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Background In primary percutaneous coronary intervention (PCI) for acute myocardial infarction, we occasionally experience challenging cases where conventional guidewires cannot pass through the lesion. In such cases, if the use of a tapered guidewire or polymer jacket guidewire is also unsuccessful, coronary artery bypass surgery becomes inevitable. Therefore, other methods to enable revascularization in a reliable and timely manner are desirable. Case summary We present the first case of intravenous ultrasound (IVUS)-guided tip detection (TD)-antegrade dissection re-entry (ADR) in a 73-year-old man who suffered ST-segment elevation myocardial infarction (STEMI). The patient had a total thrombotic occlusion of the right coronary artery and stenotic lesion of the left anterior descending artery. Primary PCI was unsuccessful and IVUS-guided rewiring using a chronic total occlusion (CTO) wire failed due to thrombus attenuation. However, IVUS imaging revealed the presence of intimal and subintimal space, which led us to perform IVUS-guided TD-ADR using Conquest Pro 12 ST (Asahi Intecc). Using the TD method, we were successful in swiftly puncturing the true lumen wall, and a stent was implanted following successful re-entry. Final angiography showed the establishment of Thrombolysis in Myocardial Infraction-3 flow and resolution of ST-segment elevation. Discussion IVUS-guided TD enables accurate puncture in an ADR procedure, enabling successful recanalization in a relatively short time. Thus, IVUS-guided TD-ADR is a reliable option for revascularization in STEMI cases wherein the guidewire fails to pass the occlusion using conventional techniques.

Various vaginoplasty procedures have been developed for patients with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome. Here, we describe a novel laparoscopic vaginoplasty procedure, known as the Kisu modification, using a pull-down technique of the peritoneal flaps with additional structural support to the neovaginal apex using the incised uterine strand in patients with MRKH syndrome. Ten patients with MRKH syndrome (mean age at surgery: 23.9 ± 6.5 years, mean postoperative follow-up period: 17.3 ± 3.7 months) underwent construction of a neovagina via laparoscopic vaginoplasty. All surgeries were performed successfully without complications. The mean neovaginal length at discharge was 10.3 ± 0.5 cm. Anatomical success was achieved in all patients, as two fingers were easily introduced, the neovagina was epithelialized, and the mean neovaginal length was 10.1 ± 1.0 cm 1 year postoperatively. No obliteration, granulation tissue formation at the neovaginal apex, or neovaginal prolapse was recorded. Five of the 10 patients attempted sexual intercourse and all five patients were satisfied with the sexual activity, indicating functional success. Although the number of cases in this case series is few, our favorable experience suggests that the Kisu modification of laparoscopic vaginoplasty procedure is an effective, feasible, and safe approach for neovaginal creation in patients with MRKH syndrome.

The present study examined gamma-aminobutyric acid B (GABAB ) receptor, GABA, choline acetyltransferase (ChAT), and neuronal nitric oxide synthase (nNOS) immunoreactivities in the mouse adrenal medulla. GABAB receptor immunoreactivity was seen in numerous chromaffin cells and in a few ganglion cells of the adrenal medulla. By using a formaldehyde-induced fluorescence (FIF) method, GABAB receptor immunoreactivity was observed in numerous adrenaline (A) cells, but not in noradrenaline (NA) cells showing blue-white fluorescence. This suggests that GABAB receptors may be present in the A cells and be related to the secretory activity of A cells but not NA cells in the mouse adrenal medulla. GABAB receptor immunoreactive ganglion cells were shown to be nNOS immunopositive by using a double immunostaining method. Weak GABA immunoreactivity was visible in some chromaffin cells and in the numerous nerve fibers of the medulla. By using the FIF method, weak GABA-immunoreactive chromaffin cells were shown to be in the NA cells showing blue-white fluorescence. GABA-immunoreactive nerve fibers were in dense contact in A cells, but not NA cells. GABA-immunoreactive nerve fibers closely contacted a few ganglion cells. Numerous GABA-immunoreactive nerve fibers in the medulla showed ChAT immunoreactive. This result suggests that GABA and acetylcholine may be released from the same nerve fibers and may have a secretory effect on the A cells of the medulla.

From postnatl-day-0 to postnatal-day-2, a few acetylcholinesterase (AChE)-active and choline acetytransferase (ChAT)-immunoreactive nerve fibers and relatively numerous vesicular acetylcholine transporter (VAChT)-immunoreactive puncta were observed in the rat adrenal medulla. Despite relatively numerous clear vesicles in the nerve fibers, the synthesis and hydrolysis of acetylcholine may not be fully activated until postnatal-day-2. The number of AChE-active and ChAT-immunoreactive nerve fibers dramatically increased and that of VAChT-immunoreactive puncta gradually increased from postnatal-day-3 to postnatal-week-1. The synthesis and hydrolysis of acetylcholine may be dramatically activated in the nerve fibers of the medulla until postnatal-week-1. From postnatal-week-2 to postnatal-week-3, the number of AChE-active and the ChAT-immunoreactive nerve fibers gradually increased and reached the adult levels. The VAChT-immunoreactive puncta per unit area was maximum number at postnatal-week-2. The synthesis and hydrolysis of acetylcholine in the nerve fibers of the medulla may be completed between postnatal-week-2 to postnatal-week-3. The diameter of the VAChT-immunoreactive puncta gradually increased from postnatal-day-0 with aging. However, the number of the VAChT-immunoreactive puncta gradually decreased from postnatal-week-2 onwards. In electron-microscopy, the VAChT-immunoreactive deposits were seen in clusters of clear vesicles, and the diameter of the nerve fibers and the number of clear vesicles at postnatal-week-8 increased compared with those at postnatal-week-2. The AChE-active, ChAT-immunoreactive, and VAChT-immunoreactive nerve fibers observed around noradrenaline (NA) cells were denser than those around adrenaline (A) cells in the medulla at postnatal-week-8. These suggest that the preferential innervation of NA and A cells may cause the differential secretion NA and A. Anat Rec, 292:371–380, 2009. © 2009 Wiley-Liss, Inc.

