Successful Stent Implantation in Acute Myocardial Infarction and Successful Directional Coronary Atherectomy of a Stenotic Lesion Involving an Aneurysm in a Woman with Kawasaki Disease of Adult Onset

Our patient was a woman who suffered from Kawasaki disease at the age of 20. Coronary aneurysms were confirmed in the left main trunk and proximal sites of the left anterior descending artery and the circumflex artery by coronary angiography at the age of 21. When she suffered an inferior acute myocardial infarction at the age of 24, two Palmaz-Schatz stents were successfully implanted in the right coronary lesion in order to prevent acute closure. One month later, directional coronary atherectomy was successfully performed to the left anterior descending artery lesion which had a rapid progression of the stenosis, and the pathological examination revealed that the cause of the stenosis was thrombus. She has remained well during the following 2 years.     

OUTCOME OF PATIENTS WITH GRAVES' DISEASE AFTER LONG-TERM MEDICAL TREATMENT GUIDED BY TRIIODOTHYRONINE (T3) SUPPRESSION TEST

The value of the T3 suppressed 20-min uptake test for the prediction of post-treatment outcome was studied in 193 unselected patients with GRAVES' disease treated with thionamide drugs and T3. One hundred and twenty-nine of 193 patients were studied previously and followed thereafter (Group A). Sixty-four were newly treated patients: thirty-three (Group B) were treated at the same hospital as Group A; thirty-one (Group C) were treated at another hospital. In total, 126 patients out of 193 satisfied our criteria for suppression (total suppression rate, 65%). The suppression rate for new patients (55% in Group B, 52% in Group C) was similar to that for Group A in 1977 (49%) after comparable duration of treatment. The suppression rate for Group A increased with prolongation of the treatment period (49% in 1977 and 71% in 1981). As to the time course of suppression, it was observed that about two-thirds of the suppressed patients satisfied the criteria for suppression within 3 years of starting treatment. The number of suppressed patients per year decreased thereafter as the treatment periods increased. However, the yearly suppression rate did not decrease with time. The time course of suppression in each patient could not be predicted from the results of initial thyroid function tests. The overall remission rate among the 120 suppressed patients followed for 1–13 (mean, 4) years was 96%, which was almost equal to the value obtained in Group A in 1977 (95%) with the average follow-up period of 2 years. Among the 46 patients in Group A followed for 5–13 (mean, 7) years, no increase in relapse was observed with prolonged follow-up periods. Examination on the relationship between the duration of treatment and the post-treatment outcome     

Longitudinal study on torque transmitted from a denture base to abutment tooth of a distal extension removable partial denture with circumferential clasps

Not only forces but also torque exerted on abutment teeth are important factors for planning the construction of distal extension removable partial dentures. The purpose of this study was to make longitudinal analysis of torque transmitted from denture base to a direct abutment tooth of these dentures with circumferential clasps. The results are summarized as follows: (i) Vertical Max. MT (maximal mean value of torque) was decreased and became constant after one or one and half months of the insertion of new dentures. (ii) Lateral Max. MT in one subject was changed from the lingual direction to the buccal direction while in another subject it was constant. (iii) In the vertical direction, there were no remarkable differences of Max. MT and Ave. T (average value of torque) between subjects. Max. MT was 5-10 x 10(-3) kgm-1 in the downward. Ave. T was 2-3 x 10(-3) kgm ss-1 in the downward and 0.3 x 10(-3) kgm ss-1 in the upward. (iv) In the lateral direction, there were considerable differences of Max. MT and Ave. T between subjects. Max. MT was less than 20 x 10(-3) kgm. Ave. MT was 2-8 x 10(-3) kgm ss-1.     

Immunoglobulin G subclasses of antibodies to hepatitis B core antigen in HBs antigen positive liver diseases

