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The growth of pulmonary arteries following systemic-pulmonary arterial shunt procedures in infants with cyanotic heart disease is a determining factor to the prognoses of those patients. We assessed the validity of two-dimensional echocardiography (2DE) in evaluating pulmonary arterial growth following shunt procedures. Blood flow through the shunts was measured at the times of surgery, and the correlations between shunt flows and postoperative clinical courses were studied. 2DE was validated by its assessments of the right pulmonary artery (RPA) with an excellent correlation between the RPA diameter on 2DE and that on angiography (r = 0.97) and/or the actual RPA diameter measured at the times of surgery (r = 0.96) in 20 patients. Ten patients with tetralogy of Fallot and pulmonary atresia were studied by 2DE pre- and postoperatively. The RPA diameters of six patients with effective shunts increased from 5.7 +/- 1.7 mm to 8.5 +/- 1.5 mm during six months after the shunts and their left ventricular end-diastolic dimensions also increased significantly. But the RPA diameters in four patients with ineffective shunts did not show significant increases after the shunts. The shunt flows were correlated with the diameters of the anastomoses. The shunts which were obstructed within two years showed shunt flows of 83 +/- 26 ml/min, while the shunts which were patent for more than two years showed shunt flows of 320 +/- 126 ml/min. Serial measurements of RPA diameters by 2DE serve as a useful method of following patients after systemic-pulmonary shunts. The amounts of shunt flows were correlated with post-operative clinical courses over two year periods.

The purpose of this study is to clarify the most suitable position and method to investigate bone formation in the mid-palatal suture after rapid palatal expansion in the rat. 10 of 8 week-old Wistar rats were employed to observe the structure of the normal mid-palatal suture at the line connecting the incisors, the anterior end of the anterior palatine foramen, the line bisecting the anterior palatine foramina, and the line of the 1st molars. A mid-palatal suture of 8 week-old Wistar rats was expanded laterally for 6 days by means of maxillary incisor expansion apparatus with a spring of 60 g load. After beheading, soft X-ray picture of the skull was taken to observe the suture. The maxilla was removed and decalcified sections (frontal section) were prepared. They were stained with hematoxylin and eosin for microscopy. The mid-palatal suture was observed at 4 levels to the lines drawn as follows; the line running through the centers of incisors (A), the line running the anterior ends of the anterior palatine foramen (B), the line running through the center of the anterior palatine foramen (C), and the line running through the centers of the 1st molars (D). At the opposing margins of A and B, the suture was composed of two layers; the layer of osteoblasts and the layer of interconnecting Sharpey's fibers. At C, the suture was curved and the layer of Sharpey's fibers were made up with longitudinal as well as transverse fibers.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood flow was measured with a mercury-in-rubber strain-gauge plethysmograph in the utilized and intact extremity during and 24 hours after uncomplicated (with no clinical signs of vascular insufficiency) percutaneous right and left cardiac catheterization in 20 children. In this group, there was a significant decrease of the flow in the utilized extremity after entry into the artery, with the flow returning to normal within 24 hours after the procedure. Flow was markedly reduced in the utilized extremity of a child who developed thrombosis of the femoral artery after catheterization. Seven additional children were studied one to four years after retrograde catheterization. In this group the flows in utilized and intact extremities were equal at rest and with reactive hyperemia. It is concluded that uncomplicated transfemoral percutaneous cardiac catheterization in children does not impair the blood flow in the limbs.

Male Sprague-Dawley rats were injected intraperitoneally (i.p.) with butylated hydroxyanisole (BHA) at doses of 0, 1, 4, 16, 64, 256, 384, 576, 864, 1296 and 1944 mg/kg/day for 7 days. Deaths occurred in a dose- and time-dependent manner when BHA was given in amounts greater than 576 mg/kg. The LD50 was 881 (484-1440) mg/kg. Intracranial hemorrhage was found in the dead rats, and lung hemorrhage was observed in the survivors given BHA at doses greater than 384 mg/kg/day. Histopathologically, intra-alveolar hemorrhages, thickening of alveoli and deposition of lipids in the lungs were observed. The prothrombin index was decreased only in rats given BHA at a level of 384 mg/kg/day. These observations suggest that BHA and/or its metabolite cause pulmonary hemorrhagic damage in rats. The mechanism of hemorrhage may be different from that of bleeding induced by butylated hydroxytoluene.