Substance P (SP)-immunoreactive nerve fibers in the adrenal medulla was very few during postnatal day 0-5, indicating that its synthesis in the neurons and the transport to nerve endings was incomplete by the end of this period. Since the number of SP-immunoreactive nerve fibers gradually increased during postnatal week 1-2, it was hypothesized that SP was not fully transported to nerve endings until postnatal week 1-2. At postnatal week 3, numerous SP-immunoreactive nerve fibers contacted some noradrenaline (NA) cells but not adrenaline (A) cells in the medulla. From postnatal week 3 onward, the abundance and expression patterns of SP-immunoreactive nerve fibers in the medulla were similar to those in adults. At postnatal week 3, the innervation with SP-immunoreactive nerve fibers was completed indicating the possibility that SP affected on the secretory activity of NA cells but not of A cells in the medulla. The medullary SP-immunoreactive nerve fibers contacting the chromaffin cells possessed a few dense-cored vesicles in their endings at postnatal week 8. Very few SP-immunoreactive chromaffin cells were found in the medulla from postnatal day 0 onward, and SP immunoreactivity was primarily observed in granular cores of the cells suggesting that SP and catecholamine synthesized in the chromaffin cells were released from the granules by adequate stimuli. Very few or a few SP-immunoreactive nerve fibers, acting as a vasomotor effect were found around blood vessels in the superficial cortex from postnatal day 0 onward.

It has been shown that musculoskeletal tissues undergo dynamic tissue remodeling by a process that is quite sensitive to the mechanical environment. However, the detailed molecular mechanism underlying this process remains unclear. We demonstrate here that after denervation-induced mechanical stress deprivation, tendons undergo dynamic tissue remodeling as evidenced by a significant reduction of the collagen fibril diameter. Importantly, the transient up-regulation of osteopontin (OPN) expression was characteristic during the early phase of tendon tissue remodeling. Following this dynamic change of OPN expression, matrix metalloproteinase (MMP)-13 expression was induced, which presumably accounts for the morphological changes of tendon by degrading tendon collagen fibrils. The modulation of MMP-13 expression by OPN was specific, since the expression of MMP-2, which is also known to be involved in tissue remodeling, did not alter in the tendons under the absence or presence of OPN. We also demonstrate that the modulation of MMP-13 expression by OPN is due to the signaling through cell surface receptors for OPN. Thus, we conclude that OPN plays a crucial role in conveying the effect of denervation-induced mechanical stress deprivation to the tendon fibroblasts to degrade the extracellular matrices by regulating MMP-13 expression in tendon fibroblasts.

Giant left atrium due to mitral stenosis with massive atelectasis: A successful case with perioperative approach☆ Atsushi Tanita , Yusuke Hosokawa ⁎, Takeshi Tomiyama , Maiko Kato , Junya Matsuda , Keisuke Sawai , Yoshie Arita , Toshiyuki Aokage , Hiroomi Suzuki , Hiroshige Murata , Hideki Miyachi , Toshiyuki Shibui , Takahito Nei , Koichi Akutsu , Takeshi Yamamoto , Shinhiro Takeda , Takashi Nitta , Kunio Tanaka , Kyoichi Mizuno , Keiji Tanaka a

¶Background. There have been some reports that radiation necrosis can be controlled conservatively. There are rare cases showing progressive space-occupying radiation necrosis (PSORN). It is very difficult to control PSORN by conservative treatment. The purpose of this study was to evaluate the early diagnosis of those cases and the timing of surgery for patients with PSORN. Method. We have experienced some cases where quality of life was improved by the removal of PSORN after stereotactic radiosurgery (SRS) for brain metastases. Therefore, we evaluated retrospectively the diagnosis and treatment of six cases of symptomatic PSORN at approximately 6–12 months after SRS for metastatic brain tumours. Findings. In all six cases, on Magnetic Resonance Imaging with Gd contrast material (Gd-MRI), PSORN was revealed as a ring-like enhanced mass with large perifocal oedema coupled with the appearance of neurological deficit. Proton Magnetic Resonance Spectroscopy (1H-MRS) enabled us to differentiate PSORN from recurrence of metastases in all six cases. Single Photon Emission Computed Tomography with thallium-201 chloride (201TlCl-SPECT) enabled us to do this in four cases of the six. In four cases of the six, lesionectomy of the ring-like enhanced mass (PSORN) was performed, and in two of these cases the removal was performed within 4 weeks from the time when conservative treatment became ineffective, and the neurological deficit and perifocal oedema was improved as was the quality of life. However, in the other two patients who were left for more than 16 weeks, the deficit was gradually progressive. The two patients who did not receive lesionectomy were treated by conservative means with steroids and/or heparin and warfarin and they had progressive neurological symptoms. Interpretation. Although, the number of patients is small in this study, and more data will be needed, it is recommended that lesionectomy is performed at an early stage, if possible, when conservative management has failed.

