[Biventricular repair with end-to-side aorta to pulmonary artery central shunt for ventricular septal defect, severe pulmonary stenosis with hypoplastic pulmonary artery].

The case was 11-month-old girl diagnosed as tetralogy of Fallot with severe pulmonary valve stenosis and suffering from severe cyanosis. A catheter study demonstrated pulmonary artery (PA) was well arborized, but severely hypoplastic in spite of previous transcatheter pulmonary valve dilatation; PA index was calculated as 69 mm²/m². A central end-to-side aorta to PA shunt was created. Cyanosis was well improved, but congestive heart failure occurred after 1 month from the operation. Subsequent catheter study demonstrated pulmonary artery growth, 166 mm²/m² of PA index and major aortopulmonary collateral artery (MAPCA) coil embolization was performed. Patient underwent Rastelli type definitive repair 9 month after palliation. The central end-to-side aorta to PA shunt is reported as useful measure for promoting PA size increase and definitive repair achievement in patient with pulmonary atresia, ventricular septal defect and severely hypoplastic PA. Appropriate consideration of criteria, carefull follow up and treatments are necessary.

Primary surgical correction of transposition of the great arteries and atrioventricular septal defect associated with left isomerism.

We report successful primary surgical repair of transposition of the great arteries (TGA) and complete atrioventricular septal defect (AVSD) associated with left isomerism {I,L,L} without pulmonary obstruction in a 1-month-old infant. The operative procedure consisted of an arterial switch and a two-patch repair of the AVSD. To the best of our knowledge, this is the first report of successful primary surgical repair of TGA and AVSD with left isomerism. Primary anatomic correction of this defect combination is feasible in patients with left isomerism.

Double aortic arch associated with common inlet left ventricle.

A double aortic arch is usually an isolated abnormality. We report a case with a previously undescribed combination of double aortic arch and common inlet left ventricle. The patient underwent division of the nondominant right aortic arch and the right ductus arteriosus at 2 months of age following a left modified Blalock-Taussig shunt. At 3 years of age, extracardiac total cavopulmonary connection was successfully performed via bidirectional cavopulmonary anastomosis.

Size hierarchy and stability in competitive plant populations.

A neighbourhood-based competition model for plant individuals is studied to evaluate how a hierarchical structure related to size may emerge in plant communities. It is shown by numerical simulations and linear stability analysis that many stable states exist in the hierarchical structure when both the total number of individuals and the degree of asymmetry of competition are high. When the hierarchical structures are self-organized by the dynamic instability of the homogeneous state due to non-linearity of competition, it is proved that these states are always locally stable. The relevance of the results to size structures in real plant communities (boreal forests vs tropical and temperate forests) is discussed. This is suggested to be the mechanism responsible for the coexistence of species in plant communities.

Spatial light modulators for projection displays.

Spatial light modulators (SLM's) consisting of a polymer-dispersed liquid crystal (PDLC) film and a Bi(12)SiO(20) photoconductor are discussed and demonstrated. This device, which uses light scattering in the PDLC film, has several advantages including no polarizer, a low optical loss, and video-rate operation. The device was designed by use of an electrical-image method. High-definition SLM's with a limiting resolution (36-50 line pairs/mm) were fabricated by stacking of an optimized mirror and the PDLC film. The device, which was incorporated into a Schlieren system with a 1-kW xenon lamp, provided high-contrast video images and a total luminous flux of 1000 lm.

Acute fulminant ulcerative colitis with toxic megacolon.

An 11-year-old boy with acute fulminant ulcerative colitis (UC) is presented. He had systemic deterioration with frequent diarrhea and lethargy. Acute fulminant UC associated with toxic megacolon was diagnosed by rectal endoscopy and biopsied specimen. He was treated with intensive intravenous administration of prednisolone and total parenteral nutrition. He recovered completely without any surgical intervention.

In-situ pulmonary vascular morphology and lung volume in the fetal and neonatal rat.

In situ cross-sectional morphology of the pulmonary arteries, veins, and lung volumes were studied following rapid whole-body freezing of the fetal and neonatal rat. In the fetus, the right and left main pulmonary arteries were much smaller than the pulmonary trunk, and the ratio of the internal diameter of the right or the left pulmonary artery to the diameter of the pulmonary trunk was 0.44 and 0.38, respectively. One day after birth, the right and the left main pulmonary arteries enlarged, and the ratio of the right pulmonary artery to the pulmonary trunk increased to 0.82. The proximal right and left pulmonary arteries immediately adjacent to the bifurcation enlarged slowly, and showed diffuse narrowing at the proximal portions adjacent to the bifurcation. The narrowing disappeared 3 and 4 days after birth as the proximal pulmonary artery enlarged and the ratio of the right pulmonary artery to the pulmonary trunk reached 0.8. The pulmonary vein showed rapid enlargement in these neonates, concordant with the enlargement of the pulmonary arteries. Lung volume increased to 131% of the fetal volume 10 min after caesarean section. These studies quantitated neonatal pulmonary vascular adaptation. Delayed enlargement of the pulmonary arteries adjacent to the bifurcation in the neonatal period was shown, and presented a morphologic basis for the physiologic gradient and transient systolic murmur in the pulmonary arteries in human neonates.

[Acute nongonococcal epididymitis--pharmacological and therapeutic aspects of levofloxacin].

