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A fifty-year-old man was admitted to our hospital for evaluation of an abnormal shadow in a routine chest X-ray film. Thorax CT scan revealed a relatively well defined nodule with a diameter 15 mm and pleural thickness in the posterior segment of the right lower lobe. A diagnosis by broncoscopy was undefinite and suspected to be a lung cancer. So thoracoscopic lung biopsy was performed to remove it. In a cross section of the resected nodule two degenerated worm structures were revealed and we diagnosed pulmonary dirofilariasis. Pulmonary dirofilariasis has been an increasing reported disease. Most of cases revealed a peripheral lung lesion. Thoracoscopic lung resection was useful for the diagnosis, considering as minimally invasive examination.

The single-field conductance (SF) method for continuous measurement of left ventricular (LV) volume has achieved widespread use. However, it has been shown theoretically that the ratio between the measured conductance and the actual volume varies between the different interelectrode segments of the catheter due to the convex shape of the equipotential planes at the apex and base. The dual-field conductance (DF) method has recently been introduced and reportedly provides a flatter equipotential plane within the LV. In 11 patients, we compared LV volume measured by biplane cineangiography with conductance volume by the SF and DF methods. Strong correlations were found for both the SF method (r = 0.98) and the DF method (r = 0.99). However, in comparison with the SF method, the DF method gave a regression line with a slope factor, alpha, that was closer to unity, and the intercept of the regression line was small (p < 0.01). The DF method gave a significantly greater segmental stroke volume (SV) in the apex and base than the SF method. The ratio of the DF segmental SV to the SF segmental SV in the apex increased in proportion to the end-diastolic volume (p < 0.05). In conclusion, the DF method may facilitate the accurate measurement of LV volume in the human heart.

Objectives: Recognition of the problems of conventional cardiotonic agents has led to an interest in drugs that produce a positive inotropic action by altering the responsiveness of myofilament to Ca2+ (i.e., Ca2+ sensitizing agents). The importance of the effects of these compounds on left ventricular (LV) systolic function has been emphasized, whereas the effect of them on LV diastolic function is still problematic. To investigate the lusitropic action of a novel Ca2+ sensitizing agent, MCI-154, we compared the effects of MCI-154 on LV relaxation and filling dynamics with those of dobutamine in diseased human hearts., Methods: We assessed the slope of the end-systolic pressure-volume relation (Emax), the time constant of LV pressure decay (Tw) and the maximum rate of LV early filling (dV/dtmax) before and after the infusion of dobutamine (n = 10) or MCI-154 (n = 9). LV volume and pressure were measured by a conductance catheter and a micro-tip catheter pressure transducer., Results: When both agents increased Emax comparably, dobutamine decreased Tw from 51 to 37 ms and MCI-154 decreased Tw from 54 to 44 ms. The decrease of Tw with MCI-154 was less than that with dobutamine (17 vs. 29%, P < 0.05). At the same time, dobutamine increased dV/dtmax per end-diastolic volume (dV/dtmax/V) from 2.84 to 3.88 s-1, whereas MCI-154 did not., Conclusions: Diastolic properties were not compromised by MCI-154, though the alteration in them with MCI-154 was less than that with dobutamine when MCI-154 increased LV contractile state to the same extent as dobutamine. The present results suggest that MCI-154 would be an ideal Ca2+ sensitizing agent that enhances force during systole without impairing diastolic function.

In Kyushu, Japan, where a human case of zoonotic onchocerciasis was found, a survey was conducted to know if the bovine Onchocerca species of this region, O. gutturosa, O. lienalis and O. sp., which develop in local Simulium spp., were also transmitted by Culicoides. A total of 17,006 out of 42,582 females of eight Culicoides species captured by light-traps from May to November in 1989 and 1990 at two cattle sheds, one in Oita and one in Kumamoto, were dissected and examine for Onchocerca infection. Overall results showed that none of the species had filarial infections except 4 of 946 C. arakawae, an ornithophilic species, collected in Oita which harboured filarial larvae with a short tail, belonging to Lemdaninae. Unsheathed microfilariae indistinguishable from O. lienalis or O. gutturosa were found in the midgut of only one blood-fed C. matsuzawai collected in Oita. It is concluded that Culicoides species would not be vectors of these three bovine Onchocerca species. Additional collections of Culicoides in a residential area of Oita showed that several filarial species, Lemdaninae and Splendidofilarinae, probably from birds, are transmitted by C. arakawae.

Laboratory developmental studies were carried out on Simulium bidentatum (Shiraki) under constant air and water temperatures (7, 10, 13, 16, 19, 22, 25, and 28 degrees C). The median time required for female flies to complete oocyte maturation after blood feeding decreased from 8 to 1.5 d and the median time from blood feeding to oviposition decreased from 16 to 3 d as air temperature increased from 7 to 28 degrees C. Air temperatures from 16 to 22 degrees C were most suitable for oviposition. An average of 61.4% of eggs hatched. Egg developmental period decreased from 17 to 4.5 d when water temperature increased from 7 to 19 degrees C and decreased to 3.5 d when water temperature was between 22 and 28 degrees C. Larval and pupal development occurred at water temperatures > or = 13 degrees C, but was most successful from 16 to 22 degrees C. Seven (in 16 lots) or 6 instars (in 1 lot) were indicated by using the Dyar rule. We conclude that S. bidentatum is adapted to moderate weather conditions in spring and autumn and that approximately 7 generations of this species occur per year in Oita, Japan.

