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Background:This study aimed to evaluate untreated, previous pulmonary thromboembolism (PE) in patients with acute fatal PE. Patients and Methods:We studied 64 patients diagnosed as having died from acute PE by medico‐legal autopsy. Previous PE was histologically confirmed on the basis of organized thrombi (OT). The distributions of OT were analyzed in five different sizes of pulmonary artery branches in each of 18 pulmonary segmental arteries (90 in total). The frequency of OT in each patient was evaluated by determining the percentage of examined sections containing OT. Results:OT were confirmed in 59 of 64 (92%) patients. The mean frequency of OT per patient was 27% of the 90 branches. Among the segmental arteries, the right posterior basal lobe showed the highest frequency of OT; among the five artery branches examined, the subsegmental branch showed the highest frequency of OT. OT were not detected in arterioles. Patients with recent trauma or surgery and inpatients showed significantly lower frequencies of OT than those without these risk factors. The 26 patients with prolonged pre‐existing symptoms lasting more than a day showed a higher frequency of OT than the 12 patients who suffered for less than a day and the 26 without pre‐existing symptoms. Conclusions:Most patients with acute fatal PE have a subclinical history of recurrent PE. The frequency of their untreated PE is suspected to correlate with specific risk factors for venous thromboembolism and their clinical course.

Abstract: Giant Zeeman effects of excitons were studied in hybrid nanostructures of diluted magnetic semiconductor (DMS) quantum wells (QWs) with ferromagnetic Co, where the DMS-QW wires with the width of 200 nm were sandwiched in the Co wires with the width of 400 nm. When the direction of the Co magnetization is normal to the wire plane, a magnetic field B ⊥Co‐flux perpendicular to the well plane can be applied from the Co wires to all of the DMS-QW wire. In addition, the use of a Co/Pt multilayered film with the perpendicular magnetization at zero external field was examined instead of the pure Co film. The excitonic photoluminescence spectrum from the DMS-QW shows significant broadening in the hybrid structures, indicating the giant Zeeman shift of excitons induced by B ⊥Co‐flux.

Abstract:  Two methods were developed for the quantitative sampling of rotifers and cladocerans attached to aquatic macrophytes while separating them from plankton. We named them the “covering method” and the “picking-up method.” We consider the covering method to be better for estimating the abundance of animals on plants, but it requires hard work on a boat. In contrast, the picking-up method is simple and easy to perform, but it seems to estimate animal abundance with some errors. The densities of rotifers and cladocerans on emergent and submerged plants in two Japanese lakes were estimated by the two methods, and the results were compared. The densities of most animals (e.g., the rotiferans Brachionus, Mytilina, Lepadella, and Colurella, and the cladoceran Alona) estimated by the picking-up method did not differ from those estimated by the covering method. In contrast, the densities of the rotiferans Monostyla, Euchlanis, and Trichocerca estimated by the picking-up method tended to be lower than those estimated by the covering method. These suggest that the picking-up method is suitable for estimating many densities, except for some rotiferan genera.

To maintain various T cell responses and immune equilibrium, activation signals triggered by T cell antigen receptor (TCR) must be regulated by inhibitory signals. Gab2, an adaptor protein of the insulin receptor substrate-1 family, has been shown to be involved in the downstream signaling from cytokine receptors. We investigated the functional role of Gab2 in TCR-mediated signal transduction. Gab2 was phosphorylated by ZAP-70 and co-precipitated with phosphoproteins, such as ZAP-70, LAT, and CD3zeta, upon TCR stimulation. Overexpression of Gab2 in Jurkat cells or antigen-specific T cell hybridomas resulted in the inhibition of NF-AT activation, interleukin-2 production, and tyrosine phosphorylation. The structure-function relationship of Gab2 was analyzed by mutants of Gab2. The Gab2 mutants lacking SHP-2-binding sites mostly abrogated the inhibitory activity of Gab2, but its inhibitory function was restored by fusing to active SHP-2 as a chimeric protein. A mutant with defective phosphatidylinositol 3-kinase binding capacity also impaired the inhibitory activity, and the pleckstrin homology domain-deletion mutant revealed a crucial function of the pleckstrin homology domain for localization to the plasma membrane. These results suggest that Gab2 is a substrate of ZAP-70 and functions as a switch molecule toward inhibition of TCR signal transduction by mediating the recruitment of inhibitory molecules to the TCR signaling complex.

