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78 Background: We encounter some cases of early gastric cancer treated by endoscopic submucosal dissection (ESD) that are out of the indication criteria after pathologic diagnosis. These cases require additional treatments because of a risk of lymph node metastasis in Japanese Classification. So further prediction factors associated with lymph node metastasis is expected. We are focusing on poorly differentiated adenocarcinomas in early gastric cancer that we treated by ESD and used these tissues to characterize their gene expression profiles related to canceration, invasion or conversion for metastasis. Methods: We examined two cases of intramucosal carcinoma and three of submucosal infiltrating carcinoma histologically diagnosed as poorly differentiated adenocarcinoma after ESD. Those samples are separated five adjacent normal tissues (N), five tumor tissues in mucosal layer (M) and three tumor tissues in submucosal layer (SM) in total 13 lesions. Formalin-fixed, paraffin-embedded tissues were dissected by the laser-captured microdissection technique and were analyzed for targeted 158 gene expressions using a quantitative real-time polymerase chain reaction (PCR) using commercial PCR plate (profile PCR array of genes related to cancer stem cells and epithelial mesenchymal transition). Results: Among genes that elevated in the cancer tissues (M or SM) against the normal tissues, five gene expressions (DKK1, TIMP1, THY1, FN1, COL1A2) were tended to much higher in the submucosal layer compared to the mucosal layer (N < M < SM). When we compared tumor gene expressions in depth of M, three gene expressions (FZD7, ZEB 2, CD 44) are higher in the tumors with submucosal invasion compared to within mucosal layer. Conclusions: Poorly differentiated adenocarcinoma of stomach had high expression level in cancer-related genes even if it was intramucosal tumor. Some of these genes tended to increase as its depth of invasion and the presence of invasion of the SM. It suggested that the biopsy specimen could be a prediction factor of invasion from the surface of gastric cancer, but additional specimens and analysis are necessary to prove these findings.

Conformational characteristics of poly(trimethylene sulfide) (PTMS) have been investigated by a rotational isomeric state analysis of ab initio molecular orbital calculations and 1H and 13C NMR exp...

AIM: To evaluate the dose-limiting toxicities (DLTs) and determine the maximum-tolerated dose (MTD) and recommended dose (RD) of combination chemotherapy with gemcitabine, cisplatin and S-1 which is an oral fluoropyrimidine pro-drug in patients with advanced biliary tract cancer. METHODS: Patients with histologically or cytologically confirmed unresectable or recurrent biliary tract cancer were enrolled. The planned dose levels of gemcitabine (mg/m2), cisplatin (mg/m2), and S-1 (mg/m2 per day) were as follows: level -1, 800/20/60; level 0, 800/25/60; level 1, 1000/25/60; and level 2, 1000/25/80. In each cycle, gemcitabine and cisplatin were administered intravenously on days 1 and 15, and S-1 was administered orally twice daily on days 1 to 7 and days 15 to 21, every 4 wk. RESULTS: Twelve patients were enrolled, and level 0 was chosen as the starting dose. None of the first three patients had DLTs at level 0, and the dose was escalated to level 1. One of six patients had DLTs (grade 4 febrile neutropenia, leucopenia, and neutropenia; grade 3 thrombocytopenia) at level 1. We then proceeded to level 2. None of three patients had DLTs during the first cycle. Although the MTD was not determined, level 2 was designated at the RD for a subsequent phase II study. CONCLUSION: The RD was defined as gemcitabine 1000 mg/m2 (days 1, 15), cisplatin 25 mg/m2 (days 1, 15), and S-1 80 mg/m2 per day (days 1-7, 15-21), every 4 weeks. A phase II study is planned to evaluate the effectiveness of combination chemotherapy with gemcitabine, cisplatin, and S-1 in advanced biliary tract cancer.

Salivary duct carcinoma (SDC) is an uncommon, high-grade tumor. We present 8 cases of sarcomatoid SDC, which has been defined recently as a rare variant of SDC. The 8 patients (5 men, 3 women) had a mean age of 63.6 years. Histologically, all tumors were characterized by a biphasic neoplasm composed of both SDC and sarcomatoid elements. In 3 cases, sarcomatoid components showed osteosarcomatous heterologous differentiation. A residual pleomorphic adenoma was detected in 5 tumors. The sarcomatoid component showed focal immunoreactivity for cytokeratin in 4 cases and epithelial membrane antigen in all 8 cases. Diffuse p53 immunostaining was detected in 3 cases, and it was coexpressed in both components. Our observations support the histogenetic theory of a common origin of the carcinomatous and sarcomatoid populations. Of the 13 patients, including our 8, reported to have sarcomatoid SDC arising in a major salivary gland and for whom long-term follow-up data were available, 7 have died of disease (mean survival, 15.6 months). These results indicate that sarcomatoid SDC is a highly aggressive tumor, similar to conventional SDC.

