Acute myocardial infarction due to thrombus formation in congenital coronary artery fistula

A young female patient developed acute myocardial infarctionduring physical exercise. Coronary arteriography in the acutephase demonstrated a coronary fistula originating from the leftcoronary main trunk and communicating with the right atrium.Several branches of the left coronary artery were obstructedby thrombotic material originating from the fistula, causingan acute myocardial infarction.     

Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer

BACKGROUND: High-intensity focused ultrasound (HIFU) is a minimally invasive technique used in achieve coagulation necrosis. We evaluated biochemical disease-free survival rates, predictors of clinical outcome and morbidity in patients with localized prostate cancer treated with HIFU. METHODS: A total of 181 consecutive patients underwent HIFU with the use of Sonablate (Focus Surgery, Indianapolis, IN, USA). Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The median age and pretreatment prostate-specific antigen (PSA) level were 70 years (range 44-88) and 9.76 ng/mL (range 3.39-89.60). A total of 95 patients (52%) were treated with neoadjuvant hormones. The median follow-up period for all patients was 18.0 months (range 4-68). RESULTS: The biochemical disease-free survival rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease-free survival rates at 3 years for patients with pretreatment PSA less than 10 ng/mL, 10.01-20.0 ng/mL and more than 20.0 ng/mL were 94%, 75% and 35%, respectively (P<0.0001). Multivariate analysis identified pretreatment PSA (P<0.0001) as a independent predictor of relapse. CONCLUSION: High-intensity focused ultrasound therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/mL.     

ETHANOL INDUCES HETEROGENEOUS REDUCTION OF CYTOCHROME aa3 WITHIN PERFUSED RAT LIVER LOBULE ASSESSED USING MICROSPECTROSCOPY

The redox state of cytochrome aa₃ was measured at microspots(20µm diameter) within the lobule of perfused rat livers,using reflectance microspectroscopy, and the effect of ethanolinfusion on sublobular distribution of the redox states wasevaluated. A sigmoidal relationship was observed between oxygendelivery and the reduction of cytochrome aa₃ in both the periportaland pericentral regions of the liver lobule when the influentO₂ concentration was decreased in a graduated manner. This sigmoidalcurve was shifted to the more reduced state by ethanol infusion,with ethanol (25–100mM) increasing the degree of cytochromeaa₃ reduction in a dose-dependent manner according to the distancefrom the periportal region along a sinusoid. This increase wasspatially heterogeneous within a liver lobule. These data indicatethat ethanol accelerates cytochrome aa₃ reduction, with a distinctgradient of reduction along sinusoids but a heterogeneous distributionwithin the liver lobule.     

X线照射致胚胎大鼠皮质内结构异常

目的探讨胚胎期X线照射引起大鼠皮质内异常结构的形成机理。方法选取妊娠14日(E14)大鼠接受X线(剂量为1.0Gy)照射。采用HE染色、Fluoro Jade B染色及增殖细胞核抗原(PCNA)抗体免疫组化染色观察胚脑的皮质构筑。结果HE染色观察到E14大鼠接受X线照射后大量细胞脱落入侧脑室并在2日后完全清除,Fluoro Jade B染色显示此脱落细胞为阳性。E16及E18的皮质内出现玫瑰环样结构及脑室区的凹陷,且PCNA阳性细胞表达于玫瑰环样结构及脑室区凹陷的细胞株。结论E14大鼠受X线照射可引起广泛的大脑皮质细胞构筑异常和细胞增殖。     

Pseudomyxoma Peritonei with High Carcinoembryonic Antigen (CEA) Level: Report of Two Cases

Two cases of pseudomyxoma peritonei with high serum carcinoembryonicantigen (CEA) are reported. CEA levels in serum increased incorrelation with the accumulation of ascites. Systemic chemotherapywith anticancer agents such as 5-fluorouraciI (5-FU), cyclophosphamide,mitomycin C (MMC) and chromomycin A_a showed no effect on reducingeither the production of mucinous materials or the CEA level,but repeated intraperi-toneal instillation of large amountsof MMC reduced them in one case. In the other case, the CEAlevel returned to normal after removal of the tumor. These resultssuggest that CEA may be a useful indicator of the effect oftreatment and of the prognosis of pseudomyxoma peritonei.     