A transient (lasting for 15 min) bilateral carotid artery occlusion model was created by using male Mongolian gerbils ( n=20, weight 50-60 g). The animals were divided into a group with mild hypothermia (34 degrees C, n=10) and a normothermic group (37 degrees C, n=10). High-energy phosphate metabolism (ATP, PCr, Pi) and intracellular pH were sequentially measured using (31)P-MRS during ischemia and after reperfusion for 1 week. The same animals were also subjected to a histopathological evaluation. During ischemia, there were no statistically significant differences between the two groups in the quantities of the metabolites. However, after reperfusion the rate of metabolic recovery by the mildly hypothermic (MH) group was significantly higher (by 10-20%) than the normothermic (NT) group. The intracellular pH decreased about 0.4 in both groups after ischemia; and after reperfusion the intracellular pH of the MH group returned to baseline levels faster than in the NT group. One week after ischemia, energy metabolism gradually decreased about 10-20% in both groups. In the histopathological evaluation, pyramidal cell damage in the hippocampus was 33% on average in the MH group and 79% in the NT group. The neuronal damage to the cerebral cortex was 26% in the MH group and 61% in the NT group. Astrocyte reactivity in the hippocampus and cerebral cortex was 2.9% and 1.1% in the MH group and 9.7% and 5.2% in the NT group. The results of this experiment indicate that the protective effect of mild hypothermia is due to the high recovery rate of ATP and PCr and the prevention of a secondary decline in high phosphate energy.

A novel one-step microplate cytotoxicity assay using the cytoplasmic fluorescent viability dye calcein AM was established for simple, rapid, sensitive, and quantitative measurements of the allogeneic cytotoxic reaction (ACR) mediated by hemocytes in the ascidian Halocynthia roretzi. The mutual and directional ACR was distinguishable by the assay using the hemocytes from pairs of animals with different alloreactivities. The ACR assay may allow more precise genetic analysis of the gene that controls alloreactivity of hemocytes, since the mutual and directional ACR may be related to levels of expression or numbers of the gene product or products on the target cells. The directional ACR will be useful in elucidating the cellular and molecular mechanisms of self-recognition in H. roretzi, since it allowed us to equate hemocytes from one animal with "effector cells" and those from the other animal of the pair with "target cells". In addition, the quantitative ACR assay in a large number of samples is possible and it will allow production of monoclonal antibodies that may recognize receptors or ligands functioning in self-recognition processes by the H. roretzi hemocytes.

Whether cyclical changes in energy-related phosphate metabolites arise during a cardiac cycle in isolated rat hearts and are affected by differences in myosin isozyme composition was determined. Myocardial adenosine triphosphate (ATP), phosphocreatine (PCr), inorganic phosphate (Pi), and intracellular pH in normal, hypothyroid and hyperthyroid rat hearts were measured using the pacing-gated 31P nuclear magnetic resonance technique. Maximal decrease in ATP and PCr, and maximal increase in Pi at the peak-systole in normal rat hearts were observed. In hypothyroid and hyperthyroid rats, similar cyclical changes in phosphate metabolites were observed during the cycle. However, the magnitude of fluctuations was smaller in hypothyroid rats and larger in hyperthyroid rats compared with that observed in normal rats. Cardiac myosin isozyme patterns were also different amongst the experimental groups. The results suggest that cyclical changes and the magnitude of fluctuations in energy-related phosphate metabolites during a cardiac cycle may depend on the cardiac workload and the intrinsic properties in the enzyme kinetics of myosin.

Renovascular hypertension occasionally manifests clinically as electrolyte disorders and albuminuria in addition to elevated blood pressure. A 49-year-old man who had renovascular hypertension also had severe hypokalemia, hyponatremia, polyuria and polydipsia that were treated by an angiotensin-converting enzyme inhibitor and resection of an atrophic kidney with a compromised blood supply. This is a case of hyponatremic-hypertensive syndrome related to renovascular hypertension and occurring as an additional abnormality.

医学生の講義前後における東洋医学に関する意識を検討するため, 京都府立医科大学の学生に自己記入式アンケートを配布した。医師に漢方を処方してもらったことのある学生は, 18%, 薬局で買った漢方薬をのんだことがあるのは53%, 鍼灸治療を受けたことがあるのは, わずか13%であった。84%の学生が漢方医学に関心をもっており, 漢方医学は勉強する価値があると思っている学生は82%, 現代医療において漢方は必要であると考えている学生は76%, また将来漢方を自分の診療に取り入れようと思っている学生は5496であった。これらの数値は, 講義後, それぞれ92%, 85%, 87%, 62%に増加していた。

The "contact reaction" is an extremely rapid allogeneic cytotoxic reaction (ACR) mediated by hemocytes in the solitary ascidian Halocynthia roretzi. It has been proposed that regulation of the alloreactivity of hemocytes may be involved in preference for fertilization or self-sterility in this species. To identify the receptors and target ligands involved both in self-recognition by somatic cells and self-discrimination by gametes, we produced monoclonal antibodies (mAbs) that inhibit the ACR mediated by hemocytes and tested their effects on fertilization. Six different mAbs that inhibit the ACR were prepared and categorized into three groups. Although all three mAbs seemed to have the same ability to inhibit the ACR, almost constant and statistically significant inhibition (CRB1.1) and infrequent but significant inhibition (CRB2.1, and CRB3.1) of the ACR were observed in the same pairs of animals. Pretreatment of the unfertilized eggs with CRB1.1, CRB2.1, and CRB3.1, resulted in the constant and statistically significant inhibition, infrequent but significant inhibition, and no inhibition, respectively, of fertilization. Antigens recognized by CRB1.1 (CRB1.1 antigens) were detected on the cell surface of all types of hemocytes and on the vitelline coat and follicle cells of unfertilized eggs. CRB2.1 and CRB3.1 antigens were detected on the surface of certain types of hemocytes and follicle cells, but not on the vitelline coat. CRB mAbs were directed against different epitopes in the N-linked glycan on glycoproteins. These common carbohydrate antigens on somatic cells and gametes may function in some recognition processes in ACR and fertilization in H. roretzi.