背景:卵巣の輪状細管を伴う性索腫瘍 (Sex cord tumor with annular tubules (SCTAT)) の1例において免疫染色および捺印細胞診を行ったので報告する.症例:63歳女性. 2経妊, 2経産にて自覚症状はなく, 健康診断の腹部エコー検査で下腹部腫瘤を指摘された. Peutz-Jeghers症候群の徴候はない. 右卵巣摘出手術が施行され, 9×7×6cmの多房性嚢胞がみられ, 一部に充実性肥厚部を認めた. 肥厚部からのスタンプ標本では多数の腫瘍細胞が採取され, 乳頭状ないし腺腔様構造がみられた. 腫瘍細胞は淡明な胞体内に多糖類と考えられるPAS陽性の穎粒を有していた. 腫瘍の一部には腸管上皮に類似する異所性成分が認められ, 胞体内にAlcianblueに染まる粘液を有しCEAとCAI9-9が陽性であった. 他の大部分の上皮成分ではAFPが陽性であった.結論:異所性成分の存在やAFPの陽性所見はSertoli-Leydigcelltumorlこは高頻度に認められるため, 本症例はSertoli-Leydig cell tumorの性格を有するSCTATと考えられた.

A 41-year-old man was admitted because of syncope. The electrocardiogram showed torsade de pointes (Tdp) with no long QT interval and the coupling interval of the initial beat of Tdp was 240 ms. Heterogeneity of ventricular refractoriness was observed together with shortness of the effective refractory period measured at the right ventricular inflow site where the paced QRS morphology was the same as that of the initial beat of Tdp. Verapamil could suppress frequent ventricular premature complexes with a short coupling interval, which lead to Tdp. Polymorphic ventricular tachycardia was induced by triple ventricular extrastimuli. A pure potassium channel blocker was successful in inhibiting polymorphic ventricular tachycardia inducibility by prolongation of refractoriness. These results suggested that triggered ventricular premature complexes may be represent the initiating mechanism, whereas the shortness of local refractory period and heterogeneity of ventricular refractoriness may play a role in the development and the maintenance of the Tdp.

The purpose of this study was to assess the presence and location of impaired myocardial sympathetic innervation by using 123I metaiodobenzylguanidine (123I MIBG) in 15 patients with coronary vasospasm induced by intracoronary acetylcholine. The results were compared with those using thallium-201 (Tl-201). We also examined 14 patients with severe coronary stenosis (>90%) and 8 control subjects without significant coronary stenosis (

Conformational characteristics, solution (melt) properties, and thermal properties of polyselenoethers [-(CH2)ySe-]x ( y=1, 2, and 3) have been revealed by the rotational isomeric state analysis of ab initio molecular orbital calculations and (1)H and (13)C NMR experiments for monomeric model compounds and compared with those of typical polyethers and polysulfides. The comparative results are summarized here as correlations in conformation among model compounds and unperturbed and crystalline states of the polymers, and thermal properties of the polymer crystals are discussed in terms of intramolecular and intermolecular interactions. By ab initio molecular orbital calculations under periodic boundary conditions, helical structures of poly(methylene oxide), poly(methylene sulfide), and poly(methylene selenide), and the crystal structure of poly(ethylene selenide) have been optimized, and their electronic structures have been predicted. A systematic methodology to predict and characterize up to higher-order structures and various physical properties of polymers incorporated in different phases has been attempted to be developed.

Purpose: This study was undertaken to determine whether the findings of dual SPECT with Tc-99m pyrophosphate (PYP) and Tl-201 were predictive of further cardiac events after acute myocardial infarction. Methods: The authors evaluated 88 patients with acute myocardial infarction who underwent dual SPECT for single-vessel coronary artery disease. Results: Twenty-nine patients showed overlapping of Tc-99m PYP and Tl-201 in the same location (overlap-positive group), and 59 patients had no overlap (overlap-negative group). In patients in the overlap-positive group, the incidence of subsequent events was significantly higher than in patients in the overlap-negative group (P < 0.001). In the overlap-positive group, the number of overlap segments in patients with further events was significantly greater than that in patients without further events (P < 0.005). Conclusions: Areas with overlapping of Tc-99m PYP and Tl-201 may contain jeopardized myocardium. These results suggest that patients who have a Tc-99m PYP and Tl-201 overlap-negative scan are a low risk group, whereas patients who have more overlapping segments may require catheterization and revascularization. Thus simultaneous SPECT imaging with Tc-99m PYP and Tl-201 might be useful to identify patients with greater ischemic risk after acute myocardial infarction.