Studies reported in the literature show that the stroke work (SW) versus end-diastolic volume (Ved) relationship, namely, the preload recruitable stroke work relation (PRSW), is experimentally linear in closed-chest dog hearts and its slope reflects left ventricular contractility. We considered the theoretical cardiodynamic conditions necessary for the linearity of the SW-Ved relation by utilizing ventricular end-systolic elastance, Emax (ventricular contractility), and effective arterial elastance, Ea (arterial afterload). We simulated the SW-Ved relation, using four theoretical models of the left ventricle, as follows: Ea is constant and the end-systolic pressure-volume relation (ESPVR) is linear (model 1), or nonlinear (model 2), and Ea is variable and ESPVR is linear (model 3), or nonlinear (model 4). The results show that the SW-Ved relation can be linear in both linear and nonlinear ESPVR models (models 3 and 4) only when Ea is variable. In these models, end-systolic pressure (Pes) and Ea should gradually fall, maintaining the stroke volume (SV) relatively constant with decreases in Ved until the low end of the physiological Ved range. Then, Ea should rise sharply so that Pes does not fall below the critical level. These results suggest that the autoregulation mechanisms of an intact animal operate to adapt the arterial afterload against acute changes in LV preload, maintaining cardiac output and coronary artery pressure. Such mechanisms may thus produce a linear SW-Ved relation over a wide range of conditions.

We examined the effects of a novel water-soluble forskolin derivative, NKH477 (0.5 microgram/kg/min), on arterial-ventricular (A-V) coupling and mechanical energy transduction from heart to circulatory bed in comparison with those of dobutamine (3 micrograms/kg/min) in 8 patients with left ventricular (LV) systolic dysfunction using a conductance catheter method. A-V coupling was assessed as the ratio of the effective arterial elastance (E(a)) to the slope of the end-systolic pressure-volume relation (ESPVR) (E(max), left ventricular contractility index), and the ratio of mechanical energy transduction was obtained as the fraction of PV area (PVA) comprised of stroke work (SW). E(max) (2.59 mm Hg/ml/m2), E(a)/E(max) (1.62), and SW/PVA (0.58) were impaired in control contractile state. NKH477 increased Emax to the same extent as dobutamine. E(a) decreased with NKH477 but not with dobutamine. As a consequence, the decrease in E(a)/E(max) with NKH477 was greater than that with dobutamine (52 vs. 47%, p < 0.05); the increase in SW/PVA with NKH477 was also greater than that with dobutamine (28 vs. 21%, p < 0.05). These findings suggest that NKH477 may be a superior alternative to dobutamine in A-V coupling and mechanical energy transduction in patients with LV systolic dysfunction.

Objective: The aim was to characterise the impaired myocardial mechanoenergetics in patients with heart failure due to old myocardial infarction by using the oxygen consumption versus left ventricular pressure--volume area (PVA) relationship., Methods: The VO2-PVA relationship was assessed in 15 patients: group N consisted of seven patients with vasospastic angina pectoris whose left ventricular ejection fractions were normal [72 (SD 8)%], and group F consisted of eight patients with old myocardial infarction whose left ventricular ejection fractions were reduced [45(11)%]. Left ventricular volume and pressure were measured by the conductance catheter method. VO2 was measured by thermodilution., Results: Linear VO2-PVA relationships with dextran infusions were obtained in both groups (median r = 0.92 v 0.90). There was no difference in the slope between the two groups. There was a positive correlation between Emax and VO2 at median PVA (VO2,PVA0.8) in group N. Emax, an index of left ventricular contractility, was significantly smaller in group F than in group N, at 5.1(2.1) v 3.2(1.1) mm Hg.ml-1.m2; p < 0.05). On the other hand, the VO2 intercept in group F was comparable to that in group N, at 0.71(0.63) v 0.40(0.29) J x beat-1.100 g LV-1; NS). In addition, the ratio of VO2,PVA0.8 to Emax was significantly larger in group F than in group N: 0.55(0.14) v 0.89(0.37) J x beat-1.100 g LV-1.mm Hg-1.ml.m-2 (p < 0.05)., Conclusions: These results suggest that the VO2 for non-mechanical work in group F is disproportionately high relative to the reduced contractility. An abnormality of excitation-contraction coupling rather than of crossbridge cycling may be responsible for the impaired mechanoenergetics in patients with heart failure due to old myocardial infarction.

Eleven blackfly species were examined in relation to the transmission of bovine onchocerciasis in central Kyushu, Japan. A total of 19,005 out of 47,746 females captured from June 1989 to June 1990 at two cattle sheds each in Oita and Kumamoto were dissected for their parities, infections with Onchocerca larvae, and intakes of Onchocerca microfilariae. Overall results showed that Simulium bidentatum (Shiraki), the predominant species, is a natural vector of the two bovine Onchocerca species, i.e., type I (O. sp.) in both localities and type II (probably O. gutturosa Neumann), in Oita, whereas S. kyushuense Takaoka and S. arakawae Matsumura serve as the primary vector of type III (O. lienalis Stiles) in Kumamoto and Oita, respectively. Simulium arakawae also plays a secondary role in the transmission of type I in Oita and of type III in Kumamoto. Despite the biting activities and microfilarial intakes observed throughout most of the entire year, the transmission of these bovine Onchocerca was restricted to the mild or warm months between May and November. The natural infections with mermithid, trematode, ciliates, and fungi occurred but their influence on the vector Simulium species was apparently small, if at all.

