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We evaluated the reliability and efficacy of the ultrasonically activated scalpel (Harmonic Scalpel) for pulmonary resection in video-assisted thoracoscopic surgery (VATS). Fifty-six cases of primary or metastatic lung cancer with history of lobectomy or segmentectomy from July 2003 to June 2006 were investigated. The ultrasonically activated scalpel was used to separate aborted lobulation and segment in the surgery. The outcome of the operation using the ultrasonically activated scalpel revealed the mean operation time of 224.5 minutes and mean blood loss volume of 116.7 ml. The chest drainage catheter was removed at the postoperative day 3.4 and hospitalization lasted 10.4 days on average. By means of statistical analysis, no significant differences were noted when compared with the cases using surgical stapler to separate the lobules or segments of the lungs. Histopathological results showed destruction of alveolar structures and denaturation of cells at the cut surface of the resected lung through the use of the ultrasonically activated scalpel. This method resulted in good lung expansion and preservation of the residual lung volume. Furthermore, it prevented postoperative air leakage by appropriate treatment to the cut surfaces of the residual lung. Indeed, the method appears to be useful in the separation of lung tissues in severe aborted lobulation and segmentectomy by VATS.

This paper introduces an approach for implementing product assessment in a generic mechanical parts manufacture. In Tochigiya Co. Ltd checklist items for product assessment are selected according to the properties of the products and end-of-life treatment that the assembling manufactures intend. Also, products assessment is integrated into design review with the verification of compliance with the restriction of the use of hazardous chemical substances

In this study the effects of maintenance on product life cycle management are examined. Product life cycle management systems are modeled with objects, actors and processes. Actors make decisions based on product conditions and other constraints, and activate the associated processes. Maintenance management systems are described in the same way and the behavior of a whole system is simulated stochastically. From the simulation result, effects of maintenance on lifecycle management are examined.

Prodromal angina occurring shortly before the onset of acute myocardial infarction (MI) has a cardioprotective effect in patients with acute MI by the mechanism of ischaemic preconditioning.1,2 However, it has been reported that several conditions, including aging and diabetes mellitus, may abolish the beneficial effect of prodromal angina.3,4 Recent experimental studies have reported that the cardioprotective mechanism of preconditioning is impaired by post-MI left ventricular (LV) remodelling.5 Patients with prior MI have an increased risk of developing acute MI. Once acute MI has occurred, the prognosis is worse than that for patients without prior MI. This study was undertaken to investigate the influence of prior MI on the effect of prodromal angina in patients with acute MI. This study enrolled 1076 patients with acute MI who underwent coronary angiography within 24 hours after the onset of chest pain. Acute MI was diagnosed by chest pain persisting longer than 30 minutes and concomitant ECG changes. Serum creatine kinase was measured every three hours. Peak creatine kinase concentration had to be more than twice the normal upper limit. Immediately after coronary angiography, reperfusion therapy was performed, if appropriate. Most (84%) of the patients underwent primary coronary angioplasty with (n = 584) or without coronary stents (n = 315). Contrast left ventriculography was performed before reperfusion therapy (n = 635) and at predischarge catheterisation (n = 656). Prodromal …

Recent reports have shown that aortic valve replacement in elderly patients over 65 years with atherosclerotic aortic stenosis and a small aortic annulus is possible by using a small sized bioprosthesis (Carpentier-Edwards pericardial valve). Here we present out surgical technique. Firstly, the native calcified aortic valve was removed completely to gain total exposure of the surrounding aortic root and sinus of Valsalva like Bentall procedure. Secondly, a small sized bioprosthesis was implanted with intermittent noneverting mattress 2-0 sutures with spaghetti and small polytetrafluoroethylene (PTFE) felt. Aortic annulus is the dilated by inserting Hegar dilator sizing from 25 to 27 mm. Therefore, aortic valve replacement for small aortic annulus in intra- or supra-annular position should be easily accomplished. Good surgical results and hemodynamic state were achieved in 25 consecutive cases using this technique.

