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Objective— Myocardin is a coactivator of serum response factor (SRF) required for vascular smooth muscle cell (VSMC) differentiation. HERP1 is a transcriptional repressor, which is abundantly expressed in vascular system and is known to function as a target gene of Notch. However, the role of HERP1 in the pathogenesis of vascular lesions remains unknown. The present study characterizes the expression of HERP1 in normal and diseased vessels, and tests the hypothesis that HERP1 inhibits SRF/myocardin-dependent SMC gene expression. Methods and Results— Immunohistochemistry revealed that HERP1 and myocardin expression was localized to SMC in the neointima of balloon-injured rat aorta and in human coronary atherosclerotic lesions. Expression of both HERP1 and myocardin was elevated in cultured VSMCs compared with medial SMC. Overexpressed HERP1 inhibited the myocardin-induced SMC marker gene expression in 10T1/2 cells. HERP1 protein interfered with the SRF/CArG–box interaction in vivo and in vitro. Immunoprecipitation assays showed that HERP1 physically interacts with SRF. Conclusions— HERP1 expression was associated with the SMC proliferation and dedifferentiation in vitro and in vivo. HERP1 may play a role in promoting the phenotypic modulation of VSMCs during vascular injury and atherosclerotic process by interfering with SRF binding to CArG-box through physical association between HERP1 and SRF.

Lymphoepithelioma-like carcinoma (LELC) of the bladder is very rare and only a few cases have been reported so far. Here, we report a case of LELC of the bladder with distant metastasis. A 73-year-old man presented with macroscopic hematuria and miction pain. Cystoscopy revealed non-papillary tumor and tissue biopsy was performed. Histopathological examination showed pure type of LELC in the bladder. Fludeoxyglucose positron emission tomography revealed lymph node metastasis. The tumor progressed rapidly and the patient died 4 months later. Although the prognosis of pure type of LELC has been reported to be good, our case indicates that the prognosis of pure type with distant metastasis may be poor.

Objectives We developed and validated an ultrasonographic index of intestinal inflammatory activity for patients with Crohn's disease. Methods Fifty-five patients with Crohn's disease were examined by transabdominal ultrasonography. The pathological findings were classified into three types (A-C) on the basis of wall thickness and wall stratification. To calculate the index, we divided the intestine into eight segments, and the scores for each segment were summed to calculate the index (ultrasonographic activity index of Crohn's disease) as follows: 1 point for type A lesions, [wall thickness (mm) - 21 × 2 for type B lesions, and [wall thickness (mm) - 2] × 4 for type C lesions. Endoscopic or barium contrast findings were also scored in a similar fashion, with the following parametric scores: 10 for cobblestoning, 5 for longitudinal ulcers, 3 for aphthoid ulcers, and 1 for chronic inflammatory changes. Results A strong correlation (r2 = 0.62, P< 0.01) was found between the ultrasound index and the endoscopic/ radiological score, while weak correlations were found between the endoscopic/radiological score and the Crohn's disease activity index or biological indices of inflammation. Conclusions Our results show that the ultrasonographic activity index of Crohn's disease can be of value in the ongoing assessment and treatment of patients.

A coronary stent was made radioactive by implantation of 133Xe ions for the purpose of suppressing the re-narrowing of the part of blood vessel in which the stent is implanted. Electrons of relatively low energies emitted in the decay of 133Xe may give an antiproliferative effect of ionizing radiation to the intimal cells within a limited range of 1 mm. A 133Xe+ beam accelerated at 40 or 60 keV was directed to several stainless steel stents mounted on a target-holder table that could revolve and move up and down to distribute the 133Xe+ ions within a stent as well as among the stents. The radioactive stents produced contained up to 100 kBq of 133Xe and were implanted into the abdominal aortas of rabbits. Neointimal thickening was analyzed by histomorphometry for samples taken 4 weeks after stent implantation. The results indicate that the radioactive stents have a potential to suppress neointimal hyperplasia in rabbits.