Objectives: The aim of this study was to compare the effects of a phosphodiesterase inhibitor and catecholamine on arterial-ventricular coupling and myocardial energetics in the diseases human heart., Background: Recent experimental studies have indicated that the arterial-ventricular coupling analysis using the time-varying elastance model could discriminate between inotropic and vasoactive effects of the two agents., Methods: With the use of a conductance catheter, left ventricular contractility and arterial afterload were measured from the slope of the end-systolic pressure-volume relation, Emax, and the slope of the end-systolic pressure-stroke volume relation, Ea. Arterial-ventricular coupling was assessed by Ea/Emax before and after administration of a new phosphodiesterase inhibitor, E-1020 (0.3 microgram/kg per min), and a beta 1-stimulant, dobutamine (5 micrograms/kg per min), in 20 patients with heart disease. Left ventricular mechanical efficiency was assessed as the ratio of stroke work to myocardial oxygen consumption per beat measured by the thermodilution method., Results: The slope of the end-systolic pressure-volume relation increased comparably with both E-1020 (39%, p < 0.01) and dobutamine (47%, p < 0.01), but Ea/Emax decreased with E-1020 (1.25 to 0.78, -37%, p < 0.01) more than with dobutamine (1.23 to 0.99, -16%, p < 0.05). Although stroke work index increased with both agents, myocardial oxygen consumption remained unchanged with E-1020 but increased with dobutamine (p < 0.05). Consequently, left ventricular mechanical efficiency increased with E-1020 (0.30 to 0.36, p < 0.05) but remained unchanged with dobutamine (0.27 to 0.29, p = NS)., Conclusions: The phosphodiesterase inhibitor E-1020 improved arterial-ventricular coupling more than did dobutamine, with a resultant increase in mechanical efficiency. These data were in accordance with the theoretic prediction of the coupling analysis in the diseases human heart.

A new sandwich-type solid-phase enzyme immunoassay (EIA) for carcinoembryonic antigen (CEA) was established by using two selected monoclonal antibodies (MAbs). One MAb, F82-61, which is immobilized on polystyrene beads, reacts with an epitope present on the N-terminal domain (N) of the CEA molecule and the other, F11-39, which is conjugated to horseradish peroxidase (HRP), recognizes an epitope present on the C-terminal domain (B3) of the CEA molecule. The assay consists of incubating 0.05 ml of test serum both with F82-61-coated beads and HRP-labeled F11-39 at room temperature for 2 h. The assay system, referred to as New EIA, showed very homogeneous reactivity with purified CEA preparations from different tumors and could discriminate CEA from four CEA-related normal antigens tested; nonspecific cross-reacting antigen (NCA), NCA-2, normal fecal antigen-1 (NFA-1) and NFA-2. The assessment of technical qualities, such as reproducibility, recovery and dilution tests, demonstrated the excellent performance of New EIA. Serum samples (n = 604) from patients with malignant or non-malignant disease, as well as from healthy individuals, were analyzed by New EIA and by two commercial CEA immunoassays which both showed heterogeneous reactivity with different CEA preparations and reacted to a greater or lesser extent with NCA-2 and NFA-2, and it was found that New EIA significantly increased the sensitivity and specificity of tumor diagnosis as compared with the commercial assays.

Background: Recently, several indexes such as tension-time index (TTI), tension-time or force-time integral (FTI), rate-pressure product (RPP), pressure-work index (PWI), and systolic pressure-volume area (PVA) have been developed as predictors of myocardial oxygen consumption in experimental and clinical studies. However, it is still unclear whether these indexes are reliable predictors of myocardial oxygen consumption under various contractile states in human hearts., Methods and Results: We assessed the relation between TTI, FTI, RPP, PWI, and PVA and myocardial oxygen consumption per beat (VO2) in 13 patients with heart disease during volume loading. Left ventricular (LV) volume and pressure were measured simultaneously by the conductance catheter with the tipped micromanometer technique. VO2 was calculated from arterial coronary sinus oxygen content difference, and coronary sinus blood flow was measured by the thermodilution method. After z transformation of the correlation coefficients, mean z value for the VO2-PVA relation (1.83 +/- 0.60) was greater than those for the VO2-TTI relation (1.22 +/- 0.66; p < 0.005), VO2-FTI relation (1.18 +/- 0.61; p < 0.05), VO2-RPP relation (0.95 +/- 0.65; p < 0.05), and VO2-PWI relation (1.24 +/- 0.58; p < 0.05). During dobutamine infusion (5 micrograms.kg-1.min-1) in five of the 13 patients, VO2 also correlated best with PVA (z = 1.70 +/- 0.89) compared with TTI (z = 1.43 +/- 0.86), FTI (z = 1.48 +/- 0.95), RPP (z = 1.00 +/- 0.53), and PWI (z = 0.88 +/- 0.80). The contractile efficiency (38 +/- 14% to 38 +/- 20%), the reciprocal of the slope of the VO2-PVA relation, remained unchanged, whereas the VO2,PVA 0.8 (VO2 at PVA = 0.8 J per beat/100 g LV) increased from 1.48 +/- 1.16 to 2.06 +/- 1.13 J per beat/100 g LV (p < 0.05). These results show the parallel upward shift of the VO2-PVA relation during dobutamine infusion. Because increases in the VO2-intercept represent the VO2 for the increased excitation-contraction (E-C) coupling associated with the augmented contractile state, the parallelism of the VO2-PVA relation could discriminate between VO2 for mechanical work (PVA-dependent VO2) and VO2 for E-C coupling (PVA-independent VO2)., Conclusions: The results of the present study indicate that PVA is a reliable and valuable predictor of myocardial oxygen consumption under different contractile states in human hearts. The VO2-PVA relation could provide useful information about mechanoenergetics in diseased human hearts.