This paper presents an object-aware video surveillance system that is not only smart and friendly for users, but allows for transmission of the scene over limited bandwidth networks. The proposed system stores high-quality video data and associated object metadata, which includes ROI (region-of-interest) information. To satisfy bandwidth constraints and display important parts of the images fast and precisely, the stored images are efficiently transcoded in the compressed-domain based on the ROI information. At the receiver, effective display methods such as a mosaic style allow for an intuitive understanding of the important objects in the scene, as well as their movement over time

We investigate a new type of element to realize a body protection orthosis with human compatibility. The element is a flexible actuator (silicon outer fence of mold actuator) and its structure is a soft mechanism that a sponge rubber is covered with silicon rubber. In order to develop the orthosis, basic characteristics of the element are cleared through some experiments. At first, we explain about the elements to realize a body protection with human compatibility. Next, the rebound characteristics of the element are investigated. Furthermore, we clarify the characteristics of the impact force with respect to each sponge material. Finally, the impact force characteristics with respect to pressure in the sponge chamber are cleared from some experimental results.

We have investigated the laminar and the turbulent flow in superfluid 4He using a vibrating wire made from a thin NbTi wire (φ 2.5 μm). We measured vibrating velocity of the wire as a function of driving force at 1.4 K and found that the laminar and the turbulent flow around the wire are clearly separated at a critical velocity. This phenomenon suggests that expansion of vortices attached on the wire causes the turbulence and those sizes are limited to an order of microns even in the turbulent flow. This limitation is considered due to tangle and reconnection of the vortices by oscillating flow. The critical velocity varies with frequency of the oscillating flow and the vortices seem to be confined closely at high frequencies. We also found a stable state of the vortices thickly attached on the wire by controlling cool down through the superfluid transition. © 2005 Elsevier Ltd. All rights reserved.

It is desirable that battery driven vehicles are charged in automatically with contactless and high-efficiency. The magnetic coupling that is one of the contactless charges is suitable. However, a precise positioning system of a power supply unit is required in this method. This paper proposes a relative position detection method between the power supply unit and the autonomous vehicle. Especially the position detection is obtained by utilizing the voltage induced for the battery charge. To use the induced voltage as a position detection signal, the relation between the position of cores and the induced voltage is theoretically obtained. Moreover, to confirm theoretical results, the induced voltage is measured with experiments. From experimental results, it was confirmed that the induced voltage is able to use as a feedback signal for the position control.

We report a case of a 40-year-old male with a posterior mediastinal mass that was 8 cm in size and located behind the trachea. The thoracoscopic surgery was performed. The tumor was located from the level of left brachiocephalic vein to the carina. The mediastinal pleura over the tumor was longitudinally opened by cautery-scissors. The azygos vein lying over the tumor was divided by means of an endoscopic stapler. The muscular layer of the esophagus was also longitudinally opened. The tumor was enucleated. Then, the dissected proper muscle layer of the esophagus was suture-closed. The postoperative course was uneventful. On the first postoperative day Gastrografin was swallowed, showing the absence of leaks. The patient was discharged on the fourth postoperative day. The advantages of the thoracoscopic surgery are as follows: rapid, full recovery of the patient; decreased postoperative pain; short postoperative hospital stay. Esophageal leiomyoma in selected patient was suitable for thoracoscopic enucleation.

A new target for RF reactive sputter deposition technique was adopted to deposit lead zirconate titanate (Pb(Zr,Ti)O/sub 3/) thin films using a metal-oxide composite (ZrTi+30%PbO/sub n/ (n=l,2)) targets. PZT films were deposited on Pt/Ti/SiO/sub 2//Si substrate with temperature varied from 200 to 550/spl deg/C, O/sub 2/-Ar mixture gas was used for the sputtering with changing the mixing ratio from 0% to 6.3%. In this study it is confirmed that PbO/sub 2/ supplied more oxygen than PbO by the gas analyzer. Moreover perovskite PZT peak was observed in XRD measurement for film grown with PbO/sub 2/ target without introducing any oxygen gas during the deposition, whereas no peak was observed for PbO target under the same conditions.

