Anabolic response of mouse bone-marrow-derived stromal cell clone ST2 cells to low-intensity pulsed ultrasound.

The effects of 20-min exposure to low-intensity, pulsed ultrasound were investigated in ST2 cells of bone marrow stromal origin. They responded to ultrasound with elevated levels of IGF mRNAs, osteocalcin, and bone sialoprotein mRNAs. The upregulated expression of these messages appeared in a biphasic manner, with the first peak resistant to the protein synthesis inhibitor cycloheximide, and a second peak that was eliminated by NS398, an inhibitor of the inducive prostaglandin G/H synthase (cyclooxygenase-2). A cumulative effect of mechanical loading called the memory effect, which has been observed in vivo, can be explained from such a biphasic anabolic reaction mediated by prostaglandins. The upregulation of IGF or osteocalcin mRNAs can be observed even at 24 h after the initiation of the 20-min exposure to ultrasound. Our results suggest that this low-intensity, pulsed ultrasound, which has been clinically used to accelerate the healing processes of fractured bone, induces a direct anabolic reaction of osteogenic cells, leading to bone matrix formation.

[Surgery for metastatic brain and spinal tumor from colorectal cancer].

UNLABELLED: The results of invasive treatment of brain metastasis of colorectal cancer (6 cases) and spinal metastasis of colorectal cancer (3 cases), aimed at alleviating the symptoms, were analyzed. In all 6 cases of brain metastasis, metastases were also found in some other remote sites (often the liver). The average period from resection of the primary lesion to resection of the brain metastasis was 3 years and 3 months for this group. Of these 6 cases, 5 had cerebral metastasis and 1 had cerebellar metastasis. The preoperative performance status (PS) was 1 in 1 case and 2 in 5 cases. After surgery, the PS improved in all 6 cases, allowing all the patients to be discharged. There was only one patient whose death was attributable to brain metastasis. In all 3 cases of spinal metastasis, metastases were also detected in the lungs or liver (synchronous in) 1 case, metachronous in 2 cases). The preoperative PS was 2 in 1 case, 3 in 1 case and 4 in 1 case. After surgery, the PS improved in 2 cases. One of the three patients is still alive. CONCLUSION: The results of this study suggest that it is not impossible to improve the QOL of patients with brain or spinal metastasis of cancer by surgical intervention, although the response may vary from patient to patient.

[Relation between calcaneal bone mass and lifestyles in young adult women. Influence of experience of delivery and months post delivery].

The aim of this study was to clarify the cross-sectional relation between calcaneal bone mass and lifestyles in healthy pre-menopausal young adult women classified by the experience of pregnancy and the months after delivery. The 457 healthy Japanese women aged 20-39 years living in an urban community underwent a health check up for osteoporosis. Calcaneal bone was measured by ultrasound using the Lunar Achilles, and stiffness was used as an index of bone mass. The information on pregnancy, delivery and lactation, and lifestyles including past and current exercise and frequency of food consumption were collected by a questionnaire. In addition, two-day dietary records were obtained to assess the nutrient intake, and seven-day walking records as an index of physical activities. These subjects were divided into 3 groups according to the experience of pregnancy, and the time after delivery (subgroups of no experience of pregnancy, 12-35 months post-delivery and 36 months or more post-delivery), and the relation between stiffness index and lifestyle factors was examined in the 3 groups. 1) Stiffness correlated significantly with experience of pregnancy, age at menarche, current exercise and frequency of intake of dairy products. 2) In the group without experience of pregnancy, stiffness in women with current exercise habit was significantly higher than women without the habit. Those with past exercise habit, current milk consumption and current calcium intake showed relatively greater stiffness. 3) In the 12-35 months post-delivery group, there was no relation of past and current physical activity to stiffness. For women whose frequency of milk consumption or daily calcium intake were high, the stiffness was significantly greater. In addition, past milk consumption and current frequency of dairy products consumption tended to show higher stiffness. 4) In 36 months or more post-delivery group, women with current exercise habit exhibited significantly higher stiffness than women without the habit. Low calcium intake tended to show low stiffness. These results indicated that the effects of lifestyle on calcaneal bone mass were different depending on the experience of pregnancy and the months after delivery in pre-menopausal young adult women.