Several studies have recently reported that the relationship between myocardial oxygen consumption per beat (Vo2) and left ventricular (LV) systolic pressure-volume area (PVA), which represents total mechanical energy generated by contraction, is linear and independent of loading conditions in excised, supported, and intact hearts. We assessed the Vo2-PVA relationship in nine patients with heart disease. LV volume and pressure were measured simultaneously by conductance catheter and tip-micromanometer. Vo2 was calculated from the difference between arterial and coronary sinus oxygen content, and coronary sinus blood flow measured by the thermodilution method. We obtained the linear relationship between Vo2 and PVA by dextran infusions (median r = 0.917). The slope of the Vo2-PVA relationship was (1.82 +/- 0.66) x 10(-5) mlO2 mmHg-1 ml-1 and the contractile efficiency, the reciprocal of the slope of the Vo2-PVA relationship, was 40 +/- 13%. The Vo2 intercept, which reflects Vo2 for non-mechanical work, was 0.0284 +/- 0.0286 ml O2 beat-1. These results suggest that PVA is a good predictor of myocardial oxygen consumption and a powerful tool to evaluate the coupling of LV mechanical performance to energy use in human hearts.

To validate the accuracy of human left ventricular (LV) volume measured by the conductance catheter method, conductance volume was compared with LV volume measured by biplane angiography in 19 patients with ischaemic heart disease. Angiographic LV volumes were calculated frame by frame and matched with instantaneous conductance volumes. Calibration was determined by both gain constant, 1/alpha, and parallel conductance, alpha V c. The gain constant, 1/alpha, was the ratio of stroke volume measured by the thermodilution method to that measured by the conductance catheter. The parallel conductance, alpha Vc, was estimated by the saline injection method. There was a good correlation between the corrected conductance volume (Vcc) and the angiographic volume (V angio) such that Vcc = 0.94 V angio + 5.3 ml, r = 0.94, P < 0.001. There were no differences in the correlation coefficients between normal and depressed hearts. Compared with the angiographic data, LV end-diastolic volume, end-systolic volume and ejection fraction were determined accurately by the conductance catheter. We conclude that the conductance catheter method, corrected for gain constant and parallel conductance, can accurately and continuously estimate the LV volume throughout the cardiac cycle in the diseased human heart.

We compared linearity, inotropic sensitivity (using dobutamine) and afterload dependency (using captopril) of contractile indices derived from the end-systolic pressure-volume relationship (ESPVR) and preload recruitable stroke work (PRSW) in man. We investigated 60 patients, 39 with normal (EF > or = 50%, group 1) and 21 with decreased ventricular function (EF < 50%, group 2). Variably loaded P-V loops were constructed by conductance catheters with vena caval occlusions. The slopes of the ESPVR (Emax) and PRSW (Mw) were assessed by linear regression analysis. The correlation coefficients of the ESPVR (r = 0.964) and PRSW (r = 0.976) were both very high, but the Z-value of the ESPVR was lower than for PRSW. During the control period, normalized Emax and Mw were significantly higher in group 1 than group 2 (Emax: 4.6 +/- 2.3 vs 2.8 +/- 0.8 mm Hg ml-1 m-2, Mw: 109 +/- 31 vs 86 +/- 28 10(3) dyn cm-2. After dobutamine, Emax and Mw increased significantly both in group 1 (128% and 124% vs control respectively) and in group 2 (132% and 130% respectively). After captopril, the ESPVR tended to shift to the right with a decrease in afterload; PRSW was unchanged. We conclude that PRSW may be a more linear and reliable index for evaluation of contractility in man.

To validate the usefulness of the conductance catheter in the clinical setting, we first studied the accuracy of human left ventricular (LV) volume measured by conductance catheter in comparison with LV volume measured by biplane angiography in 19 patients with heart disease. Secondly, we made a comparison of end-systolic pressure volume relation (ESPVR) and preload recruitable stroke work (PRSW) relation in 60 patients with heart disease. Thirdly, we studied the myocardial oxygen consumption (VO2)-pressure volume area (PVA) relation to assess contractile efficiency in 22 patients with heart disease. There was a good correlation between the corrected conductance volume (Vcc) and the angiographic volume (V angio) (Vcc = 0.94 Vangio + 5.4, r = 0.94, P less than 0.001). Two relations, ESPVR and PRSW, were well described by straight lines with high correlation coefficients. However, PRSW was a more linear contractile index than ESPVR. The reciprocal of the slope of the VO2-PVA relation was approximately 40% in the control contractile state. We conclude that the conductance catheter accurately measures LV volumes and facilitates the assessment of ESPVR, PRSW and contractile efficiency in human LV.