This paper presents a detailed complexity-quality analysis of various MPEG-2 to MPEG-4 transcoding architectures that perform spatial resolution reduction. The optimization of several processing components is also presented.

This paper proposes a method to recognize human gestures from an image sequence based on hidden Markov model and subspace method. As our method uses the motion vector field of the scene for recognition, it is robust for variety in the background of the scene and it doesn't require the users to wear a sensor or a marker. The motion vector field of the scene is projected to an eigensubspace and is used as the input symbols for the HMM.

An in-hospital 72-year-old male with complaint of anterior chest pain was presented with shock. Pericardial effusion was confirmed by echocardiography, and therefore, he was brought to the operating room immediately with diagnosis of ventricular free wall rupture. The repair was performed using fibrin glue, fibrin sheet, and pericardial patch. His post-operative course was uneventful until massive bleeding came through the chest tube on the 5th day from the initial surgery. The emergency sternotomy was made again for hemostasis. In the re-operation, an approximately 20 mm laceration along the proximal circumflex artery was found and this was successfully repaired with 2 pledgetted horizontal mattress sutures. It is important and necessary to treat a postoperative patient taking care of re-rupture.

The appearance of local cerebral dysfunction at remote regions from the focus in the acute stage of stroke (diaschisis) is well known, but its mechanism has not been established. We have analysed serial MR images of the infarcted brain of rats to evaluate the distribution of oedema. Forty-seven Sprague-Dawley rats were anaesthetized with halothane, and the right middle cerebral artery (MCA) was permanently occluded via the intraluminal approach using a nylon 2-0 suture. At 3, 6, 9 and 24 hours after the occlusion, coronal T(2)-weighted MR images were taken and the signal intensity (SI) was computed at each region of the brain. After occlusion of the right MCA, SI increased diachronically up to 24 hours on the occluded side of the cortex (52.9+/-3.2 to 104.8+/-22.4) and striatum, which are within the perfusion territory of the MCA. SI increment was also observed at the hippocampus, alveus hippocampi and pyriform lobe, which are not within the territory of the MCA, and at some regions of the contralateral side (52.5+/-4.8 to 69.4+/-14.8 at the cortex). These changes were prominent in ischaemia-vulnerable portions, mild in the cortex, and minimal in the striatum. This contralateral side SI increment indicates remote oedema, which corresponds to diaschisis. We suggest that the mechanism of this remote contralateral oedema is the movement of extravasated protein from the lesion.

To compare the use of two-dimensional, color Doppler and three-dimensional ultrasound for predicting the presence of a nuchal cord at birth.Eighty-five singleton pregnancies without nuchal cord and 35 with nuchal cord (30 with a single coil of cord, four with a double coil, and one in which the cord was coiled around the neck three times) were studied within 1 week before delivery using transabdominal three-dimensional sonography. Two-dimensional and color Doppler ultrasound were also conducted for comparison.Two-dimensional, color Doppler and three-dimensional sonography identified in utero 24 (69%), 29 (83%) and 25 (71%), respectively, of the cases of nuchal cord found at birth. There were no significant differences in overall diagnostic indices of each diagnostic modality for detecting nuchal cord. However, the ability to view the nuchal cord (subjective assessment of the ease of visualization of nuchal cord) was better with three-dimensional sonography than with two-dimensional or color Doppler ultrasound.Three-dimensional surface imaging does not provide more useful diagnostic information compared with two-dimensional and color Doppler ultrasound for detecting nuchal cord in utero.