Emergency triage and therapeutic decisions using the recently developed whole blood rapid troponin T test were evaluated and compared with conventional electrocardiographic (ECG) diagnosis in a total of 155 patients with chest pain who visited 16 emergency outpatient clinics in the Tokyo metropolitan area. Thirty-seven patients (23.9%) had a final diagnosis of acute myocardial infarction or high-risk unstable angina requiring emergency coronary intervention and these events were defined as acute coronary syndrome. Diagnostic values using the second-generation rapid troponin T test were evaluated according to 3 time-windows in 85 patients. The sensitivity of the test was 10% for patients assessed within 3 h after the onset, 62.5% for 3-6 h after, and 75% for more than 6h, whereas conventional ECG diagnosis had 100% sensitivity at any time-window. In contrast, the specificity of the rapid troponin T test was 100%, 100%, and 97.4%, whereas that of conventional ECG diagnosis was 25%, 57.1%, and 42.2%, respectively for the 3 time-windows. The positive predictive value of ECG diagnosis was inferior to the rapid troponin T test, which reflected the prudent attitude of physicians taking ECG decisions as positive when myocardial ischemia was suspected. The diagnostic efficacy of the rapid troponin T test was remarkable in patients with the non-ST elevation type of acute coronary syndrome. A questionnaire survey on therapeutic decisions revealed that only 10% of Tokyo outpatient institutes performed prehospital thrombolytic therapy, 30-33% administered aspirin or nitrate, and 16.7% gave heparin. The rapid troponin T test is extremely useful for cardiac emergency triage and therapeutic decision making. There is a requirement for practical guidelines for the primary therapeutic decisions for patients with suspicious acute coronary syndrome.

It is often difficult to make a correct diagnosis of ring-like enhanced lesions on Gd-enhanced MR brain images. To differentiate these lesions using proton MR spectroscopy (1H-MRS), we retrospectively evaluated the correlation between the 1H-MR spectra and histopathological findings. We evaluated proton MR spectra obtained from the lesions in 45 patients, including metastasis (n = 19), glioblastoma (n = 10), radiation necrosis (n = 7), brain abscess (n = 5), and cerebral infarction (n = 4). The rate of misdiagnosis was found to be lowest at the threshold level of 2.48 for the (choline containing compounds)/(creatine and phosphocreatine) ratio (Cho/Cr) obtained from the whole lesions, which include the enhanced rim and the non-enhanced inner region. That is, the positively predictive values of a Cho/Cr greater than 2.48 for diagnosing metastasis or glioblastoma was 88.9 and 60.0%, respectively, and the positively predictive value of a Cho/Cr less than 2.48 for diagnosing radiation necrosis or cerebral infarction was 71.4 and 100%, respectively. For further differentiating between metastasis and glioblastoma, information about the presence and absence of an N-acetyl-aspartate (NAA) peak and lipid- or lactate-dominant peak was found to be useful. In 73.7% of metastasis cases a lipid-dominant peak was observed in the whole lesion without an NAA peak in the inner region, whereas the same pattern was observed in only 10% of the glioblastoma cases. Correlation with the histopathological findings showed that a high Cho signal is suggestive of neoplasm. Lipid signal in the non-enhanced central region was correlated to necrosis. Lactate signals were often observed in glioblastoma, abscess and sometimes metastasis, presumably reflecting the anaerobic glycolysis by the living cells in the ring-like enhanced rim. Single-voxel proton MR spectroscopy may serve as a potential tool to provide useful information of differentiation of ring-like enhanced lesions that cannot be diagnosed correctly using enhanced MR images alone.

The effects of d -cis- and l -cis-diltiazem on the hydrogen peroxide (H2O2)-induced derangements of mechanical function and energy metabolism, and accumulation of intracellular Na+ were studied in isolated rat hearts. The intracellular concentration of Na+ ([Na+]i) in the myocardium was measured using a nuclear magnetic resonance technique. H2O2 (600 μM) increased the left ventricular end-diastolic pressure, decreased the tissue level of ATP, and increased the release of lactate dehydrogenase from the myocardium. These alterations induced by H2O2 were significantly attenuated by d -cis-diltiazem (15 μM) or l -cis-diltiazem (15 μM). H2O2 (1 mM) produced a marked increase in the myocardial [Na+]i, which was effectively inhibited by tetrodotoxin (3 μM), d -cis-diltiazem (15 μM) or l -cis-diltiazem (15 μM). These results suggest that both d -cis- and l -cis-diltiazem protect the myocardium against the H2O2-induced derangements in the isolated, perfused rat heart. The protective action of d -cis- and l -cis-diltiazem may be due to their ability to inhibit the H2O2-induced increase in [Na+]i, at least in part.

In patients with paraneoplastic cerebellar degeneration (PCD) due to gynecologic malignancies, a high titer of anti-Purkinje cell antibody (anti-Yo) has been found. Most patients, however, have limited oncologic disease at the time of onset of neurologic symptoms. We describe 2 cases of PCD due to tubal cancer with anti-Yo antibody. The onset of PCD occurred 4 and 14 months before the detection of cancer, respectively, and the presence of anti-Yo antibody facilitated early laparotomy in both cases. These patients, whose neurologic symptoms have not progressed, have survived without evidence of disease for 81 and 30 months since surgery, respectively. The presence of the anti-Yo antibody in patients with PCD warrants an aggressive approach to diagnosis and treatment of the underlying gynecologic cancer.