The egg dormancy and embryogenesis of the univoltine black fly, Prosimulium kiotoense Shiraki, in southwestern Japan were examined under natural and laboratory conditions. Eggs laid in April remained dormant until August (approximately 14 wk after oviposition). Hatching commenced in early October (after 23 wk), when air and water temperatures decreased to 20 and 15 degrees C, respectively, and continued until mid-December (32 wk) in the field. Laboratory experiments showed that lower temperatures (10 and 14 degrees C) supported embryogenesis similar to that observed in the field. In contrast, higher temperatures (18 and 22 degrees C) retarded or completely suppressed embryogenesis after the termination of dormancy. However, completion of dormancy was accelerated when eggs were exposed experimentally to these higher temperatures for 3-12 wk, then returned to a constant low temperature (14 degrees C). Daylength did not affect the maintenance and termination of dormancy. Therefore, temperature played an important role differentially affecting completion of dormancy and postdormancy development. Variable lengths of developmental periods among egg batches under the same conditions indicated possible genetic control of dormancy intensity.

We compared the oxygen cost of increasing ventricular contractility using Emax (slope of the ventricular end-systolic pressure-volume relation) as the index of ventricular contractility. Contractility was enhanced by calcium and epinephrine in paired experiments on dog left ventricles. Firstly, we obtained left ventricular oxygen consumption (VO2) and systolic pressure-volume area (PVA, a measure of total mechanical energy) of contractions at different volumes in the control contractile state to determine a reference VO2-PVA relation. PVA was obtained as the area in the pressure-volume (P-V) diagram which was bounded by the end-systolic P-V line, end-diastolic P-V curve and systolic P-V trajectory of individual contractions. Secondly, we gradually enhanced Emax with calcium and epinephrine in two consecutive runs at a fixed ventricular volume. Both VO2 and PVA increased with enhanced Emax. From these VO2-PVA data, we calculated the PVA-independent VO2 values at the respective enhanced Emax levels and determined the oxygen cost of Emax as the slope of the relation between the PVA-independent VO2 and Emax. The cost per beat and per 100 g was 0.00158 ml O2/(mmHg/ml) for calcium and 0.00166 ml O2/(mmHg/ml) for epinephrine on average, values not significantly different from each other (P less than 0.05). We conclude that epinephrine and calcium have similar oxygen costs of contractility over a wide range of Emax despite their different pharmacological mechanisms of positive inotropism.

Oviposition habits of a univoltine mammalophilic blackfly, Prosimulium kiotoense Shiraki, were investigated at a stream in Kyushu Island, Japan. The flies oviposited on bryophyte mosses growing on river bank rock surfaces. The eggs were laid singly, but large irregular egg masses were often formed because many females oviposited within the same small areas. Wet sites with dense bryophyte cover at heights between 0 and 15 cm above water level were selected for oviposition. Oviposition activity was observed in the latter half of April. P. kioteonse females came to the site to lay eggs after 11.00 hours in the morning, when air temperature rose to about 15 degrees C. Peak ovipositional activity occurred between 12.00 and 14.00 hours.

Seven larval instars were detected for a natural population of Prosimulium kiotoense Shiraki in Kyushu, Japan, from the size frequency distribution of postgenal lengths. Growth in P. kiotoense larvae followed a geometric progression from first to sixth instars, but the size ratio between sixth and seventh instars was smaller than between other successive stadia. The linear relationship between the mean instar value and daily cumulative water temperature indicated that development between instars required 82.6 degree-days (DD). The accumulated temperature for larval development of this species was estimated to be 600 DD.

Between 1986 and 1988, epidemiologic studies were carried out in a small rural community in an Andean region of Ecuador, where cutaneous leishmaniasis is highly endemic. A total of 25 human cases, positive for Leishmania parasites by culture and/or smear, were examined. Fourteen of the cases were in infants less than one year of age, suggesting intradomiciliary transmission of the disease. Clinically, many of these cases were similar to descriptions of "uta," a form of cutaneous leishmaniasis which occurs in Andean regions of Peru and is reported caused by L. peruviana. Of the 11 positive cultures obtained from human cases in the present study, eight were identified by molecular characterization as L. mexicana and three were identified as L. major-like. Two additional isolates of L. mexicana were also made from an infected dog and from a sand fly, Lutzomyia ayacuchensis, living in the region, thus implicating the latter species as possible reservoir and vector, respectively, of L. mexicana in this highland community. The significance and validity of recent isolates of L. major-like parasites from the New World are also discussed.