Some plasma membrane receptors in yeast are known to be internalized and degraded in lysosomes upon ligand-dependent ubiquitination. However, the role of ubiquitination in endocytosis and lysosomal degradation in higher eukaryotes has been controversial. In order to directly assess this question, we investigated the fate of chimeric molecules in which ubiquitin moiety was fused in-frame to the cytoplasmic region of membrane proteins. The chimeric proteins with the wild-type ubiquitin were endocytosed and delivered to lysosomes efficiently. Mutant ubiquitin with lysine-to-arginine substitution could still mediate endocytosis, suggesting that polyubiquitination is not required for the endocytosis. We next searched for the existence of an endocytosis signal(s) in the ubiquitin moiety, and identified a di-leucine signal, Leu(43)-Ile(44). The Leu(43)-Ile(44) sequence mediated endocytosis and lysosomal sorting in a Leu(43)-dependent manner. These results suggest that the di-leucine signal in ubiquitin can be involved in ubiquitination-mediated endocytosis and lysosomal targeting of membrane proteins.

In order that the factors causing poor surgical outcome might be clarified, 175 duplicated thumbs bifurcating at the metacarpophalangeal joint level were analyzed. Cases were further divided into types A-D, based upon the details of the bifurcation form; that is, based on the connection of the radial digit to the ulnar components by either cartilage, joint, or fibrous tissue. The incidence of each type was 16% for type A (wide cartilaginous connection between phalanges), 68% for type B (2 separate phalanges), 6% for type C (cartilaginous connection to metacarpal), and 10% for type D (fibrous connection to joint capsule). Triphalangeal types and the relative size of the excised digit were determined by the preoperative radiograph. One hundred six cases were available for evaluation with a minimum of 3 years' follow-up. Good results were obtained in 50% of types A and C and in 80% of types B and D. Three phalanges in the preserve digits were observed in 10 cases and surgery on all but 1 resulted in a fair outcome. In cases where the size of the excised digit was more than 75% of the preserved digit, the results were fair or poor in 93%. The presence of subdivisions of types A and C, of 3 phalanges in the preserved digit, and of a relatively bigger excised digit were factors causing poor results, despite intensive reconstructive surgery.

From 1965 to 1986, thirty-four patients with retinoblastoma were born in Nagasaki Prefecture, Japan, 23 with unilateral and 11 with bilateral retinoblastoma. The incidence of retinoblastoma was calculated to be approximately 1 in 16,053 births; it was bilateral in 1 in 49,618 births. There was no significant difference in the incidence of retinoblastoma between urban and rural areas. In Shimabara district it was 1 in 10,331 births - much higher than in any other district of Nagasaki Prefecture. Historically, almost all the natives had been killed in the Shimabara War in 1637, and then people immigrated to Shimabara mainly from Hyogo, Aichi and Shizuoka Prefectures. The authors compared the incidence and distribution of retinoblastoma in these three prefectures with the figures in Shimabara. The incidence in the Tamba and Tajima districts of Hyogo Prefecture was 1 in 10,570 and 1 in 10,411, respectively, very similar to that in Shimabara. The authors wonder if this similarity is only an accidental coincidence when the historical relationship among the three districts is considered.

Circadian blood pressure (BP) variation were studied in patients with renovascular hypertension (RVH) and primary aldosteronism (PA). Ambulatory BP (ABP) was monitored every 5 min for 24 hrs in a ward setting in 23 patients with PA and 17 patients with RVH (13 patients with unilateral renal arterial stenosis and 4 with bilateral stenosis). In patients with RVH, ABP was monitored before and after treatment with a converting enzyme inhibitor or percutaneous transluminal angioplasty. Plasma renin activity (PRA) was high before percutaneous transluminal angioplasty in almost all patients with RVH and low in those with PA. Ordinary circadian BP variation, i.e. nocturnal fall and diurnal rise in BP, was confirmed in the patients with unilateral or bilateral renal artery stenosis. Percutaneous transluminal angioplasty successfully normalized both BP and PRA in those with RVH. Normal circadian BP variation was observed in those with RVH before the treatment with a converting enzyme inhibitor or percutaneous transluminal angioplasty as well as during treatment with the former and after treatment with the latter. Circadian BP variation in the patients with RVH was affected by the pathogenesis of renal artery stenosis alone, i.e, fibromuscular hyperplasia and atherosclerosis; with fibromuscular hyperplasia normal circadian BP variation was observed, while with atherosclerosis, nocturnal BP fall was restricted or eliminated. Circadian BP variation in those with PA before and after excision of adrenal adenoma was essentially similar to that in normal subjects and essential hypertensive patients. From these it seems that in patients with RVH or PA, circadian BP variation is not affected by hypertension per se or by pathogenesis of hypertension.