Background: Recent studies have shown that the eradication of Helicobacter pylori results in a gastric acid secretion which decreases to normal levels in patients with duodenal ulcer disease. The aim of this study was to evaluate the effect of eradication of H. pylori in a 24-h study of gastric acidity in patients with atrophic gastritis of the corpus. Methods: Intragastric acidity was measured by continuous 24-h pH monitoring, and the histology of the gastric antrum and corpus were evaluated in 14 H. pylori-positive patients with histologically proven atrophic gastritis of the corpus (10 men, 4 women; mean age, 57 years) before and 1 year after anti-H. pylori therapy. Results: H. pylori was absent in 13 of 14 patients 1 year after treatment. Both gastritis and atrophy scores were significantly lower after eradication therapy (P

A 23-year-old woman with heterozygous Fabry's disease who had acroparesthesia was admitted to hospital for precise examination of the disease before childbearing. She had no cardiac-related symptoms and no abnormality on physical examination. The alpha-galactosidase A activity in her leukocytes was present, but lower than normal. However, the endomyocardial biopsy showed specific changes for Fabry's disease. As Fabry's disease is a rare X-linked recessive inborn error of glycosphingolipid metabolism, heterozygous females are usually asymptomatic, but rarely can be affected as severely as hemizygous males. This is an isolated case of heterozygous Fabry's disease in a female in whom cardiac involvement was detected by endomyocardial biopsy, although she had no cardiac abnormality on physiological examinations. In conclusion, endomyocardial biopsy is useful for evaluation of the cardiac involvement of Fabry's disease even in an asymptomatic case.

Background: Somatostatin exerts inhibitory effects on physiological functions in the gastrointestinal tract. The actions differ, however, depending on the test meal, dose, and other factors. Aims: To determine by use of ultrasonography and scintigraphy the effect of a somatostatin analog, octreotide, on gastric emptying and antral contraction. Subjects: Twenty healthy men; mean age 23.9 years Methods: Subjects were studied for 7 days, once after subcutaneous injection of octreotide, 50 μg, 5 min before the ingestion of a test meal and once after subcutaneous injection of placebo. Ten subjects received a liquid meal, 10 others received a solid meal. With the liquid meal, gastric emptying was measured 15 min after its ingestion and antral contraction was measured for 15 min by ultrasonography. With the solid meal, gastric emptying was measured both by ultrasonography (n=10) and by simultaneous scintigraphy (n=6), with antral contraction measured by ultrasonography for 5 h after ingestion of the meal. Results and Conclusions: Octreotide given with a liquid or solid meal inhibited gastric emptying in healthy subjects. A significant suppression of antral contraction occurred only with a solid meal.

We describe the novel karyotype of a 33-year-old woman with severe mental retardation and multiple cardiac anomalies, including patent ductus arteriosus, a ventricular septal defect, pulmonary atresia, and an overriding aorta. Her karyotype was 46, XX, add(17)(p13). The short arm of chromosome 17 was slightly elongated owing to the deletion of the distal portion of that chromosome and the addition of extra material from another chromosome. Miller-Dieker syndrome is characterized by a patent ductus arteriosus, lissencephaly, and the deletion of chromosome 17p13.3; however, as the patient's brain surface appeared normal on computed tomography, Miller-Dieker syndrome was excluded. The breakpoint in her chromosome 17 was probably located distal to band 17p13.3. In fact, fluorescence in situ hybridization analysis demonstrated that band 17p13.3 was intact. To date, genes distal to 17p13.3 have not been implicated in cardiac anomalies. This patient probably carries a novel deletion on the short arm of chromosome 17.

症例は74歳,女性.眼,皮膚サルコイドーシスと診断されていた.胸部X線,心電図,心エコー, Gaシンチにて心異常はなかったが, FDG-PETにて心集積を認めた.経過観察中に左脚ブロックを経て完全房室ブロックに進展しステロイド治療を開始した.この際のFDG-PETにて心集積が増強していたが, Gaシンチでは変化なかった. Gaシンチで検出できなかったサルコイドーシスの心病変を, FDG-PETにより早期より観察できた.

The angiotensin-converting enzyme (ACE) inhibitor enalapril was administered to 13 patients with chronic heart failure (New York Heart Association class II or III) for 12 weeks, and its effects on resting cardiac function (shown by echocardiogram), exercise capacity, and biochemical factors were investigated. Left ventricular end-diastolic and end-systolic diameters improved significantly from 60.3 ± 5.4 mm at baseline to 57.2 ± 5.7 mm after 12 weeks of treatment and from 50.2 ± 5.9 mm to 46.8 ± 5.6 mm, respectively; however left atrial dimension did not change significantly after treatment. Peak oxygen uptake also improved significantly after enalapril treatment (20.0 ± 6.9 mL/kg/min at baseline to 22.4 ± 7.6 mL/kg/min after treatment), as did anaerobic threshold by gas exchange (17.1 ± 6.4 mL/kg/min vs 18.4 ± 5.8 mL/kg/min). The serum levels of atrial natriuretic peptide and beta-endorphin decreased significantly after treatment (47.6 ± 42.1 pg/mL before vs 31.6 ± 29.2 pg/mL after treatment and 11.6 ± 3.6 pg/mL vs 5.9 ± 2.8 pg/mL, respectively). These results indicated that enalapril is useful for improving resting cardiac function, exercise capacity, and biochemical factors in patients with chronic heart failure.