This study assessed a new method of estimating the slope (Ees) of the end-systolic pressure-volume relation (ESPVR) from a single beat of the human heart. Left ventricular pressure was recorded with a high-fidelity micromanometer in patients with heart disease during left ventriculography. Peak isovolumic pressure at the end-disastolic volume was estimated by a curve-fitting technique from an isovolumic left ventricular pressure curve. The ESPVR line was drawn from the estimated peak isovolumic pressure-volume point tangential to the left upper corner of the pressure-volume loop. The slope of this estimated ESPVR line from single-beat analysis was compared with the slope of the ESPVR line obtained from three pressure-volume loops in 16 patients given angiotensin II or nitroglycerin infusion. The estimated Ees was 5.0 +/- 2.2 mm Hg/ml/m2, and the conventional Ees was 4.9 +/- 2.7 mm Hg/ml/m2. The estimated Ees showed a positive correlation with the conventional Ees (r = 0.91, p less than 0.001, SEE = 1.2 mm Hg/ml/m2). In the other 13 patients, after dobutamine infusion (5 micrograms/kg/min i.v.) the estimated Ees increased significantly from 5.6 +/- 1.4 to 7.4 +/- 2.0 mm Hg/ml/m2 (p less than 0.01). Thus, the estimated Ees approximated the conventional Ees and was sensitive to a positive inotropic intervention. We conclude that this single-beat analysis method facilitates assessment of the beat-by-beat ESPVR of the human heart.

In the Andean town of Paute, Ecuador, 2 of 97 (2%) Lutzomyia ayacuchensis Cáceres and Bianchi were found to be naturally infected with Leishmania promastigotes. The parasites were confined to the midgut of the sand fly, indicating they did not belong to the subgenus Leishmania (Viannia).

A 2-year-old girl living in southwestern Japan had a nodule of 2 months' duration on the left foot. A biopsy from the lesion showed transverse sections of a worm surrounded by granulomatous tissue. The worm was identified as an Onchocerca sp. from the morphological characteristics such as relatively thick cuticles, annular ridges on the cortical layer, and high somatic muscles. Positive serological tests using ELISA for Onchocerca gutturosa and Onchocerca volvulus supported the diagnosis. This was the first case of zoonotic Onchocerca infection detected in Japan. The clinicopathological aspects of zoonotic onchocerciasis of this case were discussed.

We compared the predictive capability of two indexes of ventricular oxygen consumption (VO2) in excised cross-circulated dog hearts. One of the indexes was Bretschneider's Et, formulated as the sum of energies for 5 different mechanical and nonmechanical activities of myocardium. The other one was the left ventricular systolic pressure-volume area (PVA), originally proposed by Suga. PVA is a measure of total mechanical energy and has been combined with Emax (ventricular contractility index) to predict VO2 in different inotropic states. When all data sampled from different hearts under various loading and inotropic conditions were pooled, both VO2 (Bret) predicted from Bretschneider's index and VO2 (Suga) predicted from Suga's index correlated well with the measured VO2 (VO2 (Measured)). However, VO2 (Bret) was more affected by the contraction mode as compared with VO2 (Suga), because the former includes ejection period as a parameter. Among the 5 terms of VO2 (Bret), the major correlate of VO2 (Measured) was found to be tension development energy term E3 which includes dP/dtmax as a parameter. VO2(Suga), as a predictive index of VO2 (Measured), was more reliable in each heart than in pooled data from all the hearts because of the interindividual variations of the coefficients. We conclude that both indexes have usefulness and limitations, and should be chosen depending on the application.

Immature follicles grow autonomously even without pituitary gonadotropins. In order to explore this reason, promoting effects of oocyte and some endocrinological substances on the proliferation of granulosa-cells (G-cells) have been investigated using the labelling index (LI) with 3H-Thymidine (3H-Tdr) and mitotic index (MI) in mature mice and immature hypophysectomized (hypox) rats. The following results were obtained: In preantral follicles with the oocyte diameter below 69 mu, the LI was low (9.5 +/- 1.7%) (m +/- SE) and the follicular diameter was small (69.0 +/- 7.7 mu). As the oocyte developed with its diameter 80-89 mu, the LI increased (20.3 +/- 3.8%) and the follicular diameter also increased (192.3 +/- 19.4 mu). In preantral follicles with the oocyte diameter over 80 mu the G-cells near the oocyte had a much higher LI than the distant G-cells. After the antrum formation, the LI and MI of cumulus layers adjacent to the oocyte were three times higher than those of mural layers. Among the mural cell layers in the antral follicle, the layer adjacent to the antrum showed remarkably high LI in comparison with the distant layers. In FSH primed group the LI of G-cells was two fold higher than that in hypox control group (p less than 0.001). In the preantral follicle of hypox control group the G-cells near the oocyte had a much higher LI than the distant G-cells. Moreover in FSH primed group the LI indicated high value not only in the cell layers adjacent to the oocyte but also in the cell layers adjacent to the theca interna. In LH, E2 and P4 primed groups the LI of G-cells had no change significantly in comparison with that in hypox control group. In FSH + LH primed group the LI of G-cells decreased significantly in comparison with that in FSH primed group (p less than 0.05). In FSH + E2 group the LI had no change significantly in comparison with that in FSH primed group. These results suggest that the granulosa-cell growth factor (GGF) in oocyte, which seems to play a role in the formation of cumulus, is secreted with the growth of the oocyte. In antral follicles the GGF is transported through the follicular fluid.(ABSTRACT TRUNCATED AT 400 WORDS)

