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Background In the field of oncofertility, patients with breast cancer are often administered letrozole as an adjuvant drug before and after oocyte retrieval to prevent an increase in circulating estradiol. Case presentation We report a case of abdominal hemorrhage due to an ovarian rupture in a 29-year-old Japanese patient who restarted letrozole 2 days after an oocyte retrieval procedure in which 14 mature oocytes were retrieved. The patient had sought embryo cryopreservation as a fertility preservation option before undergoing treatment for recurrent breast cancer. A day after restarting letrozole treatment, the patient unexpectedly developed severe abdominal pain. Laparoscopic hemostasis was performed to manage the ovarian swelling and hemorrhage. Conclusions The ovaries can be restimulated by restart letrozole after an oocyte retrieval procedure. Therefore, reproductive-medicine practitioners should understand the potential complications of letrozole administration in such cases and take steps to ensure that they are minimized.

Objectives Pregnancy complicated with ovarian endometrioma is a risk factor for preterm delivery and rupture or infection during pregnancy. This study aimed to clarify the effectiveness and safety of transvaginal aspiration during pregnancy for endometrioma diagnosed in the first trimester. Design This retrospective observational study included 8 pregnant women with endometrioma who underwent transvaginal cyst aspiration at 12–14 weeks (aspiration group) between March 2011–March 2018 and 23 pregnant women with endometrioma who refused aspiration during the same period (observation group). Methods Characteristics of patients were compared in both groups. Safety, feasability and complications of transvaginal cyst aspiration were reported. Complications and obstetrical outcomes were reported and compared in both groups. Results The maximum cyst diameter was 8.9 ± 1.5 cm (mean ± standard deviation) in the aspiration group, which was significantly larger than that in the observation group (4.7 ± 0.2 cm). Four preterm deliveries (17.3%) occurred in the observation group and none in the aspiration group. The emergency cesarean section rate during delivery was 14.2% in the aspiration group and 43.7% in the observation group. Conclusions The aspiration group tended to have lower rate of preterm deliveries and emergency cesarean sections, suggesting that cyst aspiration could be an effective, minimally invasive, and safe management option for endometrioma during pregnancy.

Background Ovarian hyperstimulation syndrome is normally induced by ovarian stimulation drugs. Severe cases of ovarian hyperstimulation syndrome involve complications such as renal failure and thrombosis. Evidence has recently been developed for a method to prevent ovarian hyperstimulation syndrome. Most cases of ovarian hyperstimulation syndrome are of an early-onset type, which occurs shortly after injection of human chorionic gonadotropin. However, late-onset ovarian hyperstimulation syndrome, which occurs in a pregnancy cycle, also requires caution. We report our experience in treating a woman who was transported to our hospital with a severe case of ovarian hyperstimulation syndrome occurring during ovarian stimulation and who was determined to have an ectopic pregnancy. Case presentation Assisted reproductive technology was planned for a 29-year-old nulligravida Japanese woman diagnosed with bilateral fallopian tube obstruction and right-sided hydrosalpinx. On day 1 of controlled ovarian stimulation, the result of her human chorionic gonadotropin urine test was negative, and her serum levels of luteinizing hormone, estradiol, and progesterone were normal. On day 11 of controlled ovarian stimulation, the levels of estradiol and progesterone had risen to 9679 pg/ml and 16 ng/ml, respectively, prompting suspension of controlled ovarian stimulation. Eleven days after controlled ovarian stimulation was suspended, the patient demonstrated ascites that did not improve despite administration of cabergoline, and she was transported to our hospital 2 days after. Late-onset ovarian hyperstimulation syndrome suggested that she was pregnant, and her serum human chorionic gonadotropin level was 27,778 IU/ml. She underwent laparoscopic bilateral salpingectomy and was diagnosed with right tubal pregnancy. Conclusion In an ectopic pregnancy, human chorionic gonadotropin sometimes increases later than in an intrauterine pregnancy. In our patient’s case, endogenous human chorionic gonadotropin following the start of controlled ovarian stimulation may have caused late-onset ovarian hyperstimulation syndrome. The key to early detection of similar cases may be to suspect pregnancy in the event of unexpectedly high progesterone levels during ovarian stimulation.

