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Aggregatibacter actinomycetemcomitans, a potent pathogen of periodontitis, typically grows as a rough and adherent colony on primary isolated cultures. The colony transforms into a smooth phenotype during repeated subculture. In this study, we aimed to identify highly expressed genes in the rough-colony-forming phenotype for isolation of host-induced genes. Using a cDNA-subtractive hybridization technique, three genes, homologous to a macrophage infectivity potentiator gene (mip), peroxiredoxin gene (prx) and outer membrane protein gene (ompA), were identified. The expression levels of these genes in the rough-colony-forming phenotype were 4-10-fold higher as compared with the smooth-colony-forming phenotype. Attention was focused on the mip-like gene, and a recombinant protein and a deficient mutant were constructed. The recombinant protein reacted with sera from patients with periodontitis, suggesting the production of the Mip-like protein in periodontal lesions. Viable quantitative invasion assay demonstrated that the viable cell counts of the wild-type strain that invaded HeLa cells were more than fourfold as compared with the mip-deficient mutant. The expression of the mip-like gene, prx-like gene and ompA-like gene may be enhanced in the host, and the mip-like gene may play an important role in the infection of A. actinomycetemcomitans, especially in its invasion of the epithelium.

われわれは日常臨床でよく経験する皮下腫瘤がマンソン孤虫症であった2例を経験したので報告する．症例1は78歳，女性．乳癌として紹介されてきたが，手術の結果，乳癌でなく乳房の皮下腫瘤の原因がマンソン孤虫症によるものであった．この症例は下肢にも皮下腫瘤を認め，そこからもマンソン孤虫症のプレロセルコイドを認めた．症例2は77歳，男性．鼠径部の脂肪腫と診断したが，腫瘤内にマンソン孤虫症のプレロセルコイドを認めた．症例1，2ともに，マムシ，生の鶏肉，スッポンの生血，タニシ，淡水魚の摂取既往歴をもっていた．われわれ外科医は，皮下腫瘤の中にマンソン孤虫症のような寄生虫疾患もごく稀にはあり得ることを考慮するべきである．

Accurate quantification of bacterial species in dental plaque is needed for microbiological diagnosis of periodontal diseases. The present study was designed to assess the sensitivity, specificity and quantitativity of the real-time PCR using the GeneAmp Sequence Detection System with two fluorescence chemistries. TaqMan probe with reporter and quencher dye, and SYBR Green dye were used for sources of the fluorescence. Primers and probes were designed for Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and total bacteria based on the nucleotide sequences of the respective 16S ribosomal RNA genes. Since spread of antibiotic resistance genes is one of the crucial problems in periodontal therapy, quantitative detection of tetQ gene, which confers resistance to tetracycline, was included in the examination. The detection of P. gingivalis, P. intermedia and A. actinomycetemcomitans was linear over a range of 10-10(7) cells (10-10(7) copies for tetQ gene), while the quantitative range for total bacteria was 10(2)-10(7) cells. Species-specific amplifications were observed for the three periodontal bacteria, and there was no significant difference between the TaqMan and SYBR Green chemistry in their specificity, quantitativity and sensitivity. The SYBR Green assay, which was simpler than TaqMan assay in its manipulations, was applied to the clinical plaque samples. The plaque samples were obtained from eight patients (eight periodontal pockets) before and 1 week after the local drug delivery of minocycline. Although the number of P. gingivalis, P. intermedia and A. actinomycetemcomitans markedly decreased after the antibiotic therapy in most cases, higher copy numbers of the tetQ gene were detectable. The real-time PCR demonstrated sufficient sensitivity, specificity and quantitativity to be a powerful tool for microbiological examination in periodontal disease, and the quantitative monitoring of antibiotic resistance gene accompanied with the antibiotic therapy should be included in the examination.

A patient with advanced rectal cancer which necessitated total removal of intrapelvic organs was able to be followed up for 2 years 7 months after the reconstruction with Sheele's bladder substitute. For this the patient's strong will for recovering social activities was satisfied. The patients was a 52-year-old man. There was a history of pulmonary resection of the right upper lobe and thoracoplasty for pulmonary tuberculosis. The patient underwent transurethral prostatectomy in 1988, when an ulcer was noted in the posterior wall of the bladder. The ulcer was not cured. In, April 1989, a Borrmann II tumor was detected by colonoscopy in the rectum 10 cm oral to the anus, and a diagnosis of ademocarcinoma was made by biopsy. Pelivic CT scan revealed invasion to the posterior wall of the bladder, the right ureter and the ileocecum, and the lesion was considered as advanced rectal cancer on May 9, 1989. Low anterior resection of the rectum, resection of the posterior wall of the bladder, ileocecal resection, and partial resection of the right ureter were carried out. Intestinal continuity was made by rectosigmoidostomy, ileo-ascending colon anastomosis. Reconstruction of the urinary bladder was made using substitute. Which was made by prepaing a 30 cm ileal loop into which the bilateral ureters were grafted. And this ileal loop was anastomosed to the auterior wall of the bladder. This bladder substitute had a capacity of 600 ml and tolerated a maximum internal pressure of 50 mmHg. Evacnation of urine was performed by adding abdominal pressure at the time of louer abdominal distension feeling. No urinary in captiuence bas been noted residual urine.

血管腫を伴ったリンパ管腫,いわゆるhemolymphangiomaは,ほとんど報告をみない.最近,我々は後腹膜原発のhemolymphangiomaを経験し,超音波, CT,血管造影などに加え,磁気共鳴映像法(MRI)を施行し,術前診断を試みた。嚢腫内容は, CTではenhanceされなかったが, MRI計算値においてT1時間の著明な短縮を示したことから陳旧性血液成分と診断でき,内容の性状診断にMRIは有用であった.また,術後の免疫組織学的検索では,血管腫の内皮だけでなく,リンパ管腫の内皮にも,第VIII因子関連抗原が陽性であった.既報告の後腹膜リンパ管腫99例とhemolymphangiomaの病態を比較し,リンパ管腫の発生に関し,若干の考察を加えて報告する.