To evaluate whether the findings of dual single-photon emission computed tomography (SPECT) with technetium-99m pyrophosphate (Tc-99m PPi) and thallium-201 were predictive of further cardiac events in their hospital course, we studied 130 patients recovering from acute myocardial infarction (AMI). Fifty-four patients showed overlapping of Tc-99m PPi and thallium-201 in the same location (overlap positive group), and 76 patients had no overlap (overlap negative group). Of the 130 patients, 36 (28%) had a cardiac event. In patients in the overlap positive group, the incidence of subsequent events was significantly higher than in patients in the overlap negative group (44% versus 16%; p < 0.001). In the overlap positive group, the Tc-99m PPi uptake score and the number of overlap segments in patients with further events was significantly higher than those in patients without further events (10.2 ± 5.1 versus 6.4 ± 4.1, p < 0.005 and 5.2 ± 2.0 versus 3.3 ± 1.3, p < 0.001, respectively). These results suggest that patients who have a Tc-99m PPi and thallium-201 overlap negative scan can be candidates for early hospital discharge. In contrast, patients who have a greater number of overlap segments may require early catheterization and revascularization, so that simultaneous SPECT imaging Tc-99m PPi and thallium-201 might be useful for identifying patients with further ischemic risk after AMI in their hospital course.

The purpose of this study was to determine whether thromboxane A2 (TXA2) is involved in the development of ventricular arrhythmias produced by coronary artery occlusion. Ventricular arrhythmias were induced by coronary artery occlusion in 66 male Sprague-Dawley rats. Rats were separated into 4 groups, and saline (n=19) or CV4151 (a TXA2 synthetase inhibitor)(10 mg/kg, n=14; 30 mg/kg, n=15; or 100 mg/kg, n=18) was injected intravenously 5 min before coronary artery occlusion. The antiarrhythmic effect of CV4151 was assessed in terms of the number of ventricular premature complexes (VPCs), the combined duration of ventricular tachycardia (VT) and ventricular fibrillation (Vf) , the incidence of Vf, and the mortality rate within 30 min after occlusion. The total number of VPCs was as follows; control: 1789±330 beats: 10 mg/kg group: 1289±302 beats: 30 mg/kg group: 1008±229 beats: 100 mg/kg group: 986±275 beats, with no significant differences between groups. The incidence of Vf was significantly reduced in the 30 mg/kg and 100 mg/kg groups, as was the combined duration of VT and Vf and the mortality rate. Our results indicate that the TXA2 synthetase inhibitor CV4151 reduces the incidence of lethal arrhythmias induced by coronary artery occlusion in rats. (Jpn Circ J 1996; 60: 349 - 354)

We investigated the antiarrhythmic effects of bidisomide (SC-40230), a new class I antiarrhythmic drug, in early-phase ventricular arrhythmias induced by coronary artery occlusion and reperfusion in anesthetized rats. The effects of bidisomide were compared with those of mexiletine (MXT) and disopyramide (DSP), established class I antiarrhythmic drugs. Drugs were administered intravenously, 5 min before induction of coronary occlusion. Bidisomide (5 mg/kg) reduced the number of premature ventricular complexes and the incidence of ventricular tachycardia and ventricular fibrillation similarly to MXT and DSP in rats with ventricular arrhythmias induced by coronary artery occlusion. In rats with ventricular arrhythmias induced by coronary artery reperfusion following a 5-min coronary occlusion, the antiarrhythmic effects of 5 mg/kg of bidisomide were similar to those of the same doses of MXT and DSP. All three drugs significantly slowed the heart rate. Our results suggest that bidisomide may effectively reduce the severity of life-threatening ventricular arrhythmias that occur during acute coronary syndrome.