Aim Umbilical cord ulceration (UCU) is a disease in which an ulcer forms in the umbilical cord in the pregnant uterus and is accompanied by hemorrhaging from the same site. UCU occurs in fetuses with congenital upper-intestinal atresia (CUIA); however, its onset mechanism remains unclear. Here, we report our investigation of cases of UCU in our hospital. Methods Among the 9825 deliveries performed between 2007 and 2016 at this hospital, 20 fetuses were diagnosed with CUIA, 4 (20%) of which had UCU. There was no difference in the backgrounds of the fetuses with UCU (UCU group: 4 fetuses) and those without (non-UCU group: 16 fetuses). Results There was no intergroup difference in gestational age at delivery. Four cases in the UCU group had maternal age 35 weeks (26-39), weeks of delivery 35 weeks (35-36) and weight 2178.5 g (1600-2640); three out of four fetuses were female; and the location of gastrointestinal obstruction was in the duodenum in one case and in the jejunum in three cases. Death occurred in three of four fetuses in the UCU group versus none in the non-UCU group. Conclusion We performed a retrospective statistical investigation on the risk of UCU onset in cases from this hospital; however, we could not identify any prognostic factors for its onset. We investigated a total of 27 past reported UCU cases and the 4 cases in this study. Mean gestational age at onset was 33.3 ± 2.7 for all 27 cases. Various methods for the early discovery of UCU have been reported in the past; however, there is currently no gold standard. Based on this report and a review of past papers, for CUIA, it is desirable to perform in-hospital management from gestational week 30 onward and decide proper delivery timing on a case-by-case basis.

Introduction The prorenin (PR) receptor [(P)RR] contributes to the regulation of the tissue renin-angiotensin system (RAS) and Wnt signaling, which is involved in embryogenesis and the pathological progression of malignant tumors and diabetes mellitus. Placental (P)RR is significantly upregulated in placental tissues from preeclamptic women. However, because it cannot be examined during pregnancy, the chronological relationship between the acceleration of tissue RAS and the disease state of hypertensive disorder of pregnancy (HDP) has not been reported. In this study, we examined whether chronological changes in placental tissue RAS can be assessed by measuring soluble (P)RR [s(P)RR]. Methods We obtained maternal and umbilical cord blood samples from 517 pregnant women (441 singleton and 76 twin pregnancies). The concentrations of s(P)RR and prorenin (PR) were measured using enzyme-linked immunosorbent assays. Results Multivariate analysis showed that maternal serum s(P)RR levels were significantly higher in patients with HDP or fetal growth restriction (FGR) and were positively correlated with serum PR levels. Furthermore, the maternal s(P)RR level was significantly higher in HDP with severe hypertension and after the onset of HDP. However, maternal s(P)RR levels were not affected by the severity of proteinuria. Serum s(P)RR levels in umbilical cord blood of singleton pregnancies were significantly correlated with gestational week at delivery and PR level. Discussion Maternal serum s(P)RR concentrations may reflect acceleration of tissue RAS in the placenta and blood pressure severity; however, the umbilical serum s(P)RR concentration was not affected by maternal HDP.

Most guidelines for the management of hypertension define it as a home blood pressure (HBP) value >135/85 mm Hg. However, there is no reference HBP value to diagnose hypertension in pregnant women. Therefore, in this study, we analyzed HBP measurements of pregnant women to determine whether it is appropriate to use the criteria for non-pregnant subjects for pregnant women. The participants of this study were 100 singleton pregnant women who visited our hospital between September 2013 and September 2016. We lent sphygmomanometers to the patients so they could measure their BP at home twice daily, and we measured their clinical BP when they visited the hospital. Six patients developed hypertensive disorders in pregnancy, whereas there were 63 women without hypertension or other complications that may affect BP. In the normotensive pregnant women, HBP values significantly correlated with the clinical BP values. HBP values equivalent to a clinical BP of 140/90 mm Hg, determined using the standard major axis method, were 120.8/83.5 mm Hg, 126.0/85.2 mm Hg and 136.3/89.3 mm Hg in the first, second and third trimesters, respectively. In normotensive pregnant women, HBP levels that indicate a risk of hypertensive disorder in pregnancy may be lower than 135/85 mm Hg before 28 weeks of gestation.

Objectives To evaluate home blood pressure (HBP) measurements during pregnancy and postpartum and investigate differences between singleton and twin pregnancies. Methods This prospective study involved normotensive, pregnant women who were planning to give birth at Saitama Medical Centre, Saitama, Japan between September 2013 and March 2017. HBP and pulse rate were measured twice daily and clinical blood pressure values were determined from patient records. Results HBP values were available from 101 participants; 69 women with singleton and 32 women with twin pregnancies. Systolic BP was statistically significantly higher in twin pregnancies from 23 weeks of gestation until 8 weeks after delivery compared with singleton pregnancies. Pulse rate was also statistically significantly higher between 11 and 30 weeks gestation in women with twin pregnancies compared with those with singleton pregnancies. Conclusions BP monitoring is important in the management of twin pregnancies, especially during the later gestational weeks and postpartum period and HBP would facilitate this monitoring.