Dibutyryl cAMP (DBcAMP) has a high membrane permeability, and maintenance of the intracellular cAMP concentration may improve the viability of organs. In this study, the effect of DBcAMP pretreatment on warm ischemic injury of rat livers was evaluated. Warm ischemic liver injury was induced in adult Wistar rats weighing 250-280 g by leaving them at room temperature (22-25 degrees C) after cardiac arrest. The hepatic cAMP concentration, %ATP, and trypan blue-positive nuclear ratio were determined after different durations of warm ischemia. In addition, transaminase and endothelin-1 (ET-1) release into the perfusate were examined during 60 min of isolated liver perfusion with Krebs-Henseleit solution. The optimal dose and time of DBcAMP pretreatment were determined to be 15 mg/kg and 60 min prior to warm ischemia, respectively. Data on the trypan blue-positive nuclear ratio and the release of transaminases and ET-1 revealed that warm ischemia first damaged the endothelial cells and then the hepatocytes. DBcAMP pretreatment appeared to protect the liver from warm ischemic injury by increasing the intracellular cAMP concentration and stabilizing the cell membranes of endothelial cells and hepatocytes.

A new endogenous proteinase inhibitor from the cell-free hemolymph of a solitary ascidian, Halocynthia roretzi, was purified by a combination of ammonium sulfate fractionation, hydrophobic interaction chromatography on Ether-Toyopearl and affinity chromatography on Heparin-Sepharose. The purity of the inhibitor was examined by SDS-PAGE, gel-permeation chromatography, reversed-phase chromatography, isoelectric focusing, immunological analysis and amino-terminal amino acid sequence analysis. The inhibitor is a single polypeptide chain whose molecular weight, isoelectric point and the first 10 amino-terminal amino acid sequences are 58 kDa, pI 9.2 and NH2-Thr-Lys-Lys-Asp-Gly-Glu-Glu-Lys-Val-Ala, respectively. The purified protein inhibits plasma enzyme(s) of H. roretzi, and the rate of inhibition to the plasma enzyme(s) activity was accelerated by incubation with dextran sulfate, but the effect was neutralized by further incubation with polycation, such as polybrene or protamine sulfate. The inhibitory activity was not affected appreciably by pH 7-10 but ceased completely below pH 5 or by heating at 50 degrees C for 30 min.

Using31P-NMR spectroscopy, we studied the process of the functional recovery of the regenerating rat liver at 1–5 weeks after a 65% partial hepatectomy from the viewpoint of phosphate metabolism. Portal vein clamping (20 min) or fructose administration (250 mg/kg body weight) was performed to temporarily reduce adenosine triphosphate (ATP) content in the remnant liver. Changes in ATP level were observed for 60 min after declamping the portal vein or after fructose administration. Significant differences in the increased ATP levels after declamping the portal vein or after fructose administration were observed in each hepatectomized group. Until 3 weeks after hepatectomy, ATP levels during 60 min after declamping the portal vein or after fructose administration were significantly lower than those in the nonresected control rats. However, the increase in ATP in the 4-week group was almost identical to the increase in the control group throughout the 60 min. Remnant liver weight already returned to the nonresected control level 1 week after hepatectomy, and remained constant thereafter. On the other hand, the final ATP levels 60 min after declamping the portal vein or after fructose administration returned to the nonresected control level only after 4 weeks following hepatectomy. These results demonstrate that from the viewpoint of ATP synthesis, functional recovery of the regenerating liver to normal can be observed within 4 weeks after partial hepatectomy.

Linkage between social and environmental psychology is illustrated through examination of the theoretical and empirical implications of a concept of "group space" defined as collectively inhabited and socioculturally controlled physical settings. This concept is applied to three levels of environmental settings, that is, school buildings, a university cafeteria, and urban residential areas. Such social-dynamic processes as group territorialities, group conflicts, social regulation of space-use, formation of group identity, and differentiation of public, semipublic, and private space were situated in physical environmental contexts. Three pilot studies revealed that (a) social space such as cafeteria and school buildings are differentiated and hierarchically integrated in terms of multifaceted group space depending on the social group, (b) groups exhibited different space-maintaining strategies and rules that strengthen socialization of group members, and (c) radical changes in the physical environment of a community initiated group-conflicts and renegotiation of group space.

モルモット単一心室筋細胞のNa電流 (INa) に対するbepridilの作用を吸引電極法を用いて検討した.bepridilは-140mVの静止状態から-30mVへの脱分極により活性化されるINaを用量依存性に減少させた (解離定数369μM) .本用量曲線は保持電位を-90mVにすると低濃度側へ平行移動した.2連パルス法によるINaの遮断発現過程実験では, 本剤は4msの条件パルスではINaを14%遮断し, 16ms以上では不活性化状態のINaをより顕著に遮断した.本剤は顕著な使用依存性抑制を示し, INa遮断が定常状態に達するまで迅速であった.定常状態におけるINaの不活性化曲線は, 本剤10μMにより11mV過分極側に偏位したが, 勾配因子は不変であった.不活性化されたINaの回復過程は, -140mVにおいて290msの時定数を示した.以上より, bepridilはNaチャネルの静止状態よりも不活1生化状態に高い親和性を有するが, 活性化チャネルブロックも一部もたらすこと, チャネルからの解離が速いことが明らかとなった.

The aim of the present study was to investigate whether percutaneous coronary intervention–related periprocedural myocardial infarction (MI) can be suppressed more significantly with high- compared with low-dose rosuvastatin. A total of 232 patients scheduled to undergo elective percutaneous coronary intervention within 5 to 7 days were assigned to groups that would receive either 2.5 or 20 mg/day of rosuvastatin (n = 116 each). The incidence of periprocedural MI did not significantly differ between the high and low-dose groups (8.7% vs 18.7%, p = 0.052). In patients who were not taking statins at the time of enrollment, high-dose rosuvastatin significantly suppressed periprocedural MI compared with the low dose (10.5% vs 30.0%, p = 0.037). The difference was not significant in patients who were already taking statins (high vs low dose 7.6% vs 10.6%, p = 0.582). In conclusion, the incidence of percutaneous coronary intervention–related periprocedural MI was reduced more effectively by high-dose than by low-dose rosuvastatin in statin-naive patients. However, low-dose rosuvastatin is sufficient for patients who are already taking statins.