For the purpose of achieving emergency hemostasis of a ruptured hepatocellular carcinoma (HCC) or prevention of such rupture, we applied a new method of transcatheter therapy: intra-arterial alcoholization. Five patients with a ruptured HCC and 42 with an impending rupture were treated by intra-arterial injection of absolute ethanol mixed with an equal volume of iodized oil, Lipiodol (EtOH-Lp). The tumor size ranged from 4 to 26 cm (mean 7.8 cm) in diameter. The catheter tip was placed in the segmental branch or a more distal position of the hepatic artery, and 2–40 (mean 10.6) ml of EtOH-Lp was infused under fluoroscopic guidance. Infiltration of ethanol into the HCC mass was recognized as a dense deposition of Lipiodol on plain abdominal X-rays and computed-tomography. In all five cases of ruptured HCC, hemostasis was achieved. In all 42 cases of impending rupture, tumor rupture was prevented, and all except 3 patients could be discharged. No significant complication of the gastrointestinal tract or biliary tract was seen. The incidence and severity of postembolization syndrome were markedly lower than those seen in cases treated with Gelfoam embolization.

Serial examination of the electrocardiograms of a 69-year-old man with autopsy proven dilated cardiomyopathy revealed gradual prolongation of the PR interval and development of Q waves in leads II III and aVF over the post last 3 years. On the vectorcardiogram, the QRS loop was gradually distorted and displaced posteriorly in the horizontal plane during the follow up period. Thallium-201 myocardial scintigram revealed perfusion defect of the entire left ventricle, except the lateral wall, consistent with diffuse myocardial fibrosis at autopsy. We thought that gradual loss of electromotive force of the left ventricle resulting from extensive myocardial fibrosis and progression of the intraventricular conduction disturbance might be responsible for the serial electrocardiographic and vectorcardiographic changes in this case.

A 73-year-old man presented with lymphadenopathy, hepatosplenomegaly, and a variety of hematological and immunological abnormalities. The bone marrow was replaced by polymorphic cellular infiltrates containing aggregates of CD10(+) T-cells. Circulating lymphoplasmacytic/immunoblastic cells showed an early plasma cell immunophenotype on flow cytometric analysis. Combination of these observations indicated that the underlying disorder of this patient was angioimmunoblastic T-cell lymphoma (AITL); postmortem pathology was consistent with progression of peripheral T-cell lymphoma. Even in the absence of definitive lymph node biopsy, the appearance of the bone marrow and the peripheral blood can lead to the diagnosis of AITL.

Background: Helicobacter pylori stool antigen (HpSA) test is a new tool for evaluating the H. pylori infection. The present study was carried out to investigate the clinical usefulness of the HpSA test in the evaluation of eradication therapy by comparing it with the 13C-urea breath test (UBT). Methods: One hundred and five patients received eradication therapy for H. pylori. After more than 8 weeks, the success of the therapy was evaluated by the HpSA test and the UBT. Concordant results were regarded as a final diagnosis, but when the results were discordant, histological examination was carried out. Results: Of the 105 patients receiving eradication therapy for H. pylori, 25 patients were regarded as H. pylori positive by the UBT and and 20 patients were regarded as H. pylori positive by the the HpSA test. Nine patients (8.6%) showed discordant results (seven cases with UBT(+) and HpSA(–), and two with UBT(–) and HpSA(+)). Five cases out of nine were ultimately judged as having a false-positive result of the UBT, and in these cases the UBT values were relatively low (below 10 per thousand). The final diagnostic accuracies of the UBT and the HpSA test were 94.3% (88.0–97.9%; 95% CI) and 97.1% (91.9–99.4%), respectively. When we used the HpSA test in cases with weakly positive UBT values, we were able to diagnose the correct status of H. pylori infection after eradication in 99% of all patients (94.8–100.0%). Conclusion: The HpSA test is a useful tool for the evaluation of eradication therapy and a combination of the HpSA test and UBT is clinically recommended.