A leukemic phase occurred in 7 of 11 (64%) Japanese patients with follicular lymphoma. The clinical and hematologic features at the onset of this phase were splenomegaly, anemia, and thrombocytopenia. The lymphoma cells expressed monoclonal surface immunoglobulins with moderate to strong intensity in all 7 of the patients diagnosed as leukemic. Various B-cell associated antigens were expressed as follows: CD19 (5/6), CD20 (7/7), and CD10 (6/7). The reactivity to these markers was comparable in the lymph node and blood samples. The expression of CD38 antigen was much lower in the lymphoma cells of the blood than in those of the lymph nodes. Cytogenetic studies of the lymph nodes of follicular lymphoma in leukemic phase revealed a common chromosomal aberration, of t(14;18)(q32;q21) and +18, in 2 patients successfully analyzed. Although the follicular lymphomas in the leukemic phase in these patients in Akita, Japan, were consistent with those in the West with respect to morphology, immunology and cytogenetics, the high incidence of leukemic manifestations may be a salient feature of Japanese cases.

目的: リン酸を表面処理剤とするレジン系装着材料の仮着した象牙質に対する接着強さの影響を明らかにするために, 比較検討を行った.方法: HY-Bond Temporary Cement Hard (以下HYB), Freegenol Temporary Pack (以下FTP) およびNeodyne T (以下NDT) の3種類の仮着材で, レジンプレートを牛歯象牙質に仮着した.Variolink II (以下V2) およびRely X ARC (以下RX) を用いて, IPS Empressを接着して勢断接着試験用試料を作製した.仮着を行っていないものをコントロール (以下CON) とした.仮着した象牙質およびIPS Empressに対する表面処理は, 製造者指示に従って行った.試料を37℃ で24時間精製水中保管後, 勇断接着強さを測定した.結果: V2の接着強さは, CON (11.4MPa, a, b), HYB (12.7MPa, a), FTP (7.6MPa, b, c) およびNDT (5.9MPa, c) であった.CONと比較してNDTが有意に (P

まれな大網原発類上皮血管内皮腫の1例を報告する. 症例は58歳の女性で, 臍周囲の不快感を主訴に来院した. 約5cmの弾性軟な腫瘤が臍周囲で腹壁に近く触知された. 精査により原発性腹膜腫瘍が疑われたが, 呼吸性移動を示すことから特に大網由来の可能性が考えられた. 1999年11月22日に手術が施行された. 腫瘍は明らかに大網内に存在し, 胃壁と固着しており, 胃壁を部分切除し腫瘍の完全摘出を施行した. 光顕像では, 腫瘍は類上皮血管内皮腫に一致する特徴を有し胃筋層へ浸潤していた. 免疫組織化学染色では, 血管内皮系マーカー (CD34, F-VIII) が一部陽性を示した. 以上より, 大網から原発した類上皮血管内皮腫と診断された. 術後経過は順調で, 30か月後も再発を認めていない.大網原発類上皮血管内皮腫に関して英語文献検索を行ったところ, 過去の報告は1例のみであり, 極めてまれである.

We examined the levels of autoantibodies against prethrombin-1 and fragment-1 in pregnant women to determine the type of autoantibodies that were associated with severe preeclampsia or spontaneous abortion.We measured autoantibodies bound to prothrombin, prethrombin-1, and fragment-1 by using an enzyme-linked immunosorbent assay (ELISA) in 12 healthy nonpregnant women, 36 women with normal pregnancies, 28 pregnant women with severe preeclampsia, and 19 pregnant women who subsequently had spontaneous abortion.Plasma samples in 10 (36%) of the 28 women with severe preeclampsia and 11 (58%) of the 19 women with spontaneous abortion were positive for antiprothrombin antibodies as compared with 3 (9%) of the 36 women with normal pregancies. All 11 of the positive samples from women who had spontaneous abortions were positive for antiprethrombin-1 antibody, but only 1 was positive for antifragment-1 antibody. The mean (+/- SD) titer of antiprethrombin-1 antibodies in patients with spontaneous abortion (36 +/- 9 U) was higher than that in women with normal pregnancies (10 +/- 4 U; P0.01). Antiprethrombin-1 antibody was detected in only 2 women with severe preeclampsia, whereas all 10 women with antiprethrombin antibodies were positive for antifragment-1 antibody. The antifragment-1 antibody titer in patients with severe preeclampsia (49 +/- 15 U) was higher than in women with normal pregnancies (13 +/- 6 U, P0.01).There is a strong and specific association between various types of antiprothrombin antibodies with severe preeclampsia and spontaneous abortion.

目的: 近年, 耐摩耗性の向上を目的として, 従来の歯冠用硬質レジンよりも高密度に無機質フィラーを添加した高フィラー型硬質レジンが開発され, 数々の材料が市販され, 臨床応用されている. 本実験の目的は, 新規高フィラー型硬質レジンの歯ブラシ摩耗について実験を行い, 耐摩耗性について評価を行うことにある.方法: 当教室が行っている歯ブラシ摩耗試験法で, 吸水量, 摩耗量, 耐摩耗性, 表面粗さの測定を行った.結果: 1. 吸水量は, Gradia enamel (GE) ≒Gradia dentin (GD)>belleGlass HP enamel (BE)>bellGlass HP dentin (BD) の順に有意 (p BEの順で有意 (p BDの順で有意 (p