Serum immunoglobulin G (IgG) subclasses of hepatitis B core antibody (anti-HBc) in 54 patients with different types of hepatitis B surface antigen positive (HBsAg+) liver diseases (asymptomatic carrier (ASC), acute hepatitis (AH), chronic hepatitis (CH) and liver cirrhosis (LC)) and 18 normal controls were estimated by enzyme-linked immunosorbent assay (ELISA) using subclass specific anti-human mouse monoclonal antibodies. In 11 cases, the estimations were carried out at both exacerbation and remission stages of chronic active hepatitis (CAH). In 4 cases of CAH, serial observations of anti-HBc IgG subclasses were made according to the clinical course. In 5 cases of CAH, the estimations were carried out at the HBe antigen positive (HBeAg+) stage and after sero-conversion to anti-HBe positive (anti-HBe+) stage. In ASC the main anti-HBc IgG subclasses were restricted to one subclass--anti-HBc IgG1. In AH on the other hand, all the subclasses were represented. In CH all the subclasses were detected under different diagnostic conditions but anti-HBc IgG1 was the main subclass. In LC the mean concentration of anti-HBc IgG3 was higher than the concentration of anti-HBc IgG1. In exacerbation stages of CAH, the different anti-HBc IgG subclasses had higher concentrations than in remission stages. The concentrations of different anti-HBc IgG subclasses fell just after seroconversion from HBeAg+ stage to anti-HBe+ stage. These data suggest that the estimation of anti-HBc IgG subclasses may be helpful in establishing the diagnosis of different types and stages of HBsAg+ liver diseases.     

A facile method for preparation of t-butyloxycarbonylamino acid p-nitroanilides

A series of p-nitroanilides of t-butyloxycarbonylamino acids, including Boc-Trp, Boc-Asn, Boc-Gln, Boc-Ser(Bu′), Boc-Thr(Bu′), Boc-Asp(OBu′), Boc-Lys(TFA), and Boc-His(Boc), were prepared conveniently by the mixed anhydride method using 2,2-dimethylpropanoic chloride (pivaloyl chloride). The products were obtained in 40-60% yields after purification by column chromatography on Sephadex LH-20. p-Nitroanilide of histidine was purified after deprotection of Boc-His(Boc)-pNA and obtained as H-His-pNA-2HCl.     

Circular dichroism investigations on the conformation of linear,cyclic and polymeric peptides containing His,Ser and Asp residues

Conformational studies on the linear, cyclic and polymeric peptides with the sequences -Asp-ßAla-Gly-Ser-ßAla-Gly-His-ßAla-Gly-(nonapeptide series) and -Asp-eAhx-Ser-eAhx-His-eAhx (hexapeptide series) were carried out by means of circular dichroism measurements to clarify the relationship between their conformation and ester hydrolytic activity. It was suggested that all of the present peptides take a certain ordered conformation at acidic pH region and have a tendency to transform to a disordered conformation with a rise of pH. In the course of the conformational change, the linear and polymeric peptides undergo a drastic conformational change at around pH 7.0, while the cyclic peptides maintain the ordered conformation to some extent even at the basic pH region. Although this ordered conformation maintained in the cyclic peptides was estimated not to be a tight one, it was more stable in the cyclic peptide of the latter sequence (Cyclic-6) than in the former sequence (Cyclic-9). As reported previously, Cyclic-6 showed greater activity than the others in the hydrolysis of various ester substrates. Higher activity and more stable ordered conformation of Cyclic-6 seem to be closely related. The effects of urea, organic solvent, salt and change of temperature on their conformation are also reported.     

Hybrid Assistive Limb (HAL) Rehabilitation in Patients with Acute Hemorrhagic Stroke

The efficacy of hybrid assistive limb (HAL) rehabilitation in the acute phase of stroke remains unclear. The purpose of this study was to evaluate the outcomes of patients with acute intracranial hemorrhage (ICH) who were treated with or without HAL rehabilitation. Among 270 patients with acute ICH from 2009 to 2014, 91 patients with supratentorial ICH were included in this retrospective study. Of these, 14 patients (HAL group) received HAL rehabilitation at approximately 1 week after ICH occurrence, while the remaining 77 patients received usual rehabilitation without HAL (N-HAL group). We obtained various patient data from the hospitals where the patients were moved to for further rehabilitation. Statistical comparisons were performed for the characteristics of the ICH patients, and outcomes between the HAL and N-HAL groups. There were no differences in outcomes between the HAL and N-HAL groups. However, patients with right ICH in the HAL group exhibited a significant association with a functional independence measure (FIM) score of ≥ 110 compared with patients in the N-HAL group (HAL group: 81.8%, N-HAL group: 43.9%, P = 0.04). In patients with right ICH, HAL rehabilitation was associated with improved outcomes as evaluated by the FIM score. Thus, HAL rehabilitation may improve outcomes of acute ICH in appropriately selected patients.