Myocardial sympathetic neural function in professional athletes who had the long-term tremendous cardiac load has not been fully investigated by myocardial iodine-123-metaiodobenzylguanidine (MIBG) uptake in comparison with power spectral analysis (PSA) in electrocardiography. Eleven male professional cycle racers and age-matched 11 male healthy volunteers were enrolled in this study. The low frequency components in the power spectral density (LF), the high frequency components in the power spectral density (HF), the LF/HF ratio and mean R-R interval were derived from PSA and time-domain analysis of heart rate variability in electrocardiography. The mean heart-to-mediastinum uptake ratio (H/M ratio) of the MIBG uptake, in professional cycle racers was significantly lower than that in healthy volunteers (p

Background —We have previously shown BTEB2, a Krüppel-like zinc finger transcription factor, to regulate expression of the SMemb/NMHC-B gene, which has been implicated in phenotypic modulation of smooth muscle cells (SMCs). The present study was done to assess the developmental and pathological expression profiles of BTEB2 and to further evaluate the clinical relevance of BTEB2 expression in human coronary artery disease. Methods and Results —Immunohistochemistry showed developmentally regulated expression of BTEB2 with abundant expression in fetal but not in adult aortic SMCs of humans and rabbits. In balloon-injured aortas, predominant expression of BTEB2 was seen in neointimal SMCs. Atherectomy specimens obtained from primary and restenotic lesions showed predominant expression of BTEB2 to stellate SMCs. The incidence of restenosis in primary lesions was significantly higher in lesions containing BTEB2-positive cells than in lesions without (55.6% versus 25.0%, P =0.01). Conclusions —The present study shows that BTEB2 expression is developmentally and pathologically regulated. BTEB2 is preferentially expressed in dedifferentiated or activated SMCs. Examination of human coronary artery specimens suggests that primary lesions containing BTEB2-positive cells are associated with higher risk of restenosis than BTEB2-negative lesions. These results suggest that BTEB2 can serve as a molecular marker for phenotypic modulation of vascular SMCs.

Background and Aims: Although antroduodenal motility has usually been studied by using manometric or scintigraphic methods, ultrasonography is an established, non-invasive method to evaluate duodenogastric motility. We used ultrasonography to evaluate gastric motility in patients with functional dyspepsia. Methods: Sixty-four patients with functional dyspepsia and 36 asymptomatic healthy subjects were given liquid and solid test meals. We investigated the gastric emptying rate, motility index, and duodenogastric reflux for the liquid meal and gastric emptying time, half-emptying time, and motility index for the solid meal. Results: After the liquid meal, the gastric emptying rate and motility index were significantly lower and the duodenogastric reflux was significantly higher in functional dyspepsia patients than in healthy subjects. After the solid meal, gastric emptying time, half-emptying time and the motility index were significantly lower in the patients than in the healthy subjects. Delayed gastric emptying of both meals occurred in only 20.3% of patients. Delayed emptying of the liquid or solid meal occurred in 62.5% of patients. In both groups, gastric emptying time of the solid meal was positively correlated with the motility index at 15 min post-ingestion. Conclusion: In functional dyspepsia patients, delayed gastric emptying of a solid meal was related to antral hypomotility during the early postprandial phase. Ultrasonographic assessment of gastric motility in both liquid and solid meals may provide a better understanding of the pathogenesis of functional dyspepsia.

Direct amplification of DNA from clinical specimens, such as blood and faeces, by polymerase chain reaction (PCR) is most often hindered by endogenous inhibitory substances, including haemoglobin and bile acids. We tested whether Ampdirect® A (Shimadzu), a novel reagent cocktail that has been shown to suppress the inhibitors in blood, is also useful for faecal samples, and found that the vero toxin genes (VT1 and VT2) of Escherichia coli O157 could be efficiently amplified from the supernatant of boiled faeces by PCR in the presence of this cocktail without prior extraction of DNA. We compared the efficiency of amplification with and without the cocktail, using the supernatant of boiled normal faeces supplemented with E. coli O157. PCR without the cocktail failed to amplify the vero toxin genes from the supernatant diluted < 6400-fold or containing > 0·02% (final concentration) of boiled faeces. By contrast, PCR with Ampdirect A amplified the toxin genes in the mixture containing as much boiled faeces as 0·5% and as few E. coli as 4 to 8 colony-forming units (CFU). The minimum limit for E. coli O157 detection by this method was estimated to be about 104 CFU/g faeces. The results obtained by this direct method agreed well with those obtained by the indirect method using DNA pre-extracted from patients' faeces (the detection limit being 103 CFU/g faeces).

