Reduction of fragile X expression in blood after cryopreservation.

Frequency of fragile X expression was investigated before and after cryopreservation (-196 degrees C) in the blood of 4 affected males, 3 fragile X carriers and in a fibroblast cell strain from a fragile X male fetus. The results indicate that there is a significant decrease (p less than 0.05) in the frequency of the fragile X expression in lymphocytes after cryopreservation, as compared to the fresh blood, but not in fibroblasts. This suggests that cryopreserved blood specimens may not be suitable for fragile X analysis.

[Laboratory and clinical studies on cefmenoxime in respiratory tract infections].

Cefmenoxime (CMX, Bestcall) was administered by drip infusion to 65 patients with various respiratory infections and its effect was evaluated. The rate of effectiveness was 86.2% in all cases including 40 cases of acute pneumonia and 12 cases of chronic bronchitis. CMX was examined comparatively with other drugs for antibacterial activity on clinically isolated strains of 2 bacterial species, i.e. H. influenzae and B. catarrhalis, each of which has a high frequency of clinical isolation from infected respiratory organs. On H. influenzae CMX exerted the strongest antibacterial activity among test drugs (ampicillin, piperacillin cefoperazone, latamoxef) regardless of the production of beta-lactamase by the organism, while on B. catarrhalis it also exerted an antibacterial activity strong enough to control the proliferation of all strains at a dose level of 0.39 microgram/ml. Drip infusion of this drug (2 gram) brought about an average maximum blood concentration of 127.2 +/- 21.5 micrograms/ml and an average half-life in blood of 1.10 +/- 0.28 hours. However, different values were obtained for different individual cases because these subjects were patients of chronic respiratory infections each having some underlying disease or other. Side effects of the drug were observed as allergic symptoms such as pyrexia, eruption and the like, but only 5 cases without any serious cases. Increases in transaminase suggestive of abnormal clinical test results were also observed in 5 cases. However, numerical recoveries to the normal values were obtained in all of these 5 cases with the withdrawal of the drug.

Non-surgical treatment of splenic cyst, using with installation of minocycline chloride.

Solitary splenic cysts are relatively rare and usually asymptomatic. However, large ones sometimes show clinical manifestations. Non-surgical treatment of a solitary splenic cyst by instillation of minocycline chloride is described. Minocycline chloride was instilled into the splenic cyst through a pig-tail catheter indwelt under ultrasonographic guidance. Low concentration of minocycline chloride (200 mg diluted in 100 ml of saline) was not effective to reduce discharge from the splenic cyst. Discharged volume was markedly reduced after the instillation of high concentration of minocycline chloride (2000 mg diluted in 100 ml of saline). Eight weeks after this treatment, fluid discharge ceased. After 1 year, there was no findings of enlargement of the cyst. Ultrasonogram guided percutaneous instillation of minocycline chloride is a safe, easy, and useful procedure for treatment of a solitary and benign splenic cyst.

Evaluation of perioperative administration of methylprednisolone sodium succinate and urinary trypsin inhibitor for prevention of surgical stress.

The authors could confirm that the laparoscopy-assisted cholecystectomy (LAC) elicited less postoperative biological responses compared to the ordinary cholecystectomy under laparotomy (OCL), when granulocyte elastase (GE)-alpha1-protease inhibitor complex (GEcomplex), interleukin-6, pancreatic secretory trypsin inhibitor (PSTI) and alpha1-antitrypsin (alpha1-AT) were used as biological response markers. Perioperative administrations of methylprednisolone sodium succinate (MPSL: 10 mg/kg body weigh) or MPSL with urinary trypsin inhibitor (UTI) could suppress such postoperative reactions after OCL down to the levels after LAC, especially immediately after surgery. Preoperative MPSL followed by continuous infusion of UTI for 3 days exerted the most prominent suppressive effects on these markers compared to the effect of the preoperative MPSL alone as well as the preoperative administration of MPSL followed by UTI infusion for only one hour. Bolus administration of MPSL induced no lymphocytopenia. Decreased plasma level of alpha1-AT immediately after operation is thought to be due to consumption in binding to GE as well as other lysosomal enzymes, while production of rapid turn over proteins are still not accelerated in the liver. In early postoperative phase after administration of MPSL, administration of UTI was efficacious to prevent fluctuation of biological response markers. Clinical applications of these drugs might be approved especially for those patients with poor risk.

A case of retroperitoneal abscess: an unusual complication of cholecystitis and choledocholithiasis.

A man, 73 years old, who developed acute biliary tract infection complicated with retroperitoneal abscess formation in iliopsoas region was reported. The magnetic resonance imaging was especially effective to delineate the lesion, extending from the subhepatic down to the iliopsoas muscle. The echo-guided fine needle aspiration technique was successful to make the lesion subside.

[inflammatory reaction and laboratory tests: granulocyte elastase].

The role in the so called inflammatory response of the polymorphonuclear granulocyte elastase (PMN elastase, EC 3.4.21.37) has been well established. Elastase, a neutral protease stored in the lysosomes of neutrophils and monocytes, is extracellularly released during the process of phagocytosis, and bound to alpha 1-proteinase inhibitor (E-alpha 1-PI complex). This complex can be quantified by an immunoassay. PMN elastase has been shown to be a sensitive and specific marker for the early diagnosis of inflammation and prediction of inflammatory complications.

[Membranous septal aneurysm with aortic regurgitation: a case report].