2 , but we could not determine which becomes the standard regimen. We will confirm the safety of weekly nab-paclitaxel dosed at 100 mg/m 2 in Japanese women with HER2 negative metastatic breast cancer and subsidiarily evaluate the effectiveness of this regimen. Methods: Patients with metastatic breast cancer were pathologically confirmed adenocarcinoma of the breast. Less than 3 regimens for metastatic breast cancer were eligible for inclusion. Patients received nab-paclitaxel dosed at 100 mg/m 2 with 3.3 mg of dexamethasone as premedication on day 1, 8 and 15 of 28 day cycle. The primary endpoint was safety, which was defined as the percentage of patients who achieved 2 cycle of this regimen. Secondary endpoint was efficacy. Results: Thirty-nine patients were enrolled in this trial from plural facilities in Hokkaido, Japan. The mean age of patients was 60 years old (range : 43-77). Seventy-four % of patients have ER positive breast cancer and 41 % of patients have taken adjuvant chemotherapy. We defined the ratio of achieving two cycle of this regimen as the safety. Eighty-seven % of the patients were treated not less than two cycle of this regimen safely. The mean of relative dose intensity was 91.6 %. The most frequent adverse event was neutropenia. Grade 3 or 4 neutropenia was occurred in 44.7 % of the patients. There was no grade 3 or 4 neuropathy. Conclusions: Weekly nab-paclitaxel dosed at 100 mg/m 2 proved to be a safety regimen in this trial. The choice of this regimen is appropriate not only for first-line therapy of metastatic breast cancer but also for heavily pretreated metastatic breast cancer. Disclosure: All authors have declared no conflicts of interest.

Angioplasty for the unprotected left main trunk remains controversial, but new procedures and devices such as directional coronary atherectomy and stenting have improved the results. We compared the results of angioplasty with the inflexible balloon and new devices.The procedures were performed in 239 consecutive lesions in 160 patients between April 1986 and March 2000. This study excluded emergency cases and repeat angioplasty cases, and included 120 initial and elective cases. Initial and long-term results were compared between the balloon group (n = 29) and the new device group (n = 91).Lesion success rate was lower in the balloon group (90% vs 100%, p0.05), but there were no significant differences in in-hospital results including cardiac death (0% vs 0%), noncardiac death (0% vs 3.3%), Q-wave myocardial infarction (0% vs 2.2%), non-Q wave myocardial infarction (3.4% vs 6.6%), bypass surgery (0% vs 0%) and repeat angioplasty (6.9% vs 1.1%). Quantitative angiography showed significant improvements in minimal lumen diameter (mean 2.17 vs 3.16 mm, p0.001) and percentage diameter stenosis (mean 31% vs 13%, p0.001) in the new device group after the procedures. The minimum lumen diameter remained larger at 3 (p0.001) and 6 months (p0.05) in the new device group. Therefore, angiographic restenosis rate was higher in the balloon group (55% vs 21%, p0.005). Five-year survival rate showed no significant difference between the groups (75.0% vs 83.8%).New devices significantly improved the minimal lumen diameter after angioplasty for unprotected left main trunk disease, and lead to significant improvement of restenosis rate at follow-up.

Patients with depressive disorder are often guilty of their dysfunction and desperate of their future. In acute stage, it is most important to give patients the insight into their illness and to give them such reassurance that they will recover with treatment. Clinicians should advise the patients to take a rest. To encourage and motivate the patients to do work or other activities is often harmful. In the recovery stage, it is useful for the patients to reflect on their premorbid personality and behavioral traits that facilitate the development of depressive disorder, which may lead to their changing way of life and prevent recurrence of the illness.