The association between the lack of adrenergic symptoms during hypoglycemia and myocardial 123I-metaiodobenzylguanidine (MIBG) accumulation was investigated in 12 insulin-treated non-insulin-dependent diabetes mellitus (NIDDM) patients who had no evidence of heart disease. These patients were divided into 2 groups according to the presence (group A) or absence (group B) of adrenergic symptoms during hypoglycemia. Autonomic function tests revealed significantly severe autonomic dysfunction in group B compared to that in group A. Insulin infusion test indicated no significant difference in the catecholamine response between the two groups. 123I-MIBG scintigraphy showed that the heart/mediastinum ratio of MIBG uptake was significantly lower, and scintigraphic defect was greater in group B than in group A. There were no significant differences in the washout rate between the two groups. These results suggested that the lack of adrenergic symptoms during hypoglycemia may be associated with cardiac sympathetic nervous dysfunction in insulin-treated NIDDM patients, and this dysfunction is mainly due to cardiac sympathetic denervation.(Internal Medicine 35: 94-99, 1996)

The purpose of this study was to identify predictors of development of chronic nonrheumatic atrial fibrillation within one year of onset, thereby minimizing the risk of embolic complications and death. We retrospectively studied 137 patients with new-onset nonrheumatic atrial fibrillation. Chronic atrial fibrillation developed in 30 patients at the end of one year (chronic group). Atrial fibrillation remained paroxysmal in 107 patients (paroxysmal group). Clinical characteristics, electrocardiograms, and echocardiograms at the time of the onset of atrial fibrillation were compared in the two groups. Patients in the chronic group were significantly older than patients in the paroxysmal group (70.1 ± 8.2 vs. 62.4 ± 11.0 years, p < 0.01) and had a significantly higher incidence of congestive heart failure (13% vs. 3%, p < 0.05) and diabetes mellitus (37% vs. 19%, p< 0.05). The chronic group also exhibited higher cardiothoracic ratio (52.0 ± 5.7% vs. 47.6 ± 5.0%, p < 0.01), greater f-wave amplitude in lead V 1 (1.48 ± 0.91 vs. 1.06 ± 0.45 mm, p < 0.05), larger left atrial dimension (41.0 ± 6.4 vs. 34.2 ± 7.6 mm, p < 0.01), and lower left ventricular ejection fraction (71.4 ± 5.6% vs. 75.5 ± 8.2%, p < 0.05). The presence of four or more of the following seven factors strongly predicted the development of chronic nonrheumatic atrial fibrillation within one year (88% to 100%) : age ≥65 years, congestive heart failure, diabetes mellitus, cardiothoracic ratio ≥50%, f-wave amplitude ≥2.0 mm, left atrial dimension ≥38 mm, and ejection fraction ≤76%. (Jpn HeartJ 36 : 191-199, 1995)

The basal part of the interventricular septum may easily become hypertrophic because it is exposed to strong hemodynamic stress compared to the other portions of the left ventricle. We measured the end-diastolic interventricular wall thickness both at the base and in the midsection by 2D echocardiography in 122 normotensives, and examined whether the basal thickness increases with age. The basal thickness (B) increased with age in both sexes. In males the thickness averaged 10.1 mm in the 50-59 age group, 10.2 m in those aged 60-69 and 11.4 mm (p < 0.01) in those 70 or older compared to 9.4 mm in those aged 49 or younger. In females it was 8.1 mm (p < 0.05) in the 50-59 age group, 8.3 mm (p < 0.05) in those aged 60-69 and 10.0 mm (p < 0.01) in those 70 or older compared to 6.8 mm in those 49 or younger. Concerning the midwall thickness (M), there were no significant changes among the respective age groups in either sex. As a result, a close correlation was found between the B/M ratio, a new and simple index for basal hypertrophy, and age (R = 0.46, p < 0.01 in males and R = 0.43, p < 0.01 in females). Comparison of the B/M ratio between the two age groups 49 or younger and 70 or older was as follows; 1.08 vs 1.30 (p < 0.01) in males and 1.01 vs 1.27 (p < 0.01) in females. Increase of basal hypertrophy in the aged was clearly indicated by the B/M ratio.