To identify women with severe preeclampsia or severe gestational proteinuria at high risk of having underlying renal disease.Between 1980 and 1999, 86 Japanese women who had severe hypertension, severe proteinuria, or both during pregnancy had postpartum needle biopsies of their kidneys. Diagnoses before biopsies were severe preeclampsia in 74 women and severe gestational proteinuria in 12. We compared clinical characteristics, such as antepartum hematuria and postpartum proteinuria, and maternal and neonatal outcomes with regard to presence of renal disease.Nineteen of 86 women (22.1%, 95% confidence interval [CI] 13.9%, 32. 3%) were diagnosed with underlying renal disease. Immunoglobulin A nephropathy was present in 12. Women with renal disease had a significantly earlier onset of proteinuria than those without (median 11 versus 32 weeks' gestation, P.001). Eighteen of 19 women with renal disease had proteinuria, hypertension, or both before 30 weeks' gestation. Ten of 12 women with severe gestational proteinuria (83.3%, 95% CI 51.6%, 97.9%) had underlying renal disease. Eight of the 19 women had antepartum hematuria, and seven had elevated serum immunoglobulin A levels. In women with severe preeclampsia, onset before 30 weeks' gestation was the best predictor of underlying renal disease (odds ratio 34.1, 95% CI 3.8, 304.5). Women with renal disease had lower rates of severe hypertension (nine of 19 versus 59 of 67, P.01) and small-for-gestational-age infants (four of 19 versus 34 of 67, P.05) than those without renal disease.Women who had gestational proteinuria or preeclampsia before 30 weeks' gestation were more likely to have had underlying renal disease.

In this study the first PDE4B selective inhibitor is described. Optimization of lead 2-arylpyrimidine derivatives afforded a series of potent PDE4B inhibitors with >100-fold selectivity over the PDE4D isozyme. With a good pharmacokinetic profile, a selected compound exhibited potent anti-inflammatory effects in vivo and showed less emesis compared with Cilomilast.

BACKGROUND To investigate the role of interleukin-1 related substances in amniotic fluid in normal term labor without intrauterine infection. METHODS Amniotic fluid samples were collected from forty-one patients with various backgrounds. A novel pre-assay treatment using Frigen II was introduced to improve the recovery rates of cytokines, i.e., interleukin-1alpha, interleukin-1beta and interleukin-1 receptor antagonist, prior to ELISA assay. Urine samples from newborn infants were also tested. RESULTS The concentrations of interleukin-1alpha, interleukin-1beta and interleukin-1ra were significantly higher in samples from normal vaginal delivery. The higher levels of interleukin-1alpha were also observed in samples from preterm labor without infection. Preterm infants produced more of interleukin-1 receptor antagonist in urine compared with term infants. CONCLUSIONS This study provides evidence of the possible involvement of interleukin-1 related substances in labor without signs of infection. The data from newborn urine suggests that amniotic interleukin-1ra originates from the fetus. However, amniotic fluid interleukin-1alpha and interleukin-1beta may be derived from maternal tissue, such as decidua.

To evaluate toothbrush abrasion of high filler containing resin for crown and bridge, water absorption, volume of abrasion, abrasion resistance and surface roughness were determined. The results were as follows:1. In water, absorption was increased in the order of Estenia enamel (EE), Estenia dentin (ED), Herculite XRV enamel (XE), Herculite XRV dentin (XD), ArtGlass enamel (AE) and ArtGlass dentin (AD).2. The amount of abrasion was increased in the order of EE, AE and XE (Enamel Body), ED, XD and AD (Dentin Body).3. In evaluation, abrasion resistance was increased in the order of EE, ED, AE, XD, XE and AD.4. The surface roughness at the end of the experiment was increased in the order of XE, XD, ED, AD, EE and AE.

This study was conducted to investigate the thermal properties (thermal diffusivity, specific thermal capacity and thermal conductivity) of all ceramic restorative materials. Measurement of thermal properties of IPS Empress®, DiCOR® and adhesive resin cement Variolink II were performed by the Xenon flash method. The results obtained were as follows. Thermal diffusivity (×10-2cm2s-1) was 0.372-0.423 for IPS Empress®, 0.614 for DiCOR® and 0.191-0.193 for Variolink. Specific thermal capacity (Jg-1K-1) ranged from 0.695 to 0.872 for IPS Empress®, 1.119 for DiCOR® and 0.733-4.114 for Variolink. Thermal conductivity (Wm-1K-1) was 0.644-0.770 for IPS Empress®, 1.721 for DiCOR® and 0.297-0.475 for Variolink. Thermal conductivity of IPS Empress® was found to be less than that of human enamel, while that of DiCOR® was greater than that of human enamel. Thermal conductivity of Variolink was smaller than those of human enamel and dentin.The above results indicated that IPS Empress® had greater thermal insulation capability than human enamel and dentin and that DiCOR® had less.