Inhaled nitric oxide and extracorporeal membrane oxygenation in persistent pulmonary hypertension of the newborn

Persistent pulmonary hypertension of the newborn (PPHN) may occasionally require an invasive treatment with extracorporeal membrane oxygenation (ECMO). Inhaled nitric oxide (NO) has recently been introduced as a selective pulmonary vasodilator for treatment of PPHN. We describe a case of PPHN in which neither inhaled NO nor ECMO was effective in reversing pulmonary hypertension. The clinical course of the patient suggested a potential role of NO inhalation in predicting the outcome of ECMO treatment for PPHN.     

Human macrophages modulate the phenotype of cultured rabbit aortic smooth muscle cells through secretion of platelet-derived growth factor

Phenotypic change of aortic smooth muscle cells (SMC) is a key step for their abnormal proliferation in atheromatous lesions. In this study modulation of the growth properties of SMC by macrophages was investigated to clarify the mechanism regulating the SMC phenotype. Cultured rabbit SMC preincubated with either macrophages derived from human peripheral monocytes, or conditioned medium from macrophages grew faster than control SMC in the absence of either macrophages or conditioned medium. SMC preincubated with purified platelet-derived growth factor (PDGF) also grew faster than control SMC in the absence of PDGF, and their rapid growth was maintained for at least two passages. SMC preincubated with conditioned medium of macrophages plus anti-PDGF antibody did not grow faster than control SMC. Furthermore SMC preincubated with PDGF acquired the ability to secrete some mitogen, which differed from PDGF. These results suggest that macrophages modulate the phenotype of SMC by a mechanism mediated by PDGF. As a result the SMC grow faster and at the same time secrete some mitogen probably distinct from PDGF in an autocrine manner.     

Diabetes mellitus induces accelerated growth of aortic smooth muscle cells: association with overexpression of PDGF β-receptors

Abstract. The mechanism of diabetic macroangio-pathy was studied from the view point of phenotypic change of aortic smooth muscle cells (SMC). The growth rates of cultured SMC of diabetic rats or rabbits were higher than those of non-diabetic animals (controls). This difference of the growth responses was observed specifically with platelet-derived growth factor (PDGF). Of the three PDGF dimers, PDGF-AB heterodimer (PDGF-AB) and PDGF-BB homodimer (PDGF-BB) stimulated growth of diabetic SMC more than that of control SMC but PDGF-A A homodimer (PDGF-AA) did not. The binding of '²⁵1-PDGF to the diabetic SMC was greater than that to control SMC. This was due to increase in the number of cell surface receptors for PDGF. On in vitro culture, SMC from diabetic rats expressed more PDGF β -receptor mRNA than SMC from non-diabetic rats. Moreover, in vivo , the aortic media of diabetic rabbits expressed PDGF β -receptor mRNA, but that from non-diabetic rabbits did not. Thus diabetic SMC over-react on PDGF stimulation through over-expression of the PDGF P-receptor gene. The significance of this fact in development of diabetic macroangiopathy is discussed.     

Characteristics of the cellular composition, especially the lymphocyte sub-populations of bronchoalveolar lavage fluid from patients with summer-type hypersensitivity pneumonitis

The pathogenesis of summer-type hypersensitivity pneumonitis, which often occurs in Japan, was examined by analysing the cell profile, especially the lymphocyte sub-populations, of bronchoalveolar lavage fluid from these patients: twenty-two normal volunteers and fourteen patients with localized lung cancer as controls. Lymphocyte sub-populations were determined by the micro-testplate method. In the bronchial fluid of the summer hypersensitivity group, the total cell number was much higher (five to ten times) than in the control groups, and the percentage of lymphocytes reached 84-2 + 5.1 (mean + s.e. mean); the percentage of T lymphocytes was significantly increased (95.6 + 1.0), but that of B lymphocytes (3.2 + 0.6) was similar to that of the control groups, though the absolute numbers of B and T lymphocytes were higher than in the control groups. In the peripheral blood of the summer hypersensitivity group, the percentage of B lymphocytes was significantly higher than that found in the normal volunteers, but that of T lymphocytes was not increased. Cellular changes in bronchial fluid were more evident than changes seen by X-ray examination and are considered to be a good parameter of the severity of hypersensitivity pneumonitis. It is considered that cell-mediated immunity as well as the Arthus reaction may be intimately related to the pathogenesis of summer-type hypersensitivity pneumonitis.