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We report seven large B cell lymphoma patients showing the involvement of tumor cells with cyclin D3 (CCND3) expression in bone marrow (BM) at the initial diagnosis. All patients presented with B symptoms, splenomegaly, and anemia/thrombocytopenia lacking hemophagocytosis in the BM. Five of the seven patients had suffered from immunological diseases or cancers. The tumor cells were divided into those with a lymphoplasmacytoid or blastoid appearance. Six cases were confirmed to express CD5 antigen on tumor cells. Three cases presented a chromosomal translocation between CCND3 and the immunoglobulin heavy chain (IGH) loci, t(6;14)(p21;q32). Three and two cases showed unmutated and mutated sequences of the variable region of IGH (VH), respectively, and one case showed deletion of an entire segment of VH. Two cases with t(6;14)(p21;q32) showed an unmutated VH sequence and chromosomal translocation within the switch region of IGH. Further studies are required to determine whether CCND3 expression is associated with a unique subset of diffuse large B cell lymphoma.

Management of the small aortic root is a significant problem for the surgeon with regard to operative technique and selection of the prosthesis. We report on four adults with a small aortic root who underwent aortic valve replacement with a 16-mm CarboMedics bileaflet valve. All patients now lead normal lives. Postoperative Doppler measurements demonstrated an acceptable transprosthetic gradient.

The effects of calcium antagonists (nifedipine, nicardipine, diltiazem, and verapamil) and prostaglandin E1 (PGE1) on the tension of isolated canine coronary arterial strips were studies. In a solution containing 20 mEq/L of K+, 127 mEq/L of Na+, the tension was increased by 500–1,000 mg with 4 mEq/L of Ca2+. This increase in tension was suppressed by Ca-antagonists and PGE1 dose-dependently. Nifedipine 10−5M, nicardipine 3 X 10−7M, diltiazem 3 X 10−6M, and verapamil 3 X 10−6M completely suppressed the increased tension. The maximal suppression of the tension produced by PGE1 was about 40% at 10−10M. In 20 mEq/L K+ solution (0 mEq/L Ca2+, 37°C), the reduction of the Na+ concentrations from 127 mEq/L to 12 mEq/L increased the tension by 50 to 100 mg. This increase in tension was not suppressed by Ca-antagonists or PGEI. In conclusion, this study demonstrated that Ca-antagonists and PGE1 suppressed an increase in the tension caused by Ca2+ but did not suppress an increase in the tension caused by Na+ reduction.

A 23-year-old man underwent a tracheostomy. A massive hemorrhage from the tracheostomy site occurred 50 days later. An emergency operation was immediately performed and an erosion was noted on the innominate artery. The artery was divided and the hemorrhage was successfully stopped.

The fecal bacterial flora was examined in multiple stool specimens from 14 subjects with gastrointestinal disorders before, during and after the oral administration of bifidobacterial preparation (BBG, viable B. breve and B. bifidum, 3 X 10(9) or 6 X 10(9) per day) for 2 or 3 weeks. Enumerations of fecal bacterial flora showed no conspicuous alterations in total anaerobic bacterial counts during the BBG therapy, however the total number of bifidobacteria in feces increased significantly, and of E. coli and other aerobacteria showed a tendency to decline. The administered B. breve and B. bifidum were recovered in the feces at a concentration of 10(8)/g and of 10(7) to 10(8)/g, respectively. Both species continued to be excreted over 2 weeks after completion of the medication in the feces at concentrations of 10(6) to 10(7)/g and of 10(5) to 10(6)/g respectively, and diminished rapidly in 5 patients and continued at essentially the same level as during the medication in 6 patients. During the treatment the pH, urease activity and ammonia content in feces became lowered and showed a rerise after therapy. Symptomatic discomforts including abdominal distension and pain, anorexia, edema and fever of undetermined origin were reduced during the therapy. Urinalysis, hematological examinations and blood biochemical tests including blood ammonia level, however revealed no significant change.