The objective of this investigation is to develop a rational design of Osteotropic Drug Delivery System (ODDS), which we have proposed as a novel method for drug delivery to the skeleton via bisphosphonic prodrug, based on the relationship between physicochemical and pharmacokinetic properties of bisphosphonates.The theoretical octanol/water partition coefficients (clog P) of 13 bisphosphonates were calculated by computer software, CLOGP ver. 3.05 (Daylight C.I.S., Inc. Irvine, CA) and related to pharmacokinetic or osteotropic parameters after intravenous injection into rats. On the other hand, to optimize ODDS of diclofenac (DIC-BP), the effects of doses or infusion rates on the in vivo disposition were investigated in relation to solubility product value (Ksp) of DIC-BP-calcium complex.Clog P had good correlations with total plasma clearance, apparent distribution volume and the fraction dose delivered to the whole skeleton after bolus injection into rats (r = -0.868 approximately -0.914). The targetability of bisphosphonates to the skeleton was linearly decreased with an increase in clog P value and the more hydrophilic bisphosphonates were suitable for ODDS in bolus administration. On the other hand, DIC-BP, a relatively lipophilic bisphosphonate, was effectively and selectively delivered to the skeleton only when administered as a slow infusion to keep plasma concentration lower than that calculated from Ksp value where DIC-BP could precipitate with calcium in the plasma circulation.Our results suggest the possibility of a rational design of ODDS via bisphosphonic prodrugs, after consideration of compound lipophilicity and precipitability of bisphosphonate-calcium complex.

A giant multiseptate cystic mass covering the whole left hemitruncus of fetus was detected by ultrasonography at 23 weeks of gestation. Color and pulsed Doppler ultrasonography revealed marked blood flow in the mass. No other anomaly or chromosomal abnormality was recognized. Although the cystic lesion increased in size with advancing gestation a male infant weighing 4096 g was delivered in good condition at term. Histological examination of the lesion demonstrated hemangiolymphangioma with hyperplasia of both capillaries and lymphoducts. The infant was treated effectively with OK-432 and interferon-alfa-2a.

A case of Pierre-Robin syndrome with polyhydramnios is described. Three-dimensional sonography clearly showed fetal micrognathia and hypoplastic ear antenatally. The benefits and advantages of the use of three-dimensional sonography to diagnose Pierre-Robin syndrome in utero are discussed.

Suppose that, in a sports event, a user searches for and obtains video scenes that have "better" views of interesting objects from multiple-perspective video (a collection of mutually synchronized video data taken by a lot of cameras). Because members of the general public take videos and query them in such applications, one of the most important research issues is how to provide a mechanism by means of which a user can formulate appropriate queries easily while looking for and focusing on interesting objects. Another issue is how to search for video scenes that have "better" views of the objects. In this paper, we introduce a querying method based on the concept of "querying by camera", and we propose an algorithm that searches for video intervals that have spatio-temporally "better" views of the focused-on object.

A 57-year-old woman underwent distal pancreatectomy for malignant islet cell tumor of the pancreas in 1991. One year later, multiple liver metastases appeared. Although three transcatheter arterial embolizations (TAE) with spongel and nine ethanol injections were performed over seven years, the tumors were growing gradually. Therefore, TAE with degradable starch microspheres (DSM) was selected. Under angiography, TAE of the left hepatic artery was done using 900 mg of DSM following injection of Farumorubicin (20 mg), Lipiodol (3 ml) and cisplatin (90 mg). The tumors in the embolized hepatic area were remarkably decreased in size, and satisfactory local control was obtained. Thereafter, TAE with DSM was carried out twice, and she is still living with outpatient treatment. Thus, it is suggested that TAE with DSM could be a promising, alternative therapeutic modality for liver metastases from malignant islet cell tumor of the pancreas.

We evaluated the significance of hepatectomy following hepatic arterial infusion (HAI) chemotherapy for colorectal liver metastases. The prognosis of 4 cases with initially resectable tumors was discouraging, indicating no benefit of preoperative HAI for resectable tumors. The 2- and 3-year survival of patients who underwent hepatectomy after downstaging by HAI of originally unresectable metastases were 100% and 67%, respectively, suggesting that hepatectomy combined with HAI is a promising modality for those patients. However, it seems that the control of extrahepatic disease and decision making for the timing for surgical therapy are issues requiring improvement.