Type 1 angiotensin II (ANG II) receptors play crucial roles in the regulation of blood pressure and fluid osmolarity, whereas the physiological roles of type 2 ANG II receptors (AT2) remain unclear. Because AT2is expressed in atretic follicles where granulosa cells undergo apoptosis, we examined the space and time relationship between AT2expression and follicle atresia in vivo and the effect of AT2on follicle-stimulating hormone (FSH) actions in vitro. Binding studies, autoradiography, and RT-PCR of AT2revealed that the AT2content in granulosa cells was time dependently increased at both protein and mRNA levels in equine chorionic gonadotropin-treated immature female rats. This increase paralleled the progression of atresia. ANG II suppressed FSH-caused prevention of DNA fragmentation, increases in luteinizing hormone receptor content, and estrogen production through AT2in cultured granulosa cells. Moreover, FSH-induced stimulation of extracellular signal-regulated kinase activity, critical for cell survival, was inhibited by AT2stimulation. These results suggest that AT2mediates the progression of follicle atresia through granulosa cell apoptosis by inhibiting FSH actions.

The effects of elevated glucose and aldose reductase inhibitor (ARI:ONO-2235) on nitric oxide (NO) production in cultured human umbilical endothelial cells (HUVEC) were evaluated. Aldose reductase and nitric oxide synthase(NOS) share NADPH as an obligate cofactor, therefore it is suggested that the enhanced of glucose flux (27.5 mM) by aldose reductase inhibited NO production by blunting NOS activity. However, the addition of ONO-2235 (100 μM) prevented the inhibition of [NO 2 − ] production. Since ARI decreases glucose-mediated inhibition of NO production in HUVEC, this agent might ameliorate endothelial function associated with diabetes.

Previous reports revealed that interleukin-1 (IL-1) was involved in the process of premature labor in the cases with intrauterine infection. However, the roles of the cytokine in normal spontaneous labor remain uncertain. The present studies aimed at determining the involvement of the cytokine in prostaglandin (PG)E2 production during labor by the third trimester decidual cells. The cells were obtained at the time of normal spontaneous delivery (NVD) and elective cesarean section (ECS). The NVD cells produced significantly more amount of PGE2 than the ECS cells and the both cells responded to the addition of IL-1 beta to increase PGE2 production. A specific inhibitor of cyclooxygenase-2 (COX-2), NS398, decreased basal PGE2 production and inhibited the stimulatory effect of IL-1 beta in a dose dependent manner in NVD cells. The NVD cells secreted more amount of IL-1 beta than the ECS cells and contained more amount of preprocessed 31kD IL-1 beta inside the cells. The addition of recombinant soluble human IL-1 receptor (type I) not only blocked the effect of IL-1 beta on PG secretion, but significantly reduced the basal production of PGE2 by NVD cells. These results indicate that decidual PG production depends upon COX-2 after the onset of labor. Besides it seems likely that endogenously produced IL-1 beta may be involved in autocrine or paracrine fashion in inducing COX-2 after the onset of labor.

When cementing a crown, the amount of final seating is affected by the film thickness of the dental cement. To decrease the film thickness of glass ionomer cement (GIC), a GIC powder (Shofu Hybond Glass ionomer CX) was milled and three experimental fine particle powders were produced. The purpose of this study was to investigate the physical properties of fine particle GICs (ISO-9917, compressive strength, setting time, film thickness) and retention force of the crown cemented. The powder was milled with Centrifugal Fluidized Milling Machine (CF-160 Ube Kousan Co.) to produce the particle size (CX-01: maximum particle size:∅6μm, CX-02: 8μm, CX-03: 12μm). The results were as follows: In specimen containing a large amount of fine particles (CX-01), the best seating of a crown was accomplished (total film thickness: 8.0μm), though both compressive strength and film thickness was reduced to some extent. On the other hand, there was no significant difference between the retention force of normal GIC and fine particle cement (CX-01, 02, 03). The setting time of CX-01, 02, 03 was slightly longer than that of normal GIC.

A 59-year-old man developed multiple subcutaneous and bone tumors after 2 years' duration of indolent myelofibrosis. These tumors exhibited a diffuse proliferation of pleomorphic blast cells. The skeletal x-rays showed disseminated osteolysis and osteosclerosis. Blast cells obtained from the pleural effusion did not react with myeloperoxidase, sudan black B or non-specific esterase. Genotypic analysis of DNA samples at autopsy did not demonstrate rearrangements of T-cell receptor beta-chain or immunoglobulin heavy-chain genes. Frozen-section immunohistochemical studies revealed that the neoplastic cells were derived from megakaryocytic lineage. The present case represents a novel and unusual subtype of megakaryocytic neoplasm.

Catalytic synthesis of several D-ribofuranosides from 2,3,5-tri-O-benzyl-1-O-iodoacetyl-D-ribofuranose and trimethylsilylated nucleophiles such as 3β-cholestanyl trimethylsilyl ether and phenyl trimethylsilyl sulfide is efficiently promoted by tin(II) chloride under mild conditions. When allyltrimethylsilane, azidotrimethylsilane, etc., are used as nucleophiles, combined use of catalytic amounts of SnCl2 and SiCl4 also afforded the corresponding ribofuranosides in good yields.