The present study examined gamma-aminobutyric acid B (GABAB ) receptor, GABA, choline acetyltransferase (ChAT), and neuronal nitric oxide synthase (nNOS) immunoreactivities in the mouse adrenal medulla. GABAB receptor immunoreactivity was seen in numerous chromaffin cells and in a few ganglion cells of the adrenal medulla. By using a formaldehyde-induced fluorescence (FIF) method, GABAB receptor immunoreactivity was observed in numerous adrenaline (A) cells, but not in noradrenaline (NA) cells showing blue-white fluorescence. This suggests that GABAB receptors may be present in the A cells and be related to the secretory activity of A cells but not NA cells in the mouse adrenal medulla. GABAB receptor immunoreactive ganglion cells were shown to be nNOS immunopositive by using a double immunostaining method. Weak GABA immunoreactivity was visible in some chromaffin cells and in the numerous nerve fibers of the medulla. By using the FIF method, weak GABA-immunoreactive chromaffin cells were shown to be in the NA cells showing blue-white fluorescence. GABA-immunoreactive nerve fibers were in dense contact in A cells, but not NA cells. GABA-immunoreactive nerve fibers closely contacted a few ganglion cells. Numerous GABA-immunoreactive nerve fibers in the medulla showed ChAT immunoreactive. This result suggests that GABA and acetylcholine may be released from the same nerve fibers and may have a secretory effect on the A cells of the medulla.

The power demand in Japan increases yearly especially in summer, and peaks in the daytime. The main cause is the drastically increased load of air conditioners used widely in general residences. The load pattern of air conditioners is very similar to the output pattern of a photovoltaic (PV) array. Therefore, Sanyo has been developing two types of residential solar-powered air conditioners. One is a unidirectional system by using a dc/dc converter which controls the voltage of a PV array at its optimal operation point and boosts the voltage up to the dc voltage of an inverter-type air conditioner. The other is a bi-directional system by using a bi-directional current-control converter, which regenerates surplus power into a commercial system from a PV array, and suppresses the input current distortion of an air conditioner. In this paper, the configurations and experimental results are described and discussed.

アデノシソ三リン酸(ATP)は肝臓の機能を維持するためのエネルギー源として,重要な役割を果たしている.従って,ミトコンドリァのATP生成機能は肝機能を評価する上で重要な指標となることが考えられる.本研究では約65%部分肝切除後1～4週のラットに,250mg/kg B.W.のfructose負荷及び20分間の門脈血流遮断負荷を与え,ATPをはじめとする肝内リン酸化合物の代謝動態を31P-NMR法を用いて連続的に観察した.さらにリンエネルギー代謝の観点から,再生肝の機能回復過程について検討を加えた.その結果,肝切除後の週齢とともに,肝内リン酸化合物代謝動態が変化することを見いだした.とくにミトコンドリアにおけるATP生成機能は,週齢とともに改善する傾向を認め,肝切除後4週では非切除群とほぼ同程度の機能を再生肝がもつことを明らかにできた.この結果から,リンエネルギー代謝動態からみて,機能的肝再生には,少なくとも4週を必要とすることが示唆された.

A new gating NMR technique triggered by pulses for the cardiac pacing of isolated, perfused rat heart is described. This technique is suitable for obtaining spectra at the same positions over the cardiac cycle with the same RF pulse repetition time and with constant heart rate. Accordingly, each recovered magnetization level at these positions during the cycle can be kept constant. It also allows a qualitative analysis of the myocardial energy level during the cycle under the condition of the same or different cardiac workload (rate pressure product, HR x LVP). This method was used to observe cyclical changes in the concentration of adenosine triphosphate (ATP), phosphocreatine (PCr), P(i), and in pH during the cardiac cycle, and confirmed that the levels of ATP and PCr showed reversible decreases, and P(i) showed an antiphasic increase at the peak systole. On the other hand, no significant changes in pH were noted during the cardiac cycle. This pacing-gated technique is an improvement over other gated NMR techniques triggered by the blood pressure or by ECG traces.

A new NMR imaging technique using a quadratic nonlinear field gradient is described. The center position of the nonlinear field gradient where the field intensity is minimum is moved spatially at a fixed amount in each imaging pulse sequence to produce nonlinear phase encoding as a function of position. A NMR image is reconstructed from the collected data by the computer data processing. The principle of this technique and many experimental results using a low field imaging system operating at 0.0192 T are presented. Theoretical and experimental comparison of the S/N of the image in this technique with that of the conventional Fourier imaging technique are made and the results show that both techniques have almost the same S/N. Moreover, the theoretical and experimental results show that this technique has a feasibility of a spatially localized imaging without using a conventional localization technique such as the use of the selective excitation in the presence of a linear field gradient.

The spatial localisation of NMR signals by the magnetic focusing method is examined and a method for electrical scanning of a spatially localised region is proposed. The small amount of signal from points of the star taper in static field focusing can almost be neglected, and the spatial localisation of the signal corresponds to the shape of a prolate spheroid in the centre region of the star-shaped focusing field. Electrical scanning of the focused region can be achieved at any position in the magnet system by superimposing linear field gradients on the focused field in the scanning direction. These are the inherent limitations of the static magnetic field focusing method. The embodiment of the scanning movement of the focused field is also confirmed.