The short-term and long-term predictors of outcome after coronary angioplasty in the unprotected left main coronary artery were investigated.The procedure was performed in 122 consecutive patients for de novo lesions without myocardial infarction in our hospital between April 1986 and October 1998, including 16 emergency cases. Procedures were directional coronary atherectomy (73 patients), balloon angioplasty (31 patients), and stent implantation (18 patients). There were 101 males and mean age was 68 +/- 10 years. Follow-up angiography was performed in 98% of discharged patients, and all patients were clinically followed up for more than 1 year. Clinical and angiographic predictors of in-hospital and long-term outcome were evaluated.The in-hospital mortality was 5.7% (7 of 122 patients). Multivariate analysis revealed that more patients were admitted as emergency cases (57% vs 10%, p = 0.0088), with left ventricular ejection fractionor = 35% (57% vs 22%, p = 0.029) and renal failure (43% vs 3%, p = 0.0004) finally died. Mean follow-up period was 3.5 years. Estimated survival rate was 77.1%, and cardiac-death free survival rate was 81.0% at 5 years by the Kaplan-Meier method. Univariate analysis showed that the predictors of cardiac death were emergency angioplasty, renal failure, decreased left ventricular ejection fraction, multivessel disease and unstable angina and/or congestive heart failure. Cox's regression model showed that renal failure (p = 0.0004) and multivessel disease (p = 0.0075) were significant predictors of long-term prognosis.Renal failure was the strongest predictor of outcome after unprotected left main coronary artery angioplasty.

The purpose of this study was to evaluate the circulating group II phospholipase A(2) (PLA(2)-II) levels during normal menstrual cycle and to assess alterations in maternal circulating PLA(2)-II concentrations during pregnancy and at puerperium. Circulating serum PLA(2)-II concentrations were compared between 38 nonpregnant women with normal menstrual cycle (15 at menstrual phase, 11 at follicular phase, and 12 at luteal phase), 61 normal pregnant women (13 in the first trimester, 12 in the second trimester, and 36 in the third trimester), and 14 normal postpartum women at 5th puerperal day. Serum PLA(2)-II concentrations were also measured in 11 patients with threatened premature labor. Maternal and fetal serum PLA(2)-II levels before and after delivery were made to determine differences in 11 neonates delivered vaginally and 11 neonates delivered by elective cesarean section. Serum PLA(2)-II level was measured with an immunoradiometric assay. Serum PLA(2)-II concentrations at luteal phase were significantly lower than those at menstrual or follicular phase (p0.05). There was no significant difference for PLA(2)-II levels between first trimester and menstrual phase or follicular phase. There were no significant differences among three trimesters during pregnancy. There was no significant difference in serum PLA(2)-II levels between normal pregnant women and patients with threatened premature labor. Labor stress did not affect both maternal and fetal serum PLA(2)-II concentrations. There was also no significant difference for circulating PLA(2)-II levels between maternal and fetal serum. Interestingly, serum PLA(2)-II concentrations in postpartum women were significantly higher than those in normal pregnant women (p0.05). These results suggest that a regulatory mechanism of PLA(2)-II may exist during the normal menstrual cycle and at puerperium.

A case with the giant aneurysm of the ductus arteriosus combined with severe mitral regurgitation is reported. 58-year-old male underwent MVR and patch closure of the ductal orifice for staged operation. The first operation was MVR and patch closure of the PDA orifice of the pulmonary artery end using retrograde cerebral perfusion (RCP) with deep hypothermic circulatory arrest (DHC). The second operation was performed on 3 months after the first operation using left thoracotomy approach, and patch closure of the ductal orifice via the aorta using RCP with DHC was performed. Upon following-up examination, the patient is now doing well 20 months after the initial surgery.

Between 1990 and 1999, 78 patients underwent combined valvular coronary artery operation. Aortic valve disease was present in 49 patients, mitral valve disease in 23 patients, aortic and mitral valve disease in 6 patients. The average age was 67 years. Twelve patients had had a previous myocardial infarction. The average number of grafts inserted was 1.82 per patients, and the average number of artery grafts inserted was 0.96 per patients. The most number of grafts were placed prior to valve replacement or plasty. And periods of myocardial ischemia were kept at a minimum by coronary perfusion through free grafts. Preoperative mortality was 1.3%. And event fee ratio after operation was 95% (mean follow up 42 month). Therefore the operative risk of combined surgery is, in general, low and the long term results are favorable.