Thirty-two patients with inoperable hepatic cancer underwent intra-arterial hepatic infusion using mitomycin C (MMC) and 5-fluorouracil (5-FU) or intra-arterial hepatic chemoembolization using heated albumin microspheres containing MMC with an average diameter 45 +/- 8 micron. Nineteen of the 32 patients received the MMC microsphere treatment and another 13 received the conventional infusion treatment, lasting for 3.4 months. The administered doses of MMC microspheres were 11.7 +/- 11.1 mg as MMC in the 12 with metastatic cancer and 6.9 +/- 2.1 mg as MMC in the 7 with hepatocellular cancer (HCC). On the contrary, the 13 patients who underwent conventional infusion had average doses of MMC 34.5 +/- 17.3 mg and of 5-FU 13.4 +/- 7.7 g, over 3.4 months. An objective tumor response was obtained in 13/19 (68.4%) under MMC microsphere chemoembolization, compared to 6/13 (46.2%) under the conventional infusion. The average level of CEA in the 12 with metastatic cancer, who underwent MMC microsphere therapy, dropped from 57.7 ng/ml to 16.5 ng/ml, while that in the 10 patients on conventional infusion dropped from 24.0 ng/ml to 17.4 ng/ml; that of alpha-fetoprotein dropped in all 7 with HCC on MMC microsphere chemoembolization, compared to a fall in 1/3 on conventional infusion. With the MMC microsphere treatment, 5 patients from colorectal cancer lived for 15.6 +/- 7.6 months, 2 are alive with a long life expectancy; and 7 patients from gastric or pancreatic cancer lived for only 9.3 +/- 3.3 months. In case of conventional infusion, 6 patients from colorectal cancer survived for 8.6 +/- 3.2 months; and 4 patients from gastric or gallbladder cancer survived for 6.0 +/- 1.0 months. The MMC microsphere treatment is superior at P = 0.059 in survival duration to the conventional infusion treatment. However, much the same survival occurred in 7 on MMC microsphere chemoembolization and 3 on continuous infusion.

Antitumor therapy using the polyamine antimetabolites, alpha-difluoromethylornithine (DFMO) and methylglyoxal-bis-guanylhydrazone (MGBG), combined with ACNU was studied in human gastric cancer xenotransplanted into nude mice. DFMO 1,000 mg/kg (in two divided doses) and MGBG 50 mg/kg were given i.p. for 6 successive days from the time when the xenotransplanted tumor weighed about 100 mg, and ACNU 20 mg/kg was given i.p. every other day from the same time. Antitumor efficacy was assessed by the time course of tumor weight as well as of DNA biosynthesis and polyamine levels in tumor tissue. Tumor weight was estimated using Battelle's Columbus Institute protocol and DNA biosynthesis was assayed biochemically by 3H-TdR injection at a prescribed interval after termination of therapy. Furthermore, tumoral polyamine levels were assayed by HPLC. This three-drug regimen showed a favorable antitumor effect, compared to those of the other two therapies with DFMO plus MGBG as well as ACNU only. These data suggest that this combined regimen may have a synergistic efficacy judging from the action mechanisms of these three drugs.

The concentration of phenols in the urine or feces of rats receiving a diet containing 1.00% butylated hydroxytoluene (BHT) for 10 days was determined colorimetrically. The cumulative intake of BHT was approx. 5.0 mmol/rat for 10 days. The total amount of phenols excreted in urine and feces was 3.65 mmol/rat for 10 days, i.e. 73% of the administered BHT. About 48% was excreted in the urine, and 25% in the feces; about 30%, or 11%, of the dose appeared to be present as unconjugated phenols in the urine, or feces, respectively. The major metabolite detected was 3,5-di-tert-butyl-4-hydroxybenzoic acid (BHT acid).

The hormonal and clinical efficacy of (D-Leu6)-des Gly-NH2(10)-LH.RH ethylamide (Leuprolide, TAP 144) was investigated with 12 prostatic cancer patients. The hormonal studies were performed in 8 patients who were not previously treated by any hormonal therapies including estrogen, castration and others. Serum level of LH and FSH was apparently decreased at the end of 2 weeks after the starting of leuprolide (1 mg/day) subcutaneous injection. At the same time, testosterone level was decreased to the castration level. Clinical efficacy of 1 mg/day of leuprolide was evaluated in 7 patients who were not previously treated. Three of the 4 patients with stage B2 cancer showed a partial response and 1 patient a stable response; and 1 of the 3 patients with stage D2 cancer showed a partial response and patients stable a response. No significant side effects were observed in these 12 patients. These results show that 1 mg/day of leuprolide has the same degree of potency in decreasing the serum testosterone as 20 mg/day.

Thallium-201 myocardial imaging was performed in 21 patients with transposition of the great arteries (TGA). Thirteen patients were studied before operation, eight patients after Mustard operation and five patients after Rastelli operation. Five patients were studied sequentially before and after the surgery. Each image was compared with hemodynamic and angiographic findings in order to assess the usefulness of this method. In the 13 patients with preoperative TGA, it was possible to differentiate TGA with the intact ventricular septum from TGA with associated anomalies such as patent ductus arteriosus or ventricular septal defect, and also TGA with pulmonary hypertension or pulmonary stenosis from TGA without them by evaluating the degree of thallium uptake in the free wall of the pulmonary ventricle (anatomical left ventricle). The degree of thallium uptake was well correlated with systolic pressure of the pulmonary ventricle (r = 0.98). In the 13 patients with postoperative TGA, it was less correlated with the pulmonary ventricular systolic pressure (r = 0.83). Four cases sequentially studied showed a marked decrease in thallium uptake in the pulmonary ventricle 10 to 16 months after Rastelli operation. But the corrected thallium uptake (thallium activity/ventricular systolic pressure) was more increased compared with the uptake of the systemic ventricle after the surgery. This was probably related to a decrease of the pressure load to the pulmonary ventricle following the surgery and to the fact that there should be some delay of a decrease of the ventricular mass. An increased lung uptake of thallium was noted in the cases of tricuspid regurgitation after Mustard operation, but the degree of regurgitation was not clearly correlated with the increase of thallium uptake in the lung. In five cases after Rastelli operation, one patient showed a high degree of thallium uptake of the pulmonary ventricle (anatomical right ventricle), and the conduit valve calcification and severe pulmonary stenosis were confirmed by cardiac catheterization and angiography. Thus myocardial imaging provides a reliable mean for the qualitative and quantitative assessment of TGA before and after operation.