We studied the energy metabolism of cataracts induced by ultraviolet (UV) irradiation by observing metabolic changes in lenses using 31P-, 1H-, and 13C-nuclear magnetic resonance (NMR) spectroscopy. % of hexose monophosphate shunt flux activity increased over time. The lactate/glucose ratio in the UV irradiation group decreased to about half of that of the corresponding control group (11.6 +/- 2.0% vs. 20.7 +/- 1.7%, respectively, p0.05) after 10 h of irradiation and to about 30% of that of the control group (25 +/- 2% vs. 92 +/- 6%, respectively) after 24 h. The adenosine triphosphate (ATP) level significantly decreased after 3 h of irradiation (86 +/- 29%, p0.05) and continuously decreased to 68 +/- 33% (p0.01) after 10 h of irradiation and 26 +/- 2% (p0.01) after 24 h of irradiation. Conversely, a significant increase in inorganic phosphate (Pi) was observed after 1 h of irradiation (111 +/- 26%, p0.05), and the Pi level gradually increased to 140 +/- 28% after 10 h of irradiation (p0.01) and 207 +/- 26% after 24 h (p0.01). A significant decrease in alpha-glycerophosphate was noted after 24 h (38 +/- 13%, p0.01). The ribose-5-phosphate (R-5-P) level gradually increased after irradiation to 128 +/- 13% (p0.05) after 10 h and 141 +/- 21% after 24 h (p0.01). The results suggest that of these metabolic changes a marked decline in glycolytic production of ATP, which inhibits membrane metabolism, may be an important cataract-inducing factor following UV irradiation.

Since the signal obtained in the NMR Fresnel transform technique is given by an equation similar to that of the Fresnel diffraction equation in light, a technique in which the NMR signal in the Fresnel transform technique is recorded on a transparent film as a hologram and an image is reconstructed from such a hologram by using coherent laser light. Theoretical and experimental studies on such a technique are made in conjunction with the comparison between this technique and another technique in which the hologram is made from the NMR signal in the conventional Fourier imaging technique. The experiments show that considerably good quality images are reconstructed from the holograms in 16 shades of gray made from the signals in the NMR Fresnel transform technique since the dynamic range of the signal in this technique is small. This results in a quantization of the signal with little loss of the information, and the fringe pattern of the hologram is distributed widely over the hologram plane. The experiments show also that it is difficult to reconstruct good quality images from the holograms in 16 shades of gray made from the signals in the NMR Fourier transform technique. This is because most of the information of the image is lost by a quantization of the signal in such a small number of shades of gray since the dynamic range of the signal in the NMR Fourier transform technique is extremely large. It is shown also that the dynamic range of the signal can be decreased using a quadratic nonlinear field gradient in the pulse sequence in the NMR Fourier transform technique, and great improvement in the quality of the optically reconstructed image is obtained.

The distribution of substance P (SP) immunoreactivity and the colocalization of SP with other bioactive substances in chromaffin cells and nerve fibers were investigated in the rat adrenal gland at the light microscopic level. In the capsule and cortex, SP immunoreactivity was seen in some nerve fibers around blood vessels and in thick nerve bundles passing through the cortex directly into the medulla. In the medulla, the SP immunoreactivity was observed in a small number of chromaffin cells; these SP-immunoreactive chromaffin cells were either phenylethanolamine N-methyltransferase (PNMT) immunoreactive or immunonegative, indicating that they were either adrenaline cells or noradrenaline (NA) cells. SP-immunoreactive varicose nerve fibers were also found in the medulla and were in contact with a cluster of the NA cells showing catecholamine fluorescence, which suggests that SP from medullary nerve fibers may regulate the secretory activity of the NA cells. Because no SP-immunoreactive ganglion cell was present in the rat adrenal gland, the intra-adrenal nerve fibers were considered to be extrinsic in origin. The double-immunostaining method further revealed that the SP-immunoreactive chromaffin cells also exhibit immunoreactivities for calcitonin gene-related peptide (CGRP), and neuropeptide tyrosine (NPY), suggesting that these peptides can also be released from the chromaffin cells by certain stimuli. The intra-adrenal nerve fibers in the medulla were composed of SP-single immunoreactive, and SP/CGRP-, SP/choline acetyltransferase (ChAT)-, SP/nitric oxide synthase (NOS)-, SP/pituitary adenylate cyclase activating polypeptide (PACAP)-, ChAT/NOS-, and ChAT/PACAP-immunoreactive nerve fibers, which may affect the secretory activity of the NA cells. In the adrenal capsule, the nerve fibers were present around blood vessels and showed immunoreactivities for SP/ CGRP, SP/NPY, SP/NOS, and SP/vasoactive intestinal polypeptide, suggesting that the origin of nerve fibers in the capsule may differ from those in the medulla.

This paper presents a new Magnetic Resonance imaging technique in which reconstructed images have higher resolution than that of standard Fourier transform-based (FT) imaging on condition that the same size of data is used. The signal obtained in the Phase-Scrambling Fourier Transform imaging technique (PSFT) can be transformed to the description of Fresnel transform equation. Therefore, image reconstruction can be performed by not only inverse FT, but also by inverse Fresnel transform. In general, the field-of-view (FOV) of reconstructed images and spatial resolutions are different in each reconstruction method. By combining these two images, we can obtain an image that has a higher resolution than standard FT-based imaging technique.

A novel image reconstruction technique, which avoids aliasing artifacts by scalable image reconstruction in magnetic resonance imaging, is proposed. The signal obtained in the phase-scrambling Fourier imaging technique can be transformed to the signal described in the Fresnel transform equation of the objects. Therefore, image reconstruction can be performed not only by inverse Fourier transform but also by inverse Fresnel transform. Image reconstruction by inverse Fresnel transform allows optional scaling of images Thus, alias-free images can be reconstructed even from signals that produce serious aliasing artifacts by standard inverse Fourier transform reconstruction.