Anxiety observed in animals subjected to stress was stated in relation to anxiety level and biological backgrounds of animals, changes in neurotransmitters and causal stressors. 1. Anxiety is thought to be a negative emotion caused by many kinds of stress such as restraint stress, SART (specific alternation of rhythm in temperature) stress (a repeated cold stress caused by environmental temperature), social stress, etc. 2. Emotional behavior in those stressed animals were attenuated by anxiolytics like diazepam, a benzodiazepine receptor agonist and buspirone, a serotonin (5-HT) 1A agonist. 3. Stressed rats had changed brain levels of a variety of neurotransmitters such as corticotropin-releasing factor (CRF), noradrenaline, 5-HT, dopamine, acetylcholine, histamine, cholecystokinin, etc. The percentage of time spent on the open arms of an elevated plus-maze apparatus decreased in those stressed animals. Abnormal elevated plus-maze behaviors were attenuated by diazepam, buspiron and a CRF antagonist. 4. Anxiety level differs according to the coping strategy of the recipients. Rats of different strain, sex, aging and/or family display different behaviors in elevated plus-maze. 5. Stress-induced anxiety-related behaviors were observed when levels of some neurotransmitters became unbalanced. Thus modulators of unbalanced brain substances are thought to have anxiolytic properties.

Lactacystin (LC) is a specific inhibitor of the proteasome, and has recently been shown to induce apoptosis in certain cell lines. In the present study, we established Fas-resistant adult T-cell leukemia (ATL) cell subclones RSO4 and RST1 from their parental Fas-sensitive cell lines SO4 and ST1, and examined whether LC can overcome Fas resistance. LC completely inhibited proteasome function as determined by a peptidyl-MCA substrate (LLVY-MCA and LLE-MCA), and induced apoptosis in these cell lines irrespective of Fas sensitivity at low concentrations (approximately 10 microM). LC induced the activation of caspase 3 (CPP32/Yama) and caspase 6 proteases in an identical manner to Fas-mediated apoptosis. Moreover, LC induced the activation of caspase 8 (FLICE) protease, which is the initiator of the Fas-mediated apoptotic cascade. Synthesized proteasome inhibitory peptide MG-115 (ZLLnV-CHO) also induced apoptosis in these cell lines. These results indicated that proteasome inhibitors overcome Fas-resistance by bypassing the proximal part of the Fas signal. Inhibition of the proteasome function may be a new strategy for the treatment of ATL.

Human T-cell leukemia virus type-I (HTLV-I) is the etiologic agent of adult T-cell leukemia (ATL). This study examined the status of the oncogenic transcription factor AP-1 in leukemic cells freshly isolated from patients with ATL. Leukemic cells from peripheral blood of all patients with ATL exhibited constitutive AP-1 DNA binding activity, whereas mononuclear cells from normal individuals did not. In agreement with previous studies, HTLV-I transforming protein, Tax, was found to stimulate the DNA binding activity of AP-1 in a T-cell line. However, HTLV-I genes, including Tax, were not significantly expressed in leukemic cells freshly obtained from patients with ATL. Moreover, all T-cell lines derived from leukemic cells of patients with ATL also displayed constitutive AP-1 DNA binding activity, but expressed little Tax protein. Thus, leukemic cells of patients with ATL appear to have Tax-independent mechanisms that induce AP-1 activity, both in vivo and in vitro. In antibody supershift experiments, AP-1 in fresh leukemic cells and ATL-derived cell lines were found to contain JunD. Consistently, all primary ATL cells and ATL-derived cell lines expressed high levels of JunD messenger RNA. Our results suggest that AP-1 is activated in leukemic cells of patients with ATL through a Tax-independent mechanism and this may play a role in the deregulated phenotypes of ATL leukemic cells. (Blood. 2000;95:3915-3921)