An attempt was made to analyse tumor growth after cessation of combined therapy with the polyamine biosynthesis inhibitors, alpha-difluoromethylornithine (DFMO) and methylglyoxal-bis-guanylhydrazone (MGBG), as well as mitomycin C (MMC). DFMO 1000 mg/kg, MGBG 50 mg/kg and/or MMC 2 mg/kg were given intraperitoneally to BALB/c nu/nu mice xenotransplanted human gastric cancer, and its growth as well as DNA biosynthesis were measured daily, after cessation of these combined treatments. Histological observation of the tumor was also performed by hematoxylin-eosin staining. The combination with DFMO and MGBG stunted tumor growth during the treatment, but 3 days later its growth and DNA biosynthesis were accelerated distinctly. MMC injection halted tumor growth, and 5 days after termination of MMC injection its growth rate and DNA biosynthesis almost completely recovered. The microscopic findings on the 4th day after termination of MMC injection were similar to those of DFMO + MGBG treatment. The combination DFMO, MGBG and MMC suppressed not only tumor growth during the treatment, but also tumor growth and DNA biosynthesis over 7 days. The histologic observation 4 days later revealed extensive damage.

Axons exhibiting both enkephalin- and serotonin-like immunoreactivities were observed by the double immunofluorescence method in the lumbar cord segments of the cat. Double-labeled axons were seen most frequently in laminae I, IIa and the lateral part of lamina V. They were also distributed in other parts of the dorsal horn and lamina X (especially in the dorsal part), but rarely found in laminae VII, VIII and IX. After cervical hemicordotomy the vast majority of double-labeled axons disappeared from the spinal gray ipsilateral to the lesion.

Central distribution of efferent and afferent components of the pudendal nerve was studied by the horseradish peroxidase (HRP) method in 13 macaque monkeys, i.e., in nine Japanese monkeys (Macaca fuscata), two rhesus monkeys (Macaca mulatta), and two crab-eating monkeys (Macaca fascicularis). The enzyme was applied to the central cut end of the pudendal nerve; then the monkeys were allowed to survive for 36 to 72 hr. Retrogradely labeled neuronal cell bodies of pudendal motoneurons constituted a slender longitudinal cell column in the ventral horn. The cell column extended from high or middle S1 to high or middle S2 in eight monkeys, from middle or low L7 to high S2 in four monkeys, and from high L7 to middle S1 in a monkey. The cell column appeared to correspond to Onuf's X nucleus in man. No sex difference was recognized in the position of the cell column. The average number of HRP-labeled pudendal motoneurons was larger in male than in female adult Japanese monkeys, whereas no sex difference was found in the average soma diameter of the pudendal motoneurons. Transganglionically labeled axons entered into the spinal cord through the S1 and S2 dorsal roots in 12 monkeys and through the L7 and S1 dorsal roots in one monkey. Labeled axons were distributed ipsilaterally in laminae I-VI and X of the spinal cord at the same and adjacent levels of entry of HRP-labeled dorsal root fibers (from L7 to S3 in 12 monkeys and from L6 to S3 in one monkey).(ABSTRACT TRUNCATED AT 250 WORDS)

A combined effect of the polyamine biosynthesis inhibitors, alpha-difluoromethylornithine (DFMO) and methyglyoxal-bis-guanylhydrazone (MGBG) with mitomycin C (MMC) was studied. DFMO, MGBG and MMC were given intraperitoneally to nude mice xenotransplanted human gastric cancer. This new combination of the three drugs resulted in the complete halt of the xenotransplanted tumor growth and marked decline of spermine levels in the tumor tissues. The other treatments with DFMO and MGBG as well as MMC alone were inferior to this new combined therapy in suppression in both tumor growth and tissue spermine level. These data suggest that this new combined treatment be effective against human gastric cancer.

External conduit repair was performed in 20 patients with "valved pericardial roll (VPR)" made of own pericardium (one case) or porcine pericardium (19 cases). Intraoperative measurement of peak pressure gradients across the valve ranged from 0 to 8 mmHg (mean 1), and that from the pulmonary ventricle to the pulmonary artery ranged from 0 to 38 mmHg (mean 20). Re-evaluation of 7 patients one year after surgery shows no increase in the pressure gradient except the first case, in which VPR was made of own pericardium. In pulsed Doppler echocardiographic study, no regurgitation was found in 4 patients, mild in 6, moderate in 4, severe in 1. VPR is functioning well with longest follow up at 16 months.