Experimental and natural infections with Onchocerca volvulus were studied in several anthropophilic blackfly species present in the endemic area of the Upper Orinoco region of Venezuela. When fed on four different Yanomami volunteers in the Sierra Parima, the total infection rate was 31.4% for Simulium guianense in comparison with 7.5% for S. limbatum. The proportion of ingested microfilariae that entered the thorax during the first 24 hours and completed development to the infective stage was also much lower in the latter than in the former species. There was no larval development of O. volvulus in S. antillarum, but one female harboured in its head six infective larvae of a zoonotic filaria. When S. oyapokense s.l. was fed on an infected volunteer in the Upper Orinoco most flies ingested few microfilariae, and further development reached only the L1 stage. Natural infection and infectivity rates for S. guianense in two localities of the Sierra Parima were 0.2-4.0% and 1.3-10.2%, respectively, more than 50% of the L3 larvae being in the head. The corresponding data for S. oyapockense s.l. in the Upper Orinoco were 0.1-0.5%, although the only L3 larva found did not correspond to O. volvulus. It is suggested that S. guianense is the main vector of onchocerciasis in the Sierra Parima and that S. limbatum could play a secondary role. Simulium oyapockense s.l. replaces them in the Upper Orinoco and may maintain a degree of transmission, but its epidemiological importance remains to be assessed.

The intake and development of Onchocerca volvulus in Simulium pintoi from the Parima mountain region of the Federal Territory of Amazonas in Venezuela, were studied experimentally. When wild females fed on the lower half of the legs and lower third of the back of an onchocerciasis patient harboring 23 and 264 microfilariae per skin snip, respectively, at each site, an average (median) of 14 (range, 1-77) and 245 (range, 58-495) microfilariae was ingested. However, within 24 hours of microfilarial ingestion a mortality of 47% (16/34 flies) was observed in the group of flies which fed on the back, as compared with 2% (2/101 flies) in the other group which fed on the legs. At a temperature varying between 16 degrees C and 24 degrees C, the development of O. volvulus larvae in S. pintoi was synchronous and orderly; no abnormal nor deformed larvae were observed. Third-stage larvae were first seen in the head of flies dying between 8 and 9 days after microfilarial ingestion, and 98 of 100 larvae recovered from days 10-16 were in the third stage. The proportions of females harboring third-stage larvae among flies which lived through day 8 in the two groups which fed on the legs and back, respectively, were 55% (21/38 flies) and 63% (5/8 flies). Although only two of five positive flies in the latter group contained third-stage larvae in the head (1 and 12, respectively), 71% (15/21 positive flies) of the former group had an average of 2.7 third-stage larvae in the head (range, 1-10).(ABSTRACT TRUNCATED AT 250 WORDS)

A new human carcinoma cell line (HEC-1), which was derived from low differentiated adenocarcinoma of the endometrium, has been established. Cells from tumor tissues grown in athymic mice were cultured in minimal essential medium supplemented with 20% fetal calf serum. Contaminated mouse fibroblasts were removed from the culture by the absorption of anti-mouse serum. Continuous cell growth (doubling time: 51.6 hrs) could be observed during 64 passages. The cultured cells appeared monolayer and the cellular arrangement was a pavement-like pattern. The morphology of cells was analogous to the one of adenocarcinoma cells. The modal number of chromosomes of the original tumor cells were 46. The t. dic (1; 16)(p21; q24) marker which had been identified as the clonal abnormality in the original tumor cells, was also observed consistently in cultured cells, though the loss of chromosome 19 was disappeared during the passage. This suggested that the rearrangements of the long arm of chromosome 1 played an important role for the endometrial carcinogenesis.

The possible existence of a granulosa cell growth factor (GGF) in the oocyte was investigated by using the mitotic index (%) of granulosa cells (GC) in human antral follicles. 50 follicles (0.4-13 mm in diameter) in 35 ovaries obtained from 35 women were used for the experiments. In each follicle, GC were divided into two groups, cumulus and mural GC, according to the distance from the oocyte. The following results were obtained: The Mitotic Index (MI) of cumulus GC was 8.2 +/- 0.5 (M +/- SE) and was two fold higher than that of mural GC, 4.7 +/- 0.4 (p less than 0.001). As follicles developed, MI of mural GC increased until their diameter reached 3mm but beyond 3mm, MI decreased. On the other hand, there was little relationship between MI of cumulus GC and the follicular size, and MI was constantly high in value. MI of both cumulus and mural GC was higher in the late follicular phase than in other phases of the cycle. These results suggest that the proliferation of GC in growing follicle might be regulated by some unknown substance (GGF) secreted from the oocyte as well as the endocrinological environment. It is also suggested that the presence of the oocyte plays a crucial role in the cumulus oophorus formation in the antral follicles.

An autopsy cases of Menkes kinky hair disease in a 1 year and 8 months old male infant is presented and compared with the morphological findings of the previous literatures. The main pathological changes are atrophy of the whole cerebellar cortex and bilateral temporal lobe, atrophy with demyelination of the white matter, tortuous running of the cerebral arteries, multiple diverticulosis of the urinary bladder and hyaline-like deposition in the gastric submucosa. Microscopically, the peculiar degenerative change of Purkinje cell (somal sprout) is the only characteristic lesion in our case and the others. It is suggested that Menkes kinky hair disease may be a syndrome due to metabolic disturbance appearing not only in ectoderm such as the central nervous system, but also in mesoderm such as connective tissue and bone.