We reported on 2 atomic bomb survivors(a 60-year-old man and 63-year-old woman)suffering myelodysplastic syndrome(MDS) associated with 1p32 chromosomal abnormalities. They were exposed to atomic bomb radiation at distances of 1.2 and 1.1 km, respectively, and were given a diagnosis of MDS 44 and 46 years after the bombing, respectively. The male patient had refractory anemia(RA) and a bone marrow cell karyotype of 46, XY, del(1)(p22p32), t(8;11)(p11;p15). The female patient had RA with excess of blasts (RAEB) and a karyotype of 45, X, -X, t(1;11)(p32;q23), +del(1)(p32), inv(3) (p21q27), del(5)(q15), -6, -9, -19, +mar 1, +mar 2. Multi-separated nuclear megakaryocytes were observed in both patients. These findings suggested that they had been exposed to radiation near the atomic explosion despite the fact that their symptoms of MDS developed more than 40 years after the bombing. 1p32 is known to be the locus of the TAL1 gene. However, Southern blot analysis did not reveal rearrangement of the TAL1 gene in the male patient.

For most intracardiac tumors, operation is the only means of therapy. In our institute, we have aggressively performed operation for intracardiac tumors regardless of histological type because resection for tumor had a beneficial effect on the hemodynamics with congestive heart failure. Twenty-five cases of cardiac tumors were operated upon from 1980 through 1998. The follow-up period ranged from 2 months to 19 years. The histological diagnoses of the tumors were as follows: benign tumors 24 (myxoma 21, papillary fibroelastoma 1, fibroma 1, angiomyolipoma 1) and malignant tumor (angiosarcoma 1). There was one hospital death in this series. In the New York Heart Association classification, the cardiac performances of intracardiac benign tumors after operation were Class I or II. The results of surgical treatment of intracardiac benign tumors were satisfactory both in short-term and in long-term. On the other hand the long term result of malignant tumor was extremely poor. A patient with angiosarcoma died 8 months later due to bone metastasis.

Treatment of a case of widespread superficial oral squamous cell carcinoma with external beam irradiation, followed by high dose rate Microselectron mould radiotherapy, is reported. The tumor disappeared macroscopically after treatment, but there was infield recurrence in the buccogingival sulcus where the radiation dose might have been inadequate. Apart from some radiation mucositis within the treated area, edema and a superficial ulcer were observed in the tongue. These were considered to be due to radiation overdose. Although there is room for improvement, this mode of treatment has something to offer patients with hard-to-cure cancer.

We experienced a rare case of leptomeningeal melanomatosis. The proliferative activity and nuclear accumulation of p53 in this tumor were examined, since the relationship between this tumor type and growth has not yet been elucidated. A 33-year-old Japanese man was shown to have leptomeningeal melanomatosis with multiple cutaneous pigmented nevi. The autopsy findings showed the presence not only of benign diffuse melanosis of the leptomeninges but also of leptomeningeal melanomatosis in the subarachnoid space and brain parenchyma. In the brain parenchyma, the direct invasion of tumor cells from the subarachnoid space and Virchow-Robin spaces filled with melanoma cells were observed. Multiple hemorrhagic areas invaded by melanoma cells were also present. Immunohistochemical staining with a monoclonal antibody to melanoma cells showed positivity in the tumor cells. Proliferation analysis using the MIB-1 antibody demonstrated that the labeling index of tumor cells invading brain parenchyma (2.54%) was higher than that in other lesions of the inner (0.89%) and outer layer (0.76%) of the subarachnoid space. Nuclear accumulation of p53 protein was rarely seen in the tumor cells. We reported a case of leptomeningeal melanomatosis. Higher proliferative activity was found in invading cells of the brain parenchyma. Malignant transformation of the tumor did not appear to be associated with p53 gene mutation.