Pregnant women with transient gastric obstruction managed by Naso-Jejunal nutrition.

A pregnant woman with transient gastric obstruction was fed by enteral nutrition alone for 11 wk and 6 d. Her body mass index of 23.2 kg/m2 before pregnancy declined to 21.8 kg/m2 after delivery. Although she did not gain weight during enteral nutrition, fetal growth, estimated by ultrasonography, was normal, and she delivered a 3030-g female infant at 38 wk gestation. The blood laboratory data during pregnancy and the breast milk after pregnancy were also normal. The results suggest that factors other than maternal weight gain alone should be considered in the evaluation of nutritional status for the pregnant woman.

[A case of giant mesothelioma from visceral pleura which has feeding artery from pulmonary artery].

55-year-old woman was admitted to our hospital for cough. Chest X-ray films showed a giant tumor shadow in right anterior pleural cavity. Pulmonary arteriography showed a feeding artery from the branch of right superior trunk. We diagnosed the tumor might be mesothelioma from visceral pleura with stalk. We operated the patient and the tumor was turned out to be mesothelioma pathologically. The patient had a postoperative re-expansion pulmonary edema and recovered in a week. She lives well without recurrence for 3 years 8 months.

[A case of mediastinal cystic lymphangioma with bloody fluid].

A 53-year-old woman was admitted to our hospital for chest abnormal shadow. Chest CT showed a mediastinal cyst. Tumor resection was performed and the cyst turned out to be a cystic lymphangioma with bloody fluid. There were many lymphocytes in the fluid. She lives well without recurrence.

Cloning and characterization of pejerrey mitochondrial DNA and its application for RFLP analysis

Probes were cloned, characterized, and developed for all regions of the mitochondrial DNA (mtDNA) of pejerrey Odontesthes bonariensis to provide the basis for the study of genetic diversity of South American atherinopsinii and to enable species identification from small amounts of tissue. The mtDNA was extracted from liver and cleaved with Eco RI, producing four fragments (7·4, 3·4, 3·1 and 2·9 kb) which were cloned using pUC118 plasmid vectors. Sequence analysis from both ends of the fragments showed that they encode tRNA (Asp, Phe, and Ser-TGA), 12 S rRNA, cytochrome oxidase (CO) II, NADH 4, 5, and 6, and the d-loop, and that the relative positions of these genes are identical to those in the mtDNA of other teleosts. A comparison of homology with carp mtDNA nucleotide sequences revealed that tRNA (Phe and Ser-TGA) and CO II were relatively conserved, whereas the d-loop region was highly divergent. The cloned mtDNA probes detected mtDNA fragments from about 800 ng of total DNA extracted from liver, muscle, and single embryos of O. bonariensis, and were effective for restriction length fragment polymorphism (RFLP) analysis of Patagonina hatcheri, the most distant atherinopsine relative of pejerrey. The cloned mtDNA probes may be useful for the analysis of genetic diversity and non-destructive species identification, including the examin-ation of eggs, larvae and juveniles. The mtDNA sequences reported here provide the basis for the design of primers for PCR-based RFLP analysis. 1997 The Fisheries Society of the British Isles

[A case report of anterior mediastinal cystic lymphangioma].

Fourty seven years old woman came to our hospital for further examination of incidentally found abnormal chest shadow. Chest US examination revealed lobulated cystic mass. The cyst wall was thin and smooth. Chest computed tomography showed water density cystic mass. Preoperative diagnosis was pericardial cyst. Operation was done. Lobulated cyst was attached to pericardium and diaphragma. Though adhesion to the pericardium was loose, adhesion to the diaphragma was tight. To achieve complete resection of the cyst, partial resection of the diaphragma was needed. Postoperative course was uneventful. Cystic lymphangioma is benign but complications such as infection or bleeding were reported. Then complete resection of the cyst should be done.