This work deals with the characterization of two-phase flows based on fractal techniques in order to develop objective flow regime indicators. Fractal analysis has been used previously for studying turbulent flows and it is a natural way of describing highly irregular fluctuations in two-phase flows. The fractal dimension of measured time series have been evaluated by Higuchi's method. It is shown that the error of the linear fit of the fractal dimension is a sensitive indicator of the changes in the flow regime, while the fractal dimension value itself is less suitable for flow regime identification. The developed method has been applied to the evaluation of two-phase flow experiments at the SIDAS boiling loop at Delft University of Technology, the Netherlands.

Six patients with avulsion fractures of the metacarpophalangeal joints of the fingers are reported. Operation was performed in all cases. Judging from the operative findings, the radiological assessment of fragment shape is helpful in treatment. Surgery is recommended when the fragment is triangular or rectangular in shape because the fracture involves the articular surface. Conservative treatment is effective if the fragment is round because the articular surface of the joint is not involved in this type of fracture. The avulsed fragment often overlaps the metacarpal head and a collateral ligament injury is likely to be misdiagnosed. It is important to suspect this injury and assess the shape of the wholefragment for a good functional result.

32 patients with scaphoid non-union were examined to clarify the relationship between pre-operative radiographic sclerosis in the proximal fragment and signal intensity on magnetic resonance imaging (MRI). In addition, the correlation between changes in signal intensity in the proximal fragment and surgical outcome after bone grafting and internal fixation was investigated. Proximal fragment sclerosis was observed in seven patients. Comparison of the T1 and T2-weighted images with those of the 25 patients without proximal fragment sclerosis revealed no differences. Therefore, there was no relationship between sclerotic changes on plain radiography and the degree of avascularity of the proximal fragment assessed by MRI. None of the patients who had low signal intensity on both T1 and T2-weighted images achieved union within 5 months after surgery. Thus the detection of signal intensity on both T1 and T2-weighted images can be useful to predict the prognosis after the surgery.

Six patients with avulsion fractures of the metacarpophalangeal joints of the fingers are reported. Operation was performed in all cases. Judging from the operative findings, the radiological assessment of fragment shape is helpful in treatment. Surgery is recommended when the fragment is triangular or rectangular in shape because the fracture involves the articular surface. Conservative treatment is effective if the fragment is round because the articular surface of the joint is not involved in this type of fracture. The avulsed fragment often overlaps the metacarpal head and a collateral ligament injury is likely to be misdiagnosed. It is important to suspect this injury and assess the shape of the whole fragment for a good functional result.

A retrospective radiographic and clinical analysis of 102 symptomatic patients with 104 scaphoid non-unions of at least 1 year's duration was conducted. Osteoarthritis occurred in 22% of non-unions of less than 5 years' duration, 75% of those of 5 to 9 years' duration, and 100% of those of 10 years' duration or more. An all-over incidence of osteoarthritis in the wrist was 55%. Osteoarthritic changes occurred initially at the scaphoid-radial styloid joint which were manifested by radial styloid pointing and/or dorsal radioscaphoid osteophyte formation, later progressing to the midcarpal joint. Osteoarthritis at the scaphoid-radial styloid joint was significantly associated with dorsiflexed intercalated segment instability (DISI) deformity. An overall incidence of DISI deformity of the wrist was 56%, and the frequency of DISI pattern increased with longer duration of non-union. There was an increased incidence of avascular necrosis of the proximal fragment with time, especially after 20 years. There was no correlation between symptoms of pain and the severity of arthritis or the duration of non-union, but a good correlation between the duration of non-union and reduced grip strength or decreased wrist motion. A symptomatic non-union of the scaphoid is significantly likely to progress to osteoarthritis according to a predictable sequence, becoming worse both radiographically and clinically with time.