Urachal adenocarcinoma is a rare bladder tumor, occasionally associated with calcification. We report a case of urachal adenocarcinoma with remarkable stromal osseous metaplasia and review the literature on this rare condition. This is the first complete case report in English of this uncommon entity.

A 52-year-old woman with systemic lupus erythematosus (SLE) had a hemoperitoneum following a ruptured dissecting aneurysm of the right gastroepiploic artery. We believe this event has been reported only eight times before, but this is the first time it has been associated with SLE.

経管栄養施行例22例を対象として, 血清脂質, アポ蛋白, 血液不飽和脂肪酸および血液凝固線溶関連因子を測定し, 長期の経管栄養法の影響についての検討を行い下記の結果を得た. 1. 血清脂質の検討では, TG-HDLCがNF群で有意 (p

Here, deposition of SiO2 film by RF-sputtering onto the anodic Ta2O5 film for fabrication of an SiO2-Ta2O5 thin film capacitor is reported. Reproducible film deposition rate is achieved within the accuracy of 3% by decreasing the influence of adsorbed gases in the vacuum chamber. Argon pressure is adjusted in order to obtain the uniform deposition of the SiO2 film. The thickness distribution is less than 3% within the area covered by 70% of target radius. The standard deviation of capacitance due to the distribution of SiO2 films is about 2.5% of the average capacitance.The substate temperature should be precisely controlled during RF-sputtering for the realization of the capacitor with excellent electrical characteristics. The high substrate temperature causes deterioration of Ta2O5, but the SiO2 film deposited at low temperature has poor life stability and large capacitance change in moisture. The optimum substrate temperature is about 150 °C for the SiO2 film deposition onto the anodic Ta2O5 film.

Rats were separated into four groups and four different liquid diets were given to each group. Group 1: thiamine-sufficient diet with no ethanol, group 2: thiamine-sufficient diet with ethanol, group 3: thiamine-deficient diet with no ethanol, group 4: thiamine-deficient diet with ethanol. After four weeks, all rats were fasted for 24 hr and then ethanol was given orally to every rat. After one hour, every rat was sacrificed and biochemical and histological analyses were carried out. Transketolase activity in brain and liver decreased in groups 2, 3 and 4. There was significant decrease in transketolase activity in ethanol-fed groups (groups 2 and 4) as compared to control groups (groups 1 and 3). Ethanol concentrations in blood, liver and heart of rats in groups 2 and 4 were higher than in groups 1 and 3. When comparison was made between the thiamine-deficient groups and the corresponding thiamine-sufficient groups, ethanol concentrations in liver and heart were higher in the thiamine-deficient groups. Alcohol dehydrogenase activity in liver decreased significantly in groups 2 and 4. By histological analyses, fatty degeneration was observed in the livers of groups 2 and 4. The degeneration was more prominent in group 4 than group 2. These findings suggest that chronic ethanol administration may impair the ability to metabolize ethanol and the impairment may increase when rats are in the condition of thiamine deficiency.

An autopsy case of dysgammaglobulinemia associated with affection of the central nervous system in a 61-year-old male was reported. Close similarity of the findings to those of the case reported by Bichel et al. was noticed. The abnormal protein observed in this case was proved to belong to IgG by ultracentrifugation, immunoelectrophoresis and fractionation on DEAE-cellulose column. Histological characteristics were remarkable infiltration of mononuclear cells including plasma cells, proliferative changes of the vessel walls in several organs, such as the lymph nodes, spleen, lungs, etc., and demyelinating lesions were found in the central nervous system. lmmunofluorescent study revealed the presence of human y-globulin in the infiltrates in various organs. Subacute or chronic infection by an unknown agent or hypersensitivity is suggested.

According to Schnitker, Mandel, Hirst and their associates, approximately half of the dissecting aneurysms in women under 40 years of age are associated with pregnancy. This significant relationship between dissecting aneurysm and pregnancy has been discussed by considering hemodynamic stress and also the hormonal changes of pregnancy. In this report, we describe five patients with dissecting aneurysm during pregnancy or the puerperium, review the literature and discuss the influence of pregnancy on the pathogenesis of this disease.

A cloned human hepatoma cell line (HH2-1) produced and formed collagen fibers in vitro. The relative rate of collagen synthesis by the cells was increased with an enhancement of the cell density. An analysis of the components of the collagen using sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the cells synthesized interstitial collagen, types I and III, and other collagenous proteins. Thus, human hepatoma cells may play an important role in the formation of stromal collagen in the tumor.