A protein kinase inhibitor H-7 induces process extrusion in fetal rat thyroid C-cells in vitro.

Calcitonin-producing cells (C-cells) are endocrine cells derived from the neural crest. We examined the effects of three types of protein kinase inhibitors on the induction of neuronal phenotypes in the rat thyroid C-cells in vitro. In a primary culture of 16-day-old fetal rat thyroid glands, 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H-7, 25-75 microM) induced both process extrusion and expression of highly polysialylated neural cell adhesion molecule (NCAM) in the C-cells. These effects of H-7 were completely prevented by okadaic acid, a potent protein phosphatase inhibitor. In contrast to H-7, selective inhibitors for cyclic nucleotide-dependent protein kinases such as N-(2-guanidinoethyl)-5-isoquinolinesulfonamide hydrochloride (HA1004, 25-200 microM) and N-[2-(p-bromocinnamylamino)ethyl]-5-isoquinolinesulfonamide (H-89, 0.25-20 microM) failed to induce process extrusion or the expression of highly polysialylated NCAM in fetal rat C-cells. In cultured C-cells of adult origin, H-7 failed to induce marked process elongation or the expression of highly polysialylated NCAM. These results suggest that the morphological plasticity of the fetal C-cells depends upon the degree of phosphorylation of some proteins, and that the plasticity of adult C-cells are more restricted than that of fetal origin.

Developmental change in expression of highly polysialylated neural cell adhesion molecule in C-cells in rat thyroid gland.

The expression of the neural cell adhesion molecule (NCAM), highly polysialylated NCAM, and E-cadherin was immunohistochemically studied in the calcitonin-producing cells (C-cells) of developing and adult rat thyroid glands of varying ages. In fetal and neonatal rat thyroids, almost all the C-cells displayed immunoreactivity for highly polysialylated NCAM, whereas most of the follicular cells were negative. The highly polysialylated NCAM-positive C-cells markedly decreased in number between 5 and 14 days after birth. From day 14 onward, immunoreactivity for highly polysialylated NCAM was almost negative in thyroid glands. On the other hand, the expression of immunoreactivity for NCAM peptide persisted in thyroidal C-cells throughout the life span. These results suggest that conversion of the highly polysialylated NCAM into a less sialylated form occurs in the thyroid C-cells between postnatal days 5 and 14. Intense immunoreactivity for E-cadherin was observed in the entire cell surfaces of all the C-cells and follicular cells in the rats of all ages tested. In the course of thyroid organogenesis, C-cells transiently form a cell mass, an ultimobranchial body, which is fated to disappear as the C-cells migrate diffusely into the thyroid. The duration of the polysialic acid expression in the C-cell surfaces appears to coincide with the period of C-cell migration. It is possible that the expression of highly polysialylated NCAM allows the C-cells to migrate into the thyroid by reducing the cell-to-cell adhesion of C-cells with adjacent C-cells and/or with the surrounding follicular cells.

[Chest wall Castleman's disease with massive pleural effusion].

A 38-year-old woman was admitted to our hospital due to dyspnea. A chest X-ray film showed a right-sided chest wall tumor and a massive pleural effusion. A sharply defined round tumor, 5 cm in diameter, was seen on a chest CT scan; this tumor was strongly stained by contrast medium. Angiography showed a feeding artery and strong tumor staining. Gallium scintigraphy showed no accumulation. The tumor was resected, after which the retention of pleural fluid stopped. The pathological diagnosis was hyaline vascular type Castleman's disease. In this case, hyaline vascular type Castleman's disease manifested on the chest wall as a vessel-rich tumor; can cause retention of pleural fluid without the syndrome of polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes.