Two long-chain acyl-CoA hydrolases, referred to as ACH1 and ACH2, were purified from the liver cytosol of rats fed a diet containing di(2-ethylhexyl)phthalate, a peroxisome proliferator. The molecular mass of ACH1 was estimated to be 73 kDa by gel filtration, and that of the subunits, 36 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The corresponding values of ACH2 were 42 and 43 kDa, respectively. Both enzymes were active toward fatty acyl-CoAs with chain-lengths of C_12-16, but ACH1 had relatively broad specificity as acyl-CoAs with C_8-18 were good substrates. A marked difference in their catalytic properties was found in the maximal velocity; for palmitoyl-CoA, 553 and 4.23 µmol/min/mg with K_m values of 5.9 and 5.4 µM for ACH1 and ACH2, respectively. ACH2 underwent severe substrate inhibition with high concentrations of long-chain acyl-CoAs, whereas ACH1 did not. Examination with various reagents including divalent cations, sulfhydryl-blocking reagent, nucleotides, and hypolipidemic drugs, characterized ACH1 and ACH2 with several properties distinct from those of mitochondrial and microsomal hydrolases. ACH1 and ACH2 were also discernible in that the former, but not the latter, was inhibited by ATP. In the liver cytosol of rats treated with di(2-ethylhexyl)phthalate, about 90% of palmitoyl-CoA hydrolase activity was titrated with anti-ACH1 and anti-ACH2 antibodies. Immunoblot analysis suggested the presence of the enzymes also in extrahepatic tissues, especially in the brain and testis (ACH1), and in the heart and kidney (ACH2).Copyright 1994, 1999 Academic Press

32 patients with scaphoid non-union were examined to clarify the relationship between pre-operative radiographic sclerosis in the proximal fragment and signal intensity on magnetic resonance imaging (MRI). In addition, the correlation between changes in signal intensity in the proximal fragment and surgical outcome after bone grafting and internal fixation was investigated. Proximal fragment sclerosis was observed in seven patients. Comparison of the T1 and T2-weighted images with those of the 25 patients without proximal fragment sclerosis revealed no differences. Therefore, there was no relationship between sclerotic changes on plain radiography and the degree of avascularity of the proximal fragment assessed by MRI. None of the patients who had low signal intensity on both T1 and T2-weighted images achieved union within 5 months after surgery. Thus the detection of signal intensity on both T1 and T2-weighted images can be useful to predict the prognosis after the surgery.

Clinical evaluations of middle ear inflation for secretory otitis media (SOM) were performed with special emphasis on the influence of seasonal and aging factors. One hundred and forty-nine children between the ages of 3 and 9 years (227 ears) were all diagnosed as SOM by pneumatic-otoscopic findings, and type B tympanogram (TG) at 3 weeks or more after the onset of acute SOM or the initial observation of SOM. Middle ears were inflated by Politzer's method or by our modified method once or twice each week for 2 months. After inflation, TG displayed two different time sequences: one group changed to the A or C type immediately after inflating the ear one or more times, but usually returned gradually to the B type (TG-improved group); and the other group remained without any changes (TG-unchanged group) for the duration of this study. The healing rate in the TG-improved group was significantly higher than in the TG-unchanged group at the 2-month endpoint. The cure rate of SOM was significantly higher in spring than in autumn in the TG-unchanged group but not in the TG-improved group. There were almost no differences between the healing rates in the 3-5 and 6-9 year-old children. When a TG-unchanged ear is found in autumn during the 2-month inflation treatment, more careful and forcible treatments should be introduced later, especially to children between the ages of 3 and 9 years.

The polarographic or voltammetric behaviour of a selected group of tetra-alkyl ammonium halides and related compounds in liquid sulphur dioxide was investigated, using a stationary disk platinum indicating micro-electrode and a silver/silver-bromide reference electrode with compensation for the IRdrop of the solution. The electrochemical oxidation-reduction patterns are characteristic of the natures of the cation and anion composing the compound.

A 65‐year‐old man was admitted to our hospital with acute myocardial infarction (Ml). Emergency coronary angiography showed no significant organic lesions, but a myocardial bridge was found at the mid‐left anterior descending artery. An acetylcholine provocation test revealed 90% spastic stenosis just proximal to the myocardial bridge. His acute Ml could have been caused by both a coronary spasm and the myocardial bridge.

Abstract: A case of simultaneous dorsal dislocation of the metacarpophalangeal (MP) and carpometacarpal (CMC) joints in the little finger is presented. The patient required a second surgical intervention for volar subluxation of the MP joint which occurred while wearing a dorsal splint following open reduction of the MP joint and closed reduction of the CMC joint. Two years postoperatively, the patient was asymptomatic but was left with mild stiffness of the MP joint.

The first line of page 342 should appear immediately before the first line of page 344. In other words, the third sentence of the proof of Lemma 3.1 should read: If for some iwe also have vi(ai)=vi(aai), then qiand aisatisfy the conditions of the lemma.