Growth of human squamous cell carcinoma xenografts in mice is inhibited by local angiostatin gene therapy

The possibility of inhibiting tumor growth by blocking the formation of new tumor vessels has recently received attention. Antiangiogenic tumor therapies have recently attracted intense interest because of their direct endothelial targeting and the absence of drug resistance. Local antiangiogenic gene therapy for cancer offers a potential way to achieve sustained therapeutic release of antiangiogenic substances. As a step toward this goal, we used liposomes complexed to angiostatin cDNA and targeted to human squamous cell carcinoma cell lines in vivo. Tumor cells expressing angiostatin after local gene transfer showed markedly reduced vascularity and contained many apoptotic tumor cells. These results demonstrate the potential utility of liposome-derived angiostatin for adjuvant therapy of oral cancer in humans.     

Surgical considerations after patch closure of atrial septal defect with tricuspid annuloplasty

Two patients with complications of embolism during the early postoperative period after patch closure of atrial septal defect with tricuspid annuloplasty were reported. Case 1: A 58-year-old woman underwent closure of an atrial septal defect and tricuspid annuloplasty by means of Kay's technique for tricuspid regurgitation. She had an episode of thromboembolism in the bilateral common femoral arteries 7 days after surgery. Thromboembolectomy was performed successfully using Fogarty's embolectomy catheter. Case 2: A 49-year-old woman underwent closure of an atrial septal defect and the tricuspid annuloplasty using Carpentier ring for tricuspid regurgitation. The patient had transient left hemiparesis on the 5th postoperative day. Both patients had atrial fibrillation and mild pulmonary hypertension before surgery. In relatively old patients (over 40 years old) with atrial septal defect, tricuspid regurgitation and atrial fibrillation, anticoagulant therapy should be started immediately after surgery to prevent thromboembolism.     

Surgical treatment of annuloaortic estasia: experience in 7 consecutive patients.

Seven patients with annuloaortic ectasia were treated according to the method described by Bentall and De Bono. A Björk-Shiley valve in a composite graft was the prosthesis of choice and was used in all patients except 1, who received a Starr-Edwards valve. Profound topical cooling without selective coronary perfusion was applied in 5 patients for myocardial preservation during aortic occlusion.There was 1 operative death and 1 late death, the latter from cerebral thromboembolism. Five survivors have been followed from 1 year 5 months to 2 years 10 months with an average follow-up of 2 years. Excellent results were obtained in all survivors, their physical capabilities putting them in Class I of the New York Heart Association Functional Classification. Postoperative aortograms showed no signs of kinking or compression of vascular prostheses nor abnormalities of prosthetic valves. A modified technique to secure graft fixation is discussed.     

A single pericardial patch technique for repair of partial anomalous pulmonary venous drainage associated with sinus venosus atrial septal defect

A technique is described for repair of partial anomalous pulmonary venous drainage associated with sinus venosus atrial septal defect. The procedure, using a single autologous pericardial patch, is able to facilitate both reconstruction of the pulmonary venous channel and enlargement of the superior vena cava. This technique also reduces the incidence of arrhythmias.     

Coronary artery bypass grafting using right gastro-epiploic artery and cholecystectomy

A 59-year-old male with ischemic heart disease and cholecystolithiasis underwent coronary artery bypass grafting (CABG) using the right gastro-epiploic artery (GEA) and cholecystectomy simultaneously CABG was performed under standard extracorporeal circulation followed by cholecystectomy at the same incision. The opening in the dome of the diaphragm where the pedicle of GEA was brought up was closed with fibrin glue. Then, sternum was closed and cholecystectomy was performed with no elongation of the incision. The postoperative course was uneventful without mediastinitis or other infectious events. The postoperative angiography showed good patency of the GEA graft. Combined CABG using GEA and cholecystectomy is beneficial for the selected patients.     

Analysis of hepatic and renal dysfunction after surgery of thoracic aneurysm

To analyze causes of postoperative hepatic and renal dysfunction in patients with thoracic aneurysm, we examined 31 patients who survived surgeries and 2 patients died of MOF. The patients were separated into three groups as follows; Cardiopulmonary bypass (CPB) was used for circulatory support in group A (n = 7), CPB and low flow perfusion during open distal anastomosis in group B (n = 13) and temporary bypass or left atrial distal aorta arterial bypass was used in group C (n = 11). Operation time was significantly longer in group A (9.8 hrs) compared with group C (6.1 hrs). Amount of intraoperative blood transfusion was greater in groups A (4980 ml) and B (4860 ml) compared with group C (2320 ml). Postoperative highest total bilirubin level was significantly greater in group A (7.8 mg/dl) than group C (2.5 mg/dl). LDH was higher in groups A (1322 IU/l) and B (1336 IU/l) than group C (991 IU/l). GOT was higher in group B (200 IU/l) than group C (64 IU/l). There were no significant differences in GPT, creatinine and BUN among the three groups. Operation time and amount of intraoperative blood transfusion were positively correlated with postoperative hepatic function parameters. Two patients died of MOF showed severe hepato-renal dysfunction associated with LOS. The results indicate that hypothermic low flow perfusion during open distal anastomosis do not induce hepatic or renal dysfunction, and postoperative hyperbilirubinemia is resulted from bilirubin overload which patients can tolerate well if they are not complicated with MOF.     

Cell adhesion markedly increases lucigenin‐enhanced chemiluminescence of the phagocyte NADPH oxidase

Lucigenin‐enhanced chemiluminescence (LECL) is widely used for the detection of reactive oxygen species released from various cells and mitochondria. However, the LECL response varies depending on cell species and assay conditions at least in part by unknown factors. Here we report that cell adhesion is an important factor for increasing LECL of tetradecanoylphorbol acetate (TPA)‐stimulated human neutrophils. More than 90% LECL remained even after complete removal of the cell suspension 10 min after TPA stimulation, and ~22.5% of neutrophils were adhered to the reaction tube. These results indicate that LECL by an adhering neutrophil is ~45× higher than that by a non‐adhering neutrophil. LECL by leukocyte adhesion deficiency neutrophils was one‐fifth of that by normal neutrophils and completely disappeared when the cell suspension was removed, confirming that LECL depends highly on cell adhesion. The oxidase activity of adhering neutrophils measured after permeabilization with Renex 30 together with NADPH addition was similar to that of non‐adhering neutrophils, indicating that lucigenin and cell adhesion do not enhance the oxidase activity. Based on these findings, we propose that a mixture of adhering and non‐adhering neutrophils can be used for simultaneous screenings of adhering activity and the oxidase activity of neutrophils.