 49.5 micrograms (P < 0.001). Intermediate changes were seen at intermediate Ptm. We concluded that exposing pulmonary capillaries to high Ptm results in a high-permeability form of edema. In addition, the presence of LTB4 suggests that chemical mediators are released, possibly as the result of exposure of the reactive capillary endothelial basement membrane, as demonstrated by electron microscopy.

Quantitative relations between noxious stimulus intensity and magnitude of central afferent evoked responses in rat.

Relations between intensities of electrical noxious stimulus applied to the tooth pulp and magnitudes of evoked responses at various relay stations of tooth pulp afferents were investigated with lightly anesthetized rats. The stimulus-response function in each relay station and the cerebral cortex follows the power function only in the range of lower, but noxious, stimulus intensities; however, it deviates from it in the range of higher ones, the exponent of the function becoming smaller. The higher the relay station locates, the smaller the exponent value is.

Relationship between apoptosis and immunohistochemical staining for proliferating cell nuclear antigen and Ki-67 in non-small cell lung cancer.

The relationship between apoptosis and cellular proliferative activity in human non-small cell lung cancer (25 cases) was investigated using the in situ DNA nick-end labeling method and immunohistochemistry for both proliferating cell nuclear antigen (PCNA) and Ki-67 antigen. Comparison of the distribution of Ki-67-positive cells to that of apoptotic cells shows an inverse correlation in semi-serial sections. The PCNA labeling rates were closely correlated with Ki-67 labeling rates in non-small cell lung cancer. It was concluded that the immunostainings of PCNA and Ki-67 were almost equally valuable for assessing the proliferative activity in paraffin-embedded tissue from non-small cell lung cancer and that apoptosis may be related with the cell cycle in this cancer.

A new variant of alpha-1-antitrypsin deficiency (Siiyama) associated with pulmonary emphysema.

A 38-year-old male with pulmonary emphysema due to severely reduced serum alpha-1-antitrypsin (AAT) level (14.5 mg/dl) was found to have an inherited new AAT deficient variant Siiyama. Chest roentgenogram and CT scanning revealed advanced emphysema, and severe obstructive ventilatory impairment was observed. During the 4-year follow-up period, the annual rate of decline of FEV 1.0 showed approximately 10-fold greater than the normal decline in FEV 1.0 (-380 ml/yr). Treatment with tamoxifen in order to raise the serum AAT level only resulted in an insufficient increase. Augmentation therapy of human AAT should be considered in the future.

[Interleukin-2 (IL-2) in active pulmonary tuberculosis].

To clarify the precise of cellular immunity mechanism in pulmonary tuberculosis, we investigated the amount of IL-2 in patients with untreated active pulmonary tuberculosis. When serum adenosine deaminase (ADA) activity was examined using enzyme assay, an abnormally high level was observed in all patients (29.0 + 11.6 IU/ml, mean + SD; 4.5-17.8, normal range). Likewise, the level of serum-soluble interleukin-2 receptor (IL-2R) measured by ELISA showed abnormal high level in all patients (844.3 + 584.8 IU/ml; 80-300, normal range). When stimulated using PHA, the peripheral lymphocyte's ability to produce IL-2 revealed no difference between control subjects and patients. It was, however, noted that the lymphocytes of the patients significantly suppressed IL-2 responsiveness when compared to the control subjects (P less than 0.05). The serum IL-2 concentration measured using RIA could not be detected in any of the patients as was the same for control subject. All of the above mentioned results suggest that T-cell activation which caused increment in serum ADA activity and soluble IL-2R occurred in active pulmonary tuberculosis. The suppressed IL-2 responsiveness in the peripheral lymphocytes of patients proposes the possibility of soluble IL-2R reduction by the negative feedback mechanism in IL-2-sensitive lymphocytes.

[Exercise test in respiratory system].

A ramp exercise test was thought to be adequate especially for evaluation of patients with respiratory system diseases. First, we told about the significances, the methods and apparatus, the arrangements for workload and the matters that demand special attentions of this exercise test. Next, various indices which were obtained during ramp exercise and the estimations of them were explained. Furthermore, we referred to the exercise-limiting factors for patients with COPD and pulmonary fibrosis as symmetrical respiratory system diseases.

[Exercise test in patients with pulmonary diseases].

To assess the clinical utility of a ramp exercise test in patients with pulmonary diseases, the gas exchange variables from normal volunteers and patients with pulmonary diseases during ramp exercise were compared to those during steady-state exercise. Measurements during ramp exercise could titrate the extent of the patients' maximal exercise as well as the adequate performance of parameters in gas exchange coupling. There were no significant differences in the four variables achieved between the two exercises. These gas exchange variables during ramp exercise made it possible to predict the exercise-limiting factors for patients with COPD and pulmonary fibrosis. Furthermore, a ramp exercise test could be performed safely even in patients with severe lung diseases and required a shorter period than a steady state exercise test. Thus, a ramp exercise test is thought to be useful in the evaluation of patients with pulmonary diseases.