Object. The goal of this study was to investigate the usefulness of proton (1H) magnetic resonance (MR) spectroscopy to evaluate the response of metastatic brain tumors to stereotactic radiosurgery (SRS) in comparison with Gd-enhanced MR imaging and single-photon emission computerized tomography with administration of thallium-201 chloride (201TlCl-SPECT). Methods. Forty patients with a total of 47 metastatic brain tumors were evaluated. The primary lesion was identified in all cases. Stereotactic radiosurgery was effective in 37 lesions. All patients were examined using Gd-enhanced MR imaging before and after SRS. Thalium-201 chloride was administered to 27 patients with 34 tumors and SPECT images were obtained. Proton MR spectroscopy was performed in 36 patients who harbored 43 tumors. On Gd-enhanced MR images, a decrease in the volume of the Gd-enhanced lesion and a change in the enhanced effect in the lesion after treatment were recognized as showing the effectiveness of SRS between 1 and 3 months or more (mean 8.54 ± 3.58 weeks). In 201TlCl-SPECT studies, the ratio of lesion to normal brain decreased from 2 weeks to 2 months (mean 5.03 ± 2.77 weeks) after radiosurgery. On 1H-MR spectroscopy images a high choline (Cho) peak and a lipiddominant (Lip) peak were observed in 25 lesions and a high Cho peak and a lactate-dominant (Lac) peak were observed in 12 lesions before SRS. A decrease in the Cho peak, a disappearance of the Lac peak, and an increase in the Lip peak were observed between 1 week and 1 month (mean 2.76 ± 1.62 weeks) after treatment. Conclusions. Based on histopathological findings obtained at autopsy or at surgery, we assume that a high Cho peak may be observed in viable tumor tissue and a Lip peak in areas of necrosis. The results indicate that 1H-MR spectroscopy is potentially a more sensitive tool in evaluating the response to SRS than 201TlCl-SPECT or Gd-enhanced MR imaging and that it can be used earlier for this purpose than those other imaging methods.

The purpose of this study was to assess the effects of stress shielding on the microstructure and ultrastructure of the patellar tendon using 40 mature female Japanese white rabbits. The patellar tendon was completely released from stress by drawing the patella toward the tibial tubercle with a stainless steel wire installed between them. Microstructurally, stress shielding for 3 and 6 weeks increased the number of cells approximately fivefold, to that of the control tendon. Collagen bundles were less well oriented in the stress-shielded tendon than in the control. Ultrastructurally, small collagen fibrils with a diameter of less than 90 nm increased in the stress-shielded tendon. The median collagen fibril diameter in 6-week stress-shielded tendon was significantly smaller (P ≪ 0.05) than in the control tendon (58.8% of control). The ratio of the total area of collagen fibrils to the whole visualized area in the stress-shielded patellar tendon was significantly smaller at 3 and 6 weeks than that in the control. This study demonstrated that complete stress shielding significantly affects the microstructure and ultrastructure of the patellar tendon

Renovascular hypertension occasionally manifests clinically as electrolyte disorders and albuminuria in addition to elevated blood pressure. A 49-year-old man who had renovascular hypertension also had severe hypokalemia, hyponatremia, polyuria and polydipsia that were treated by an angiotensin-converting enzyme inhibitor and resection of an atrophic kidney with a compromised blood supply. This is a case of hyponatremic-hypertensive syndrome related to renovascular hypertension and occurring as an additional abnormality.

Two distinct oligosaccharide ligands that function in both the allogeneic contact/cytotoxic reaction (ACR) by hemocytes and gamete fertilization were identified by means of the monoclonal antibodies (Mabs), CRB1 and CRB2, which inhibit both the ACR and fertilization in Halocynthia roretzi. The CRB1 epitope, determined to be the “core” α1–6 fucosylated oligosaccharide epitope (CFOE) in hybrid-type N-glycans, was detected on the cell surfaces of all types of hemocytes as well as on those of follicle cells and the vitelline coat of eggs. The CRB2 epitope, which was indicated as an outer-side sulfated and phosphorylated ojigosaccharide epitope (OSPOE) in complex-type N-glycans, was demonstrated on the cell surfaces of some types of hemocytes and egg follicle cells. Both epitopes, OSPOES and CFOE, may function as ligands in the initial attachment and binding, respectively, in the sperm-egg interaction. These epitopes may also function in the same way in the self-recognition of the ACR. We propose that the fucose residue in CFOE is among the key molecules, and perhaps the most important, involved in self-recognition in the ACR and fertilization.

The viriform cell (VC) in the tunic of Halocynthia roretzi is rod shaped (about 15x5 µm) and is characterized by intracellular eosinophilic and electron-dense granules (about 1–2 µm in diameter). The VC is confirmed to be a native tunic cell by the DNA fingerprint method. Light and electron microscopic observations and immunohistochemical findings demonstrated that VCs appeared in the tunic and hemocoel of about 3-month-old specimens but were not seen in younger juvenile specimens (2 weeks after metamorphosis). There were more VCs in the tunic matrix of 1-year-old specimens than in 3-month-old specimens. It seems that the cells migrated from the hemocoel through the epidermis. In mature specimens, the density of VCs was very high not only in the inner tunic matrix but also in the tunic of growing attachment villi. When the villi became brown, broken VCs were observed at the area just under the cuticle, where the subcuticle forms later. VCs also crowded at the repairing surface of the tunic after artificial injury. These findings suggest that VCs may play roles in subcuticle formation and wound healing.