We performed basic and clinical studies on the effects of a new oral quinolone derivative, levofloxacin (LVFX, Code No. DR 3355) which is an optical l-isomer of ofloxacin, in acute epididymitis. LVFX was administered in a dose of 200 mg to prostatic cancer patients 2 hours before operation. The mean concentration of LVFX in the tissues of testis and epididymis were 4.73 micrograms/g and 313-3.6 micrograms/g, respectively. Tissue/Serum ratios were 1.63 and 1.16-1.32, respectively. LVFX was administered in a dose of 100 mg three times daily for 13 days to healthy male volunteers. Semen and blood samples were taken 2 hrs after 7th and last day of administration. The concentration of LVFX in semen were 1.19 micrograms/ml (7th day) and 1.32 micrograms/ml (13th day). Semen/serum ratios were 1.12 and 1.26, respectively. No affection of LVFX on the sperm was observed. Antimicrobial activity of LVFX to C. trachomatis showed good MICs of 0.25-1.0 micrograms/ml. LVFX was administered in a dose of 100 mg two or three times daily for 14 days to 23 patients with acute epididymitis. The overall efficacy rate based on a criteria for acute epididymitis showed 100% (excellent: 16, good: 4, 20/20). A better efficacy rate was obtained on the 14th day than 7th day. No subjective or objective adverse reactions were observed.

[Bacteriological and clinical studies on levofloxacin in male gonococcal urethritis].

We performed basic and clinical studies in male gonococcal urethritis on a new oral antimicrobial agent, levofloxacin (LVFX, DR-3355), a new quinolone derivative. The antibacterial activity of LVFX against clinical strains of Neisseria gonorrhoeae was roughly comparable to that of ofloxacin, and ciprofloxacin. LVFX was administered to 10 males with gonococcal urethritis, 200 mg twice a day (8 cases) or 100 mg twice a day for 3 days (2 cases). Clinical evaluation was made according to the criteria of the Japanese UTI Committee. Overall efficacy rate was 100% (10/10). In the complication of chlamydia trachomatis (2 cases), efficacy rate was 100% (2/2). No subjective or objective adverse reactions occurred.

[Establishment and characterization of strain KE-24 derived from human colonic cancer].

Strain KE-24 of colonic cancer cells was established from human colonic cancer diagnosed histopathologically as poorly differentiated adenocarcinoma. Doubling time of the cancer cell line was 32.4 hrs, and the karyotype was 46, xy, t (1q:?), 6p-, 14q+. The cancer cells could be heterotransplanted in 66% of nude mice. The plating efficiency was 17% in a soft agar plate with an inoculum size of 1 x 10(3) cells/dish. The tumor cells produced and released CEA and CA19-9 in the spent medium and these cancer cells were stained with both anti-CEA and anti-CA19-9 antibodies by the immunohistological staining method. Strain KE-24 of the cancer cells could be cultured in the serum-free medium (Media-I) for more than 100 passages.

[Bacteriological and clinical studies on fleroxacin in male gonococcal urethritis].

We performed basic and clinical studies on the effects of a new oral antimicrobial agent, fleroxacin (FLRX), a new quinolone derivative in male gonococcal urethritis. The antibacterial activity of FLRX against clinical strains of Neisseria gonorrhoeae was roughly comparable to that of norfloxacin and ofloxacin. FLRX was administered to 58 males with gonococcal urethritis. Two different schedules of administration were adopted. One was a single-dose of 300 mg given orally (17 cases) and the other was the oral administration of 200 mg once a day for 3 to 10 days (41 cases). Clinical evaluation was made according to the criteria of the Japanese UTI Committee. The overall efficacy rate was 98% (49/50). For complications of Chlamydia trachomatis (11 cases), the efficacy rate was 90.9% (10/11). No subjective or objective adverse reaction occurred.

[A basic study on cefpirome].

The antibacterial activity of cefpirome (CPR), a new parenteral cephalosporin antibiotic having a cyclopentenopyridine group in the 3-position side chain, was evaluated against Neisseria gonorrhoeae and concentrations in human kidney and prostate was determined. The minimum inhibitory concentrations (MICs) of CPR against N. gonorrhoeae isolated clinically in our out-clinic (34 strains of non-PPNG and 20 of PPNG) were less than or equal to 0.003-0.1 microgram/ml in non-PPNG group and 0.006-0.1 microgram/ml in PPNG group. The 90% of MICs (MIC90s) was 0.1 microgram/ml in the non-PPNG group and 0.05 microgram/ml in the PPNG group. The concentration in the prostate was determined in 30 cases with benign prostatic hypertrophy. The maximum values was 52.8 micrograms/g at 15 minutes after administration of 1 g of CPR. The levels of CPR were gradually decreased with the lapse of time. The prostatic tissue concentration was 17.9 micrograms/g at 60 min., 10.1 micrograms/g at 180 min., 7.22 micrograms/g at 320 min. and 2.70 micrograms/g at 360 min. There was a positive correlation between concentration of the prostate and plasma collected at the time of the prostate. The concentration of CPR in human kidney, 90-100 min. after administration of 1 g to 4 cases with renal tumor, was 107-148 micrograms/g in the renal cortex, and 80.6-88.6 micrograms/g in the renal medulla. The concentration in kidney was higher than that in the plasma in all cases. In conclusion, CPR is suggested to be a useful drug for urological infection.

[Clinical evaluation of doxycycline in the treatment of Chlamydia trachomatis infections].

Thirty male patients with nongonococcal urethritis and 7 female patients nongonococcal cervicitis were treated with 200 mg doxycycline (DOXY) daily over a period of 7 days. The microbiological cure rate in infections with C. trachomatis was 92.9% with the clinical effectiveness rate being 92.9%. The clinical effectiveness rate in nonchlamydial urethritis was 63.6%. There were no statistically demonstrable difference in clinical outcome between the group of the C. trachomatis positive patients and the C. trachomatis negative patients, both treated with DOXY. Side effects were observed in 2 cases (5.4%) who complained of gastrointestinal disorder, but no dizziness was observed.