We investigated the mechanism of polyclonal B cell differentiation in mantle cell lymphoma (MCL) using peripheral blood mononuclear cells (PBMC) from a patient with MCL in leukemic stage presenting polyclonal hypergammaglobulinemia. Patient T cells not only responded to autologous non-T cells but induced polyclonal production of IgG in vitro. Flow cytometric analysis of PBMC showed the increased conversion of CD4+ T cells from the naive to the memory state. We propose the possible mechanism that autoreactive T cells may be involved in polyclonal B cell differentiation in this monoclonal B cell disorder.

The effect of 2-methyl-3-(1, 4, 5, 6-tetrahydronicotinoyl) pyrazolo [1, 5-a] pyridine (KC-764) on human platelet aggregation and its mechanism of action were investigated. The inhibitory activity of KC-764 on arachidonic acid-induced platelet aggregation was most potent with IC50 of 4.2×10-8 M and was about 100 times more potent than that of acetylsalicylic acid (ASA). KC-764 weakly inhibited prostaglandin G2-and prostaglandin H2-induced platelet aggregations. Neither KC-764 nor ASA had effect on platelet aggregation induced with STA2 (thromboxane A2 analog). KC-764 inhibited strongly human platelet cyclooxygenase activity. The effect of KC-764 on platelet aggregation, differently from ASA, was reversible. The inhibitory effect of KC-764 on cyclic nucleotide phosphodiesterases was weak. KC-764 had no effect on the concentration of cAMP and cGMP.These results suggest that the reversible inhibitory effects of KC-764 on platelet aggregations are mediated mainly via inhibition of platelet cyclooxygenase.

Five currently available glass ionomer cements (BASE CEMENT, DENTIN CEMENT, HY-BOND GLAS IONOMER-F, KETAC CEM, TOKUSO IONOMER) were studied with regard to the relationship between thermal properties and powder-liquid ratio (P/L ratio). The experiments were performed using five different P/L ratio of 0.8, 0.9, 1.0, 1.1 and 1.2 (P/L = 1.0: manufacturer's instruction) and measured with a xenon flash thermal-constant measuring device. Thermal diffusivity of the glass ionomer cements ranged from 0.212 to 0.303 x 10(-2) cm2 s-1; it increased according to the increase in the P/L ratio. The specific thermal capacity of the glass ionomer cements ranged from 1.011 to 1.369 Jg-1 K-1; it decreased with the increase in the P/L ratio. Thermal conductivity of the glass ionomer cements ranged from 0.505 to 0.712 Wm-1 K-1; it increased according to the increase in the P/L ratio.

In order to elucidate the epidemio-etiological factors of NHL in Jilin Province, a comparative study on 116 cases of the 3rd Hospital of Norman Bethune University of Medical Science (1977-1990) and 252 cases of the Akita University Hospital (1972-1992) was histologically and immunohistochemically performed, applying the modified classification of the Working Formulation by Nathwani. (Jilin Province and Akita Prefecture which respectively situated at lat. 44° and 40° N. and both have great agricultural activities.) The results obtained were as follows: 1. Overall mean age was 39.0 and 55.2 years in Jilin and in Akita, respectively. The age distribution curve of Jilin showed a bimodal pattern with peaks at 20-29 and 40-59 years of age, and the analysis in Akita revealed a peak at 50-69 years. 2. The male to female ratio was 2.9:1 in Jilin and 1.6:1 in Akita. 3. In Jilin, the commonest affected site was the intestine, particularly the small intestine, and mesenteric lymph node. The higher incidence of the intestine in Jilin suggests intestinal inflammation (by infection of pathogenic organisms, or intake of water or vegetables contaminated by agricultural chemicals) as an important risk factor. In Akita, cervical lymph node and Waldeyer's ring were the two commonest sites. 4. The incidence of follicular lymphomas in Jilin was higher than that in Akita, because of its higher incidence in the small intestine cases. The incidence of diffuse lymphomas in Jilin was similar to that in Akita. 5. The B/T ratio indicated 4.0:1 and 2.8:1 in Jilin and in Akita, respectively. DLnc was the commonest histological subtype of B cell lymphomas both in Jilin and Akita, which even prominent in Jilin. The incidence of T cell lymphomas in Jilin was slightly lower than that in Akita, possibly due to absence of the case of ATLL subtype in Jilin.