Phasic right coronary blood flow in a patient with right ventricular hypertension using transesophageal Doppler echocardiography.

Although phasic right coronary artery blood flow in right ventricular hypertension has been studied in animals, reports on human subjects are not available. We observed right coronary artery blood flow before and after operation in a patient with right ventricular hypertension secondary to atrial septal defect using transesophageal Doppler echocardiography. Prior to surgery, blood flow was predominantly diastolic in both right and left coronary arteries. Reversal of right ventricular hypertension after surgery resulted in a change in the pattern of right coronary flow, with doubling of flow during systole.

Detection of microplatelet formation using an electroimpedance cell counter.

Changes in the platelet size distribution curves during the process of ADP-induced aggregation were observed using a particle distribution analyzer (PDA) based on electronic impedance. The maximum primary aggregation was seen at a final ADP concentration of 3 microM. After stimulation, the platelet distribution curve changed rapidly from a log normal curve to a curve skewed to the left. When the changes were evaluated at 1 min after the addition of ADP, the peak height was increased, and the median and total volume were decreased significantly. These findings indicate that microplatelets are formed by membrane stimulation and this formation can be monitored with the use of this automated instrument.

Expression of highly polysialylated neural cell adhesion molecule in calcitonin-producing cells.

Calcitonin-producing cells are endocrine derivatives of the neural crest and have several neuron-like properties. Expression of the neural cell adhesion molecule in calcitonin-producing cells was examined using two types of antibodies to neural cell adhesion molecule: monoclonal antibody 12E3 recognizes the polysialic acid portion of highly polysialylated neural cell adhesion molecule, and monoclonal antibody AF11 and polyclonal antiserum react with the polypeptide portion common to three major isoforms of neural cell adhesion molecule. An immunohistochemical study revealed that highly polysialylated neural cell adhesion molecule was expressed both in fetal rat thyroidal calcitonin-producing cells and in a calcitonin-producing cell line, rMTC 6-23, established from explantable neoplasm of rat calcitonin-producing cells. The neural cell adhesion molecule in the rMTC 6-23 cells was further characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblot analysis. Two anti-neural cell adhesion molecule monoclonal antibodies, 12E3 and AF11, revealed a broad positive band around 200,000-250,000 mol. wt in solubilized proteins. When the polysialic acids were eliminated by neuraminidase treatment, the immunoreactivity to monoclonal antibody 12E3 was completely abolished, and core polypeptide corresponding to neural cell adhesion molecule with a molecular weight of 120,000 was detected by monoclonal antibody AF11. These results suggest that cells of the calcitonin-producing cell line express on their surfaces highly polysialylated 120,000 mol. wt form of neural cell adhesion molecule polypeptide.

An analysis of intravenous hyperalimentation (IVH) catheter-related infection in a university hospital in Japan over a ten year period (1982-1991).

In order to follow changes in clinical characteristics of IVH catheter-related infections, 183 patients were analyzed in whom microorganisms had been isolated from the tips of IVH catheters over a ten year period (1982-1991) in our university hospital. In 183 patients, the male to female ratio was 2.4, the internal medicine departments (Int. Med. Depts.) to surgical departments (Surg. Depts.) ratio was 0.49, 58% of the patients were over 60 years old, 27% had surgical procedures within 30 days before isolation of organisms, and 44% died before discharge. Malignancies were the highest in number for underlying diseases. The same strains of microorganisms as tip cultures were isolated from blood in around 48% of cases in which blood cultures were employed. In the first 5 years (n = 71) and the latter 5 years (n = 112), the proportion of patients form the Int. Med. Depts. increased from 21 to 40% (p < 0.01), and the proportion of Gram positive bacteria from 44 to 64% (p < 0.01). Their antibiotic sensitivity was, as a whole, slightly lower in the latter 5 years. Among Gram-negative bacteria, P. aeruginosa has shown a tendency to increase (11 to 35%). Clinical features were different depending on the kinds of organisms or types of underlying diseases. Measures against IVH catheter-related infections are discussed.