Electron spin resonance (ESR) of trivalent gadolinium in reduced barium titanate has been observed at room temperature and 163°C with an X-band spectrometer. According to this temperature rise, the amount of Gd 3+ ions substituting Ti 4+ remarkably increased in BaTiO 3 reduced at 1300°C, while those substituting Ba 2+ decreased. The local symmetry of the crystalline field acting on Gd 3+ at the Ti 4+ site is cubic. Hence the observed spectrum was analyzed using a spin Hamiltonian \begin{aligned} \mathscr{H}{=}g\beta\vec{H}{\cdot}\vec{S}+{b_{4}}^{0}\left[{Y_{4}}^{0}+\frac{\sqrt{70}}{14}({Y_{4}}^{4}+{Y_{4}}^{-4})\right]+{b_{6}}^{0}\left[{Y_{6}}^{0}-\frac{\sqrt{14}}{2}({Y_{6}}^{4}+{Y_{6}}^{-4})\right] \end{aligned} where g , b 4 0 and b 6 0 are 1.992, 26±1 and -4±3 gauss, respectively, at room temperature and 1.992, 25.0±0.5 and -1.9±0.5 gauss at 163°C (above Curie temperature).

A normalization of practical quantities has yielded systematic forms for performance calculations of an idealized couple composed of temperature‐independent parameters. The normalized quantities can be expressed by only three parameters at most instead of six, i.e., normalized current and two types of normalized temperature difference. Effects of contact resistance, current ripple, and heat leak on practical quantities are also considered as functions of the same parameters. Proposed graphs herein of performance quantities and their variations with above effects are given respectively, including no fixed parameters. The temperature difference normalized by its maximum is recommended as ``figure of performance'' as a criterion for an operating couple.

Electron spin resonances of reduced BaTiO 3 were observed in X band at 77°K and 55°K. The paramagnetic centers in the crystals reduced at temperatures between 650°C and 1000°C have three equivalent sites, each of which shows tetragonal symmetry. The g tensor is axial symmetric: g // =1,930 and g ⊥ =1,911. Spin-lattice relaxation time is of the order of 10 -6 s at 55°K. Resonance of impurity Pt 3+ disappears in the crystals reduced at above 650°C. These facts indicate that the center observed is an F-center surrounded by two Ti 4+ and four Ba 2+ ions. Another kind of complex centers appear in the crystals reduced at 1100°C. The origin of these centers, however, has not been analyzed yet. With the crystals reduced at 1300°C, the two kinds of centers mentioned above completely vanish. This is due to purge of electron traps.

An advanced acousto‐optic light deflector has been designed using the acoustic shear wave traveling slightly off the [110] axis in TeO2. The midband mode degeneracy reported by Warner et al., which decreases the diffracted light intensity, has been shifted off from the active frequency region. A linearly polarized wave can be used as the incident light instead of the elliptically polarized wave used in the conventional deflector designed by Warner et al. The deflector yields a larger number of resolvable spots due to the broadened bandwidth. Experimentally, with 6328‐A light, a 3‐dB bandwidth of 50 MHz was observed with a diffraction efficiency of 80% and an electric power of 350 mW. The new deflector has a capacity of 500 resolvable spots with a random access time of 10 μsec.

The high-speed AC elevators with a speed of 105 mpm (350 fpm) were developed by applying thyristors to their control. The acceleration of the elevators is controlled by two-phase primary voltage control of AC motor, while their deceleration is regulated by DC braking through thyristor convertor. The new technology to enable continuous torque control from motoring to braking has been developed by the Push-Pull characteristics of the control for the higher and lower speed motors. Thus, complex DC motor and motor-generator were replaced by simple AC motor and economical control system was realized.

A new melt‐grown crystal of apatite type Pb5(GeO4)(VO4)2 has been found to be well suited for acousto‐optic device applications. Acousto‐optic figure of merit is 50.6 × 10−18 sec3/g and acoustic absorption is about 1.2 dB/cm at 200 MHz.

Three figures of merit defined by Dixon for acoustooptical deflectors are reconsidered using combinations which include scattering efficiency, sound frequency bandwidth, number of resolvable spots and sound attenuation constant. A fourth figure of merit is proposed which is applicable to materials with non-negligible acoustic losses. Liquid materials were evaluated according to the proposed criteria and some were selected as good for use as acoustooptical deflectors. Experiments showed that the scattering efficiency and the fourth figure of merit of n-propyl iodide were 7.7 and 2.5 times those of water.

The electron spin resonance experiment has been performed in reduced ceramic samples of BaTiO3 containing La3+ ions. A characteristic F-center signal was observed for the Ba/Ti ration of 1.02. This observation of F-center signal indicates strongly that some of doped La3+ ions substitute Ti4+ ions and act as acceptors. The effect of some monovalent and trivalent ions on the substituting sites of Gd3+ ions has been also investigated. It was found that for a low concentration of monovalent ions they formed “pairs” with Gd3+ ions at Ba2+ sites.