The MK-0787/MK-0791 is a combination of imipenem (a carbapenem antibiotic) and cilastatin sodium (a dehydro peptidase-I inhibitor) in a 1 to 1 ratio, which produces a higher urinary recovery of imipenem than imipenem alone. The MK-0787/MK-0791 was used in 8 female patients with intrapelvic infections. Clinical efficacies were very good in all the patients. There were neither subjective nor objective side effects nor abnormal laboratory findings.

Pharmacokinetic and clinical studies on cefuzonam (CZON) were performed to evaluate its usefulness in the field of obstetrics and gynecology. A summary of the results is as follows: 1. Concentrations of CZON in female genital organ tissues showed a little variance among organs. Mean concentrations were 3.34-7.83 micrograms/g at 40 minutes, 0.523-1.08 micrograms/g at 2 hours 15 minutes and 0.286 micrograms/g (in the myometrium) at 3 hours 10 minutes after the end of drip infusion. 2. Mean concentrations of CZON in the pelvic dead space exudate were 31.0 micrograms/ml immediately after the end of drip infusion (1 hour after the start of infusion), and 37.2 micrograms/ml 1 hour after the end of infusion, then they gradually decreased to 25.6 micrograms/ml after 3 hours and 21.4 micrograms/ml after 5 hours. Mean serum concentrations of CZON in concurrently collected samples from the peripheral vein were 30.0 micrograms/ml immediately after the end of drip infusion, 14.4 micrograms/ml after 1 hour, 4.00 micrograms/ml after 3 hours and 1.84 micrograms/ml after 5 hours. The T 1/2 beta was 1.03 hours. 3. Clinical trial in 7 patients, with CZON administered at a dose level of 1 g at a time, twice daily, showed "excellent" and "good" efficacy in all the patients. No side effects were noted. From the results of the above studies, CZON seems to be highly useful for infections in the field of obstetrics and gynecology.

The effects of temperature on the development of Onchocerca volvulus in Simulium ochraceum, and on the vector's longevity were studied under simulated environmental conditions in the laboratory. When S. ochraceum (which had fed on a person infected with O. volvulus) were maintained at different, constant temperatures (10-30 C), larvae developed to the infective stage between 20 and 28 C. The time required for development to the infective stage depended on the relationship of y = -0.3760 + 0.0222x (y = velocity in development; x = rearing temperature). However, larval development to the infective stage occurred in all groups kept at different temperatures by day and by night (25 C during the day and 10-18 C during the night), although the developmental period was prolonged (10 days in the group held at 25/18 C, and 13 days in other groups). The percentage of females harboring infective larva(e) among those maintained was highest at a constant temperature of 22 C (21.9%), followed by 15.0% at 25 C. When S. ochraceum females were held at day/night differing temperatures, much higher rates were observed at 25/16 C (30.0%) and at 25/14 C (23.0%). Our results suggest that the distribution of onchocerciasis in Guatemala may be related to ambient temperature and to day/night temperature cycles.

Investigation of the seasonal occurrence of Simulium ochraceum, the principal vector of the Guatemalan strain of Onchocerca volvulus, were made from August 1978 until January 1980 in the upper reaches of the two main rivers of endemic onchocerciasis in Escuintla, Guatemala. The results showed that in the late dry season S. ochraceum larvae were restricted to permanent streams at intermediate altitudes. During the rainy season, though, the preimaginal sites of this black fly extended to the upper reaches of the numerous small intermittent streams due to partial subterranean flows. Seasonal occurrence of S. ochraceum in these temporary streams was observed throughout the wet season. However, this was most pronounced during the early months of the dry season (October-December) as long as these streamlets continued to flow. The adult population along the headwaters of these two rivers showed a high peak from October-December. This represented a pattern distinct from that of other places where the preimaginal sites of S. ochraceum occurred mostly in larger perennially running streams. The implications which the present findings have for any future larvicidal control program on the onchocerciasis-endemic region of Guatemala are discussed.

The possible existence of granulosa-cell growth factor (GGF) in the oocyte has been investigated using the labelling index (LI) with 3H-Thymidine and the mitotic index (MI) of granulosa cells (G-cells) in mice. The following results were obtained. In preantral follicles the LI increased with the development of the oocyte until its diameter reached the maximum (approximately 90 mu). In preantral follicles with the oocyte diameter below 69 mu, the LI was low and the follicular diameter was small. As the oocyte developed, the LI increased and reached the maximum value when the follicular diameter was approximately 200 mu. Then it decreased a little but maintained a high value. The antrum formation was seen when the follicular diameter was about 300 mu showing no change in LI. In preantral follicles with the oocyte diameter over 80 mu the G-cell near the oocyte had a much higher LI than the distant one. After the antrum formation, the LI and MI of cumulus layers adjacent to the oocyte were three times as great as those of the mural layers. Among the mural cell layers in the antral follicle the layer adjacent to the antrum showed remarkably high LI in comparison with the distant layers. These results suggest that GGF which seems to play a role in the formation of cumulus is secreted with the development of the oocyte. The GGF is transported through two systems the preantral follicle and cumulus layer through the G-cell gap junction and mural layers through the follicular fluid.