[Aggressive transformation and extramedullary tumor formation in IgA-lambda multiple myeloma].

A 52-year-old woman complained of lower back pain and gluteal pain in April 1997, and was found to have anemia, hypercalcemia and renal disorder. In September of the same year, she was diagnosed as having IgA-lambda myeloma (stage IIIA). VMMD-IFN therapy was started in November, 1997, and this resulted in improvement of the M-protein level, and relief of the pain in the lower back and gluteal region. A second course of VMMD-IFN therapy was also effective. In April 1998, however, the back pain worsened, and in July the patient suffered a fall and fractured her left femur. Upon readmission to our hospital, the level of M-protein was lower, and high fever, hypercalcemia, renal disorder, elevation of the LDH level, anemia and thrombocytopenia were observed. Bone marrow examination revealed 30% atypical large-sized CD19-, CD38+, CD56+ myeloma cells and chromosomal abnormalities. Although the symptoms were improved temporarily after a third course of VMMD therapy, disease aggravation occurred again, and extramedullary masses appeared on the head, face and pelvis. VAD therapy was performed without effect, and the patient died about 2 months after recurrence. This was a comparatively rare case of fulminant multiple myeloma occurring in the terminal stage.

[Pneumonitis induced by the drug ougon].

We report a case of drug-induced pneumonitis associated with the herbal medications Sho-saiko-to and Ouren-gedoku-to. A 62-year-old man experienced fever and dry cough after using Ouren-gedoku-to for 2 months. He was admitted to our hospital because a subsequent 5-day course of Sho-saiko-to for suspected bronchitis aggravated these symptoms and caused exertional dyspnea. Chest X-ray films revealed a ground-glass appearance in both lower lung fields. Cessation of these medications improved the patient's clinical and X-ray findings. Bronchoalveolar lavage showed an increase in lymphocytes with a decreased CD 4/CD 8 ratio. While drug-induced lymphocyte stimulation tests gave negative results, challenge tests for Ouren-gedoku-to and Sho-saiko-to were both positive. A diagnosis of drug-induced pneumonitis was made. Our findings suggested the involvement of Ougon, the only common ingredient in the two medications.

[Chronic hypersensitivity pneumonitis due to isocyanate in a patient presenting with acute symptoms 1 month after environmental exposure].

A 51-year-old man who had been working for 10 years with polyurethane paint containing isocyanate (MDI) was admitted to our hospital with complaints of fever and exertional dyspnea. Fine crackles were heard in both bases, and the patient had clubbed fingers. A chest X-ray film and computed tomograms of the lungs revealed patchy infiltrative shadows in both lung fields and subpleural honeycombing associated with irregular linear areas. Examination of bronchoalveolar lavage fluid showed increased T lymphocytes and a decreased CD 4/8 ratio. Specimens obtained by transbronchial lung biopsy revealed lymphoplasmacytic infiltration into the thickened alveolar walls, macrophage accumulation, and micro-epithelioid cell granulomas in the alveolar sacs. Hypersensitivity pneumonitis was suspected although the causative antigen was not identified because the results of short-term environmental provocation tests were negative in the patient's home and workplace. After discharge, the patient continued working as a paint sprayer. His acute symptoms recurred 1 month after exposure to isocyanate. Similar episodes occurred on two separate occasions. In addition, the patient tested positive for antibody to MDI-HSA in bronchoalveolar fluid. From the above observations, the patient was given a diagnosis of chronic hypersensitivity pneumonitis due to isocyanate (MDI). This condition is extremely rare. Furthermore, it is interesting that acute symptoms recurred 1 month after environmental exposure to the causative antigen.

[Dental device (sleep splint)].

Sleep splint, which is a dental device made of regin, is now widely used for the treatment of obstructive sleep apnea in our country. This device is worn in the mouth at night and makes the upper airway opened during sleep. It enlarges the velopharyngeal space as well as the space at the tongue base and prevents the collapse of the upper airway. This device is a treatment of choice for the patients with mild or moderate types of obstructive sleep apnea who are not treated ordinarily by nasal CPAP. When the patients have nasal obstruction, adenoid hypertrophy, enlarged tonsils, or improper conditions of the teeth, sleep splint is not indicated for those patients. At first, nasal obstruction should be treated, and the adenoids and enlarged tonsils should be removed surgically. The compliance of this treatment is better than that of nasal CPAP, and the major complication of this treatment is almost none.