A case of membranous septal aneurysm with aortic regurgitation (AR) in a 13-year-old male was reported. As AR was progressed rapidly in this case, aneurysmorrhaphy of membranous septal aneurysm and aortic valve plication were performed. The postoperative coarse was uneventful. It was considered that the course of AR was prolapse of aortic valve related with membranous septal aneurysm.

[Long-term follow-up studies of bronchial asthma in children. I. Prognosis and risk factors].

A questionnaire on the prognosis of bronchial asthma was sent in 1988 to 1,592 patients (1,038 males, 554 females) averaging 20 years of age after 12 years' follow up. The results were as follows: 75.6% in remission, 18.2% improved, 4.0% unchanged, 0.9% worse and 1.3% dead from asthma. The average age of onset was 2.7 years, about 1 year earlier than that in our report of 1965. The average age of remission (growing out of asthma) was 13.0 years for males and 12.3 years for females. The prognosis was significantly poorer among asthmatics with an onset age of under 2 years, with a 10-year history of asthma before the first visit to our hospital, with severe attack at the initial visit, a history of admissions for the attacks and food allergy. The asthmatic children with food allergy had a 1-year earlier onset of attack, a more severe attack at the initial visit, more eczema in infancy, and 2 or more other allergic complications than children without food allergy. We have to closely follow and care for those asthmatic children with high risk factors for an extended period.

[A case of liver metastasis of leiomyosarcoma of residual stomach successfully treated by TAE and intra-hepato-arterial chemotherapy with infusion-a-port with administration of epirubicin].

A 60-year-old man who had a partial gastrectomy for gastric cancer 10 years ago was referred to our hospital for further examination for liver tumor. He was diagnosed as leiomyosarcoma of residual stomach associated with liver metastases. After preoperative transarterial embolization (TAE) with epirubicin of the anterior branch of right hepatic artery, residual stomach was resected, and the reservoir catheter and infusion arterial port were implanted. He was treated by intra-hepato-arterial chemotherapy of epirubicin. The patient has remained well for 2 years and 3 months without apparent complications.

[Long-term follow up studies of bronchial asthma in children. II. Prognosis and complications, treatment and allergic evaluations].

A questionnaire on the prognosis of bronchial asthma was sent in 1988 to 1592 patients (1038 males, 554 females) averaging 20 years of age after 12 years' follow up. We reported on the prognosis and risk factors associated with asthmatic children in part I. The relation between prognosis and other allergic complications, treatment and laboratory data were investigated in this study. Eosinophil counts of more than 1000/mm3 and/or total serum IgE levels of more than 500 IU/ml (100 IU/ml in infants) indicated poor prognosis. However, the prognosis was not affected either by the allergens themselves or by the number of allergens determined by skin test and RAST. The prognosis was worse for patients with multiple allergic complications than for those without complications. Treatment may after the natural course of childhood asthma, but it has been difficult to evaluate the effect of each regimen over a long period. We compared the effect of hyposensitization (specific immunization) and non-bronchodilator antiasthmatic drugs (NBAAD), and found that hyposensitization alone gave better results than NBAAD and its combination. We had better results from hyposensitization over a period of 1 to 5 years than for less than 1 year or more than 5 years. We conclude that asthmatic children with risk factors should be kept under strict environmental control and given suitable therapeutic regimens to avoid the development of allergic diseases, the slow down of "allergic march", and to avoid intractable asthma.

[Evaluation of lidocaine metabolite (monoethylglycinexylidide) as a liver function test].

In order to determine whether or not the lidocaine metabolism, monoethylglycinexylidide (MEGX) formation, could be used as a liver function test, we measured the serum levels of MEGX in 38 patients. There were significant correlations between values of MEGX (MEGX15, MEGX30, AUC15-30, AUC0-180) and conventional liver function tests (ICG R15, AT III, T. Bil). It appeared that value of MEGX 30 had maximum factor loading on conventional liver function tests by using principal component analysis. The advantage of adapting the MEGX formation as a liver function test of drug metabolism is simplicity of the method. MEGX formation could be useful index of the total liver function.

[A case report of A-C bypass surgery in coronary atherosclerosis with anomalous origin of left coronary artery].

Anomalous coronary artery originating from the aorta without complicated congenital cardiac anomaly is rare. We describe a case with the left coronary artery originating from the right sinus of Valsalva. Cardiac catheterization revealed a left coronary artery transverse between the aorta and the pulmonary artery. Severe atherosclerotic stenosis was present at segment 3 of the right coronary artery. Electrocardiogram and myocardial scintigraphy revealed that the angina occurred due to stenosis of the right coronary artery. We tried PTCA, but could not pass the catheter through the stenosis. After PTCA, he complained of anterior chest pain frequently, so we performed an aortocoronary bypass operation to the right coronary artery with saphenous vein graft. Postoperative course was not eventful and angina disappeared.

[A case of coronary artery bypass grafting with right gastroepiploic artery for right coronary artery obstruction associated with aortitis syndrome].

A case of a 66 year-old female with aortitis syndrome with right coronary arterial obstruction, was reported. The coronary arteriogram showed total occlusion of the right coronary artery (segment 2). On the aortogram, stenosis of the left common carotid artery, kinking and aneurysm of the descending thoracic aorta were revealed. Because she developed frequent attacks of effort angina and the descending thoracic aneurysm was small in diameter 38 mm, coronary bypass grafting to the right coronary artery was performed using the in situ right gastroepiploic artery. Postoperative course was not eventful and chest pain disappeared. In such cases, the right gastroepiploic artery is useful for coronary artery bypass grafting.