In a recent investigation of the ovary, high levels of endothelin-1 (ET-1), the renin-angiotensin system (RAS), and atrial natriuretic peptide (ANP) were identified. It was determined that ET, RAS, and ANP, alone or together, affected ovarian function. It is important that mutual relationships of these vasoactive and hormonal peptides, which coexist in the ovary, are examined to determine their in vivo functions. This study, using immature rats treated with pregnant mare's serum gonadotropin (PMS), examined the effects of ET-1, angiotensin II (Ang II) and ANP, individually or in combination, on steroidogenesis by granulosa cells (GCs) cultured for 72 h. ET-1 Ang II, and ANP, alone or combined, also had a mutual effect on steroidogenesis. Concomitantly with previous findings on the ovary, the authors propose that the intraovarian endothelin-renin-angiotensin-ANP system (ERAANPS) functions as a novel intraovarian regulator system.

Catalytic synthesis of several D-ribofuranosides from 2,3,5-tri-O-benzyl-1-O-iodoacetyl-D-ribofuranose and trimethylsilylated nucleophiles such as 3β-cholestanyl trimethylsilyl ether and phenyl trimethylsilyl sulfide is efficiently promoted by tin(II) chloride under mild conditions. When allyltrimethylsilane, azidotrimethylsilane, etc., are used as nucleophiles, combined use of catalytic amounts of SnCl2 and SiCl4 also afforded the corresponding ribofuranosides in good yields.

A 50-year-old farmer with plasma cell granuloma had PET scans showing marked accumulation of C-11 Met. The PET had superiority in imaging the existence and extent of the lesion and monitored therapeutic response as compared with CT and MR imaging. PET yields information on hemocirculatory and metabolic aspects of this rare disease.

The authors report a 60-year-old man with Richter's syndrome, or diffuse large cell lymphoma (DLCL) occurring in a patient with either chronic lymphocytic leukemia (CLL) or Waldenström's macroglobulinemia (WM). Surface marker analysis revealed that the WM showed mu kappa surface immunoglobulin (Ig) chains, and that the DLCL showed mu lambda Ig chains. Flow cytometric DNA analysis demonstrated DNA content differences between WM and DLCL, the former diploid and the latter aneuploid. The current study suggests that Richter's syndrome derives from two independent B-cell malignancies.

To bioengineer ectodermal organs such as teeth and whisker follicles, we developed a three-dimensional organ-germ culture method. The bioengineered tooth germ generated a structurally correct tooth, after both in vitro organ culture as well as transplantation under a tooth cavity in vivo, showing penetration of blood vessels and nerve fibers. Our method provides a substantial advance in the development of bioengineered organ replacement strategies and regenerative therapies.

AIM The aim of the present study was to investigate regulatory mechanisms of angiogenesis in the decidua using immortalized human decidual fibroblasts. METHODS A sample of decidual fibroblasts was taken from a woman in early pregnancy. A cell line, DE-1, was established by infecting the decidual fibroblasts with the simian virus 40 large T antigen. Using this cell line, the ability to produce vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), beta-transforming growth factor (TGF-beta), and thymidine phosphorylase (TP) activity was investigated using immunohistochemistry, and the influences of beta-interleukin-1 (IL-1beta) and alpha-tumor necrosis factor (TNF-alpha) on these angiogenetic factors was investigated using enzyme-linked immunosorbent assays. Furthermore, the effects of TNF-alpha on proliferative capacity and apoptosis induction in DE-1 were studied. RESULTS It was demonstrated that DE-1 produced all of these angiogenetic factors. The production of VEGF, bFGF and TGF-beta respectively was enhanced by both IL-1beta and TNF-alpha. TP activity was increased by TNF-alpha, but no increase was observed as a result of IL-1beta. It was shown that TNF-alpha suppressed the proliferation of DE-1 cells and significantly increased the percentage of apoptotic cells. CONCLUSION It is suggested that IL-1beta and TNF-alpha stimulate decidual fibroblasts to up-regulate angiogenesis in the human decidua.

Objectives: Our purpose was to clarify the influence of methylenetetrahydrofolate reductase (MTHFR) gene polymorphism on plasma homocysteine (Hcy) concentrations during early pregnancy. Methods: Between 1996 and 1998, Hcy concentration and MTHFR gene polymorphism were studied in 840 pregnant women between 6 to 12 weeks' gestation. Hcy concentration was measured by amino acid autoanalyzer (DLC-300, Nihon Denshi), and MTHFR genotypes were determined by the PCR/RFLP methods. Pregnancy outcomes were compared in association with Hcy concentration and MTHFR genotypes. Results: A total of 816 of the 840 women were enrolled into the study because MTHFR genotypes were not available in 24 women. Genotypes of C677T in the MTHFR gene were CC: CT: TT (%) = 280 (34.3): 400 (49.0): 136 (16.7). Plasma Hcy concentration was significantly (p < 0.0001) higher in women with TT genotype than other genotypes [CC: CT: TT = 5.67 (2.8–10.6): 5.80 (2.5–20.1): 6.91 (3.5–20.9) nmol/ml, median (range)]. Women with hyperhomo-cysteinemia had severe preeclampsia (2 of 35 vs 5 of 714, p < 0.01) and stillbirth (2 of 35 vs 10 of 714, p < 0.05) more frequently than normohomocysteinemia. Conclusions: Plasma Hcy concentration during early pregnancy was higher in women with homozygote for the T677 allele in the MTHFR gene than other genotypes.

