A new method of conduction system staining.

Visualization of the conduction bundle is advantageous in the prevention of surgical trauma to the conduction system during open-heart surgery. Because vital staining using an iodine starch complex has been known to result in tissue damage, we have evaluated the effects of iodine gas on the specialized conduction system. The conduction bundle was stained, well enough to be identified, with iodine tincture, with Lugol's solution, and with iodine gas. However, all these agents except for iodine gas caused marked electrophysiological changes. Similar changes occurred with the use of ethanol and of 10% potassium iodine solution, which are the solvents of iodine tincture and Lugol's solution, respectively. Microscopic examination showed that iodine tincture, Lugol's solution, and their solvents caused marked histological changes in the conduction tissue. However, no significant changes in the conduction tissue were noted from iodine gas spraying. Therefore, tissue damage caused by iodine tincture and Lugol's solution was thought to be due not to a reaction to the iodine starch complex itself, but to their solvents. In a long-term experimental study of 10 dogs, we found that iodine gas caused no electrophysiological disturbances or damage of microscopic tissue. Of the agents we tested, only iodine gas is free from harmful effects and can be used clinically.

Autoregulated extra- and intracorporeal pump system for perfusion.

Recent statistics indicate that one serious event occurs once in every 300 perfusions. We have devised a cybernetic approach using photosensors and pressure sensors at critical points of the circuit which should allow feedback regulation of the bypass according to the changes in venous return. In order to avoid overtransfusion, left atrial pressure control is employed. This also enables automatic weaning and facilitates partial bypass. In the clinical setting a test system proved to be accommodated to prevent gross air contamination of the arterial line. Based on vast clinical experience with the conventional method of extrapulmonary circulation, the logical extension of this work will be the development of a compact pump oxygenator utilizing hemofilters, the pump portion of which can be temporarily implanted until the cardiac function has been restored. It is autoregulated and, if the need arises, controlled by the anesthetist, one of whose primary concerns will be physiological perfusion.

[Preoperative intra-arterial infusion of adriamycin in advanced breast cancer with reference to estrogen receptor status].

Preoperative intra-arterial infusion of adriamycin [I I A] for advanced breast cancer was performed in 22 cases, and correlation of the estrogen receptor (ER) status with the effect of I I A therapy was histologically examined. Fifty-five percent of all cases responded to I I A; 80% of ER-negative cases responded, whereas only 33% of ER-positive cases did. I I A was significantly effective in ER-negative cases (p less than 0.05). The histological effect of I I A was also remarkable in ER-negative cases and was related to the clinical effect. The ER status was thought to be a parameter not only for hormonal therapy, but also for chemotherapy. Additionally, drill biopsy was performed in order to examine the correlation between the therapeutic effect and histological type in 16 cases before I I A therapy. Scirrhous carcinoma was more responsive to the I I A therapy than other histological types.

[A case with intramucosal carcinoma of the esophagus in widely expanding dysplasia--an autopsy case with simultaneous double-cancer of the esophagus and sigmoid colon].

Upon autopsy of a 67-year-old male who died of recurrence and metastasis from a carcinoma of the colon, early esophageal carcinoma was found. Diffuse slight thickening and longitudinal linear thinning with brownish discoloration were found in the esophageal mucosa. Upon microscopical examination, the esophageal epithelium showed mild dysplasia, severe dysplasia or intramucosal carcinoma. A diagram of the distribution of these lesions indicated that the carcinoma arose multicentrically in the lower two-third of the esophagus and always within, or adjacent to, the area of severe dysplasia.

Substrate specificity of cucumisin on synthetic peptides.

The substrate specificity of cucumisin [EC 3.4.21.25] was identified by the use of the synthetic peptide substrates Leu(m)-Pro-Glu-Ala-Leu(n) (m = 0-4, n = 0-3). Neither Pro-Glu-Ala-Leu (m = 0) nor Leu-Pro-Glu-Ala (n = 0) was cleaved by cucumisin, however other analogus peptides were cleaved between Glu-Ala. The hydrolysis rates of Leu(m)-Pro-Glu-Ala-Leu increased with the increase of m = 1 to 2 and 3, but was however, essentially same with the increase of m = 3 to 4. Similarly, the hydrolysis rates of Leu-Leu-Pro-Glu-Ala-Leu(n) increased with the increase of n = 0 to 1 and 2, but was essentially same with the increase of n = 2 to 3. Then, it was concluded that cucumisin has a S5-S3' subsite length. In order to identify the substrate specificity at P1 position, Leu-Leu-Pro-X-Ala-Leu (X; Gly, Ala, Val, Leu, Ile, Pro, Asp, Glu, Lys, Arg, Asn, Gln, Phe, Tyr, Ser, Thr, Met, Trp, His) were synthesized and digested by cucumisin. Cucumisin showed broad specificity at the P1 position. However, cucumisin did not cleave the C-terminal side of Gly, Ile, Pro, and preferred Leu, Asn, Gln, Thr, and Met, especially Met. Moreover, the substrates, Leu-Leu-Pro-Glu-Y-Leu (Y; Gly, Ala, Ser, Leu, Val, Glu, Lys, Phe) were synthesized and digested by cucumisin. Cucumisin did not cleave the N-terminal side of Val but preferred Gly, Ser, Ala, and Lys especially Ser. The specificity of cucumisin for naturally occurring peptides does not agree strictly with the specificity obtained by synthetic peptides at the P1 or P1' position alone, but it becomes clear that the most of the cleavage sites on naturally occurring peptides by cucumisin contain suitable amino acid residues at P1 and (or) P1' positions. Moreover, cucumisin prefers Pro than Leu at P2 position, indicating that the specificity at P2 position differs from that of papain.

Scanning electron microscopical studies of the arterial terminals in the red pulp of the rat spleen.

The arterial terminals in the red pulp of the perfused rat spleen were studied by scanning electron microscopy. The arterial terminals were tubular or funnel-shaped and ended openly in the splenic cord. No continuity was observed between the arteries and the sinuses. The endothelial cells of the arterial terminals extended their processes at the fringe of the terminal ends, and these endothelial processes were connected to the processes of the reticular cells of the splenic cord. In addition, large pores, measuring 0.5-8 microns in size, were found in the wall of the terminals adjacent to their end.

[A case report of angiosarcoma of the breast].

The patient was a 24-year-old female, and had received 7-40 mg of prednisolone per day from the age of 19 because of SLE. The tumor occupied almost the entire right breast with a blue-red discoloration of the skin. Histological examination of the tumor disclosed angiosarcoma and a standard radical mastectomy was performed. No metastasis was seen in the regional lymph nodes. The patient received adjuvant chemotherapy with actinomycin D and remained well 26 months after the operation.

[Non-invasive secretory carcinoma of the breast].

A case of non-invasive secretory carcinoma of the breast is reported. The patient was a 33-year-old Japanese woman who complained of abnormal nipple discharge from the right breast. Although physical and radiological examinations failed to find any abnormal nodular lesions in the breast, a cytological examination revealed signet-ring-like atypical cells in the smears of nipple discharge. Radical mastectomy with axillary lymph nodes dissection was performed. No nodular lesions were macroscopically observed. However, intraductal proliferation of atypical cells was microscopically found in the excised breast. Diastase-resistant PAS-positive mucus was observed in the tumor-cell-forming-lumina and in the cytoplasm of tumor cells. No metastases were observed in the axillary lymph nodes.