Coronary angiographic abnormalities in mucocutaneous lymph node syndrome: acute findings and long-term follow-up.

Coronary arterial changes in mucocutaneous lymph node syndrome were evaluated by retrospectively analyzing 62 coronary angiograms of 42 patients with abnormal coronary arteries. A total of 108 aneurysms on the initial studies were classified as follows: eight diffuse, 18 saccular, and 50 fusiform aneurysms and 32 localized areas of dilatation. These were also classified as large, medium, or small aneurysms. Approximately one-third of the aneurysms were in the right coronary artery and two-thirds in the left. Seventy percent of the aneurysms were located in the proximal portion of the coronary artery, 16% in the middle portion, and 14% in the distal portion. Sixteen patients were followed up with angiography for periods ranging from 4 months to 8 years 11 months. At follow-up, 48% of the 62 aneurysms had regressed to normal, 37% were diminished in size, and 10% were unchanged. Small and medium-sized aneurysms frequently showed complete regression. In contrast, large aneurysms tended to persist, and stenotic lesions formed at or adjacent to the aneurysm in 41%. Aneurysms larger than 9 mm in diameter, especially those that were diffuse in shape, carried a high risk of subsequent total occlusion.

[Surgical treatment of stage III and IV thymoma].

During past 15 years, 39 cases of thymoma were underwent surgical intervention. In these cases, invasive type, so called stage III and IV in Masaoka's classification were 19 cases. This report documents the results of extended operation in 19 patients treated for malignant thymoma. All patients had neoplasm which invaded adjacent structures; superior vena cava, pericardium, and lung. Eight patients had disseminated lesions in the pleural or pericardial cavities. All patients were underwent surgical exploration through median sternotomy (18 patients) or left thoracotomy (1 patient). Our surgical management to malignant thymoma is to have complete resection, even if tumor invades the great veins. Of 8 patients, superior vena cava and left innominate vein were resected with tumor and reconstructed with ringed PTFE. Mediastinal pleura and pericardium should be widely opened and intrapericardial or intrapleural disseminated lesions should be removed as far as possible. Malignant thymoma could be resected completely applying technique of vascular surgery. Good results were expected when tumor was resected with invading adjacent structures completely. Reoperation to the recurrent tumor is also important.

Measurements of base blood pressure during sleep and its clinical significance in hypertensive patients.

The intra-arterial blood pressure (BP) was measured during 24 hours on 52 patients with essential hypertension using a portable device. The minimum BP inherent to each subject (base BP) was determined from the systolic and diastolic BP histograms during sleep. In this study the systolic and diastolic BPs were presented as a mean BP (BP) and a base BP, and the average of BPs during waking hours was considered as the sum of the base BP and the additional BP increment. The clinical significance of the base BP and BP increment was examined by comparing them with the results of clinical examinations. The comparison showed that the base BP was closely related with the left ventricular hypertrophy and severity of hypertension, while the BP increment correlated with the baroreflex sensitivity and plasma norepinephrine concentration. In this paper, a new tonometry was developed to indirectly record the BP of the superficial temporal artery. The tonometry correlated well with the intra-arterial BP measurement, and was available for the indirect base BP evaluation at an outpatient-clinic.

Transmission of human T cell lymphotropic virus type I by blood transfusion before and after mass screening of sera from seropositive donors.

The human T cell lymphotropic virus type I (HTLV-I) is transmitted by blood transfusions that contain cell components as one of the virus transmission modes. We carried out mass screening of sera from seropositive donors by a gelatin particle agglutination test to prevent the spread of HTLV-I by transfusion. Seroconversion rates were compared before and after screening. The results show a remarkable decrease in the rate of infection from 53.6 to 0.9%. Therefore, it is certain that screening by the agglutination method prevents the spread of HTLV-I transmission in blood transfusions.