Objective: To investigate where human embryos implant after ET. Design: Prospective analysis. Setting: University hospital. Patient(s): Sixty infertile women without uterine fibroids, a major uterine anomaly, or a history of cesarean section. Intervention(s): Transabdominal and transvaginal three-dimensional ultrasound examinations. Main Outcome Measure(s): The location of ET-associated air bubbles in the uterine cavity and the location of the resultant gestational sac. Result(s): Sixty ETs resulted in 22 pregnancies, and 32 gestational sacs were located. Twenty-six of the 32 embryos were within or between the area in which the catheter tip was situated and the area over which air bubbles had spread immediately after ET. Conclusion(s): In cases of pregnancy achieved through ET, approximately 80% of embryos implant in areas to which they initially are transferred and approximately 20% implant in other areas.

A 34-year-old woman was diagnosed with Cushing's syndrome after her first pregnancy ended in intrauterine fetal death at 25 weeks' gestation. She subsequently had a successful pregnancy after treatment of her disease. Although patients with Cushing's syndrome rarely conceive, abortion, preterm labor, and intrauterine growth retardation are common when they do.

The intrauterine tissues including decidua have been investigated as the sites of prostaglandin (PG) production in connection with its involvement in the onset or progress of labor (1–4). The recent papers suggested that the intrauterine infection was responsible for the pathophysiology of preterm labor through the set of events from the generation of various types of cytokines such as interleukin-1 (IL-1), the induction of cyclooxygenase (COX) to the PG synthesis in these tissues (5–7). On the other hand, IL-1 has been reported to induce COX-2, an inducible type of COX in cultured decidual cells (8). Therefore, COX-2 induction in decidua by IL-1 would play a role in the initiation of spontaneous labor as well as preterm labor. Though the physiological role of IL-1 secreted in decidual cells remains still uncertain (9), this study was aimed to reveal endogenous role of IL-1 synthesized and secreted by decidual cells in the formation of PGE2. In addition, we investigated the selective role of COX-2 in decidual cells for the initiation or maintenance of labor by using a specific inhibitor for the enzyme, NS-398.

A 10-month-old girl presented with mental retardation and enlarged head, and a 3-year-old girl presented with epilepsy, both due to suprasellar arachnoid cysts. Magnetic resonance imaging demonstrated the suprasellar arachnoid cyst and the relationship between the cyst and surrounding structures. The 10-month-old patient with accompanying hydrocephalus was treated by fenestration of the cyst wall into the basal cistern. Postoperatively, bilateral subdural effusion appeared and subdural-peritoneal shunting was required. Thereafter, she regained the ability to walk. Two years postoperatively, the cyst reenlarged but communication between the cyst and surrounding cisterns and her development was normal, so she has been followed conservatively. The 3-year-old patient presented without hydrocephalus and was treated by cyst-peritoneal shunting using a Codman-Medos programmable valve through craniotomy. Postoperatively, the cyst was reduced and there has been no recurrence for 2 years and 5 months. We consider that cyst-peritoneal shunting is the most effective treatment for suprasellar arachnoid cyst.

We report a 65-year-old woman with non-Hodgkin's lymphoma (NHL) carrying a t(3;14)(q27;q11) and BCL6 rearrangement in the affected cells. She had generalized lymphadenopathy and the bone marrow was infiltrated by lymphoma cells at presentation. Histological diagnosis was "malignant lymphoma, diffuse, large cell" type according to an International Working Formulation. Chromosome analysis revealed a t(3;14)(q27;q11), which is a new variant translocation of t(3;14) (q27;q32). Southern blot analysis showed rearrangement of BCL6, JH, and TCR beta but not of TCR delta. Cosmid probe of BCL6 hybridized to 14q11 and 3q27 by fluorescence in situ hybridization (FISH). Although the band 14q11 is a locus of T-cell receptor alpha- and delta-chains (TCR alpha/delta), lymphoma cells expressed B-cell, IgGk phenotype. The findings suggest that a novel proto-oncogene in the vicinity of TCR alpha/delta is involved in this translocation.

In an attempt to induce ovulation in Clomiphene resistant secondary amenorrhoea patients, the gonadotrophin-releasing hormone agonist (Buserelin) (600-900 micrograms/day) was administered in 13 cases aged 18 to 24 years for one week from day 5 of the menstrual cycle. Serum levels of luteinizing hormone increased in all patients, and estradiol levels increased in 10 of 13 patients in response to Buserelin. However, ovulation was observed in 6 cases, and the response to Clomiphene was recovered in all of these 6 cases in their subsequent menstrual cycles. These results imply the existence of a subgroup who respond to Buserelin in Clomiphene resistant secondary amenorrhoea patients and a possible new approach for the treatment of secondary amenorrhoea.