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同時性多発性肝転移を認め，極めて予後不良であった上行結腸内分泌細胞癌の2例を経験した．症例1は81歳の男性で，上行結腸癌の診断で右半結腸切除術を行ったが，術中に多発性肝転移を認めた．全身状態が不良であることと同意が得られなかったことより化学療法は行わなかった．術後5カ月11日で原癌死した．症例2は68歳の女性で，前医より上行結腸癌および多発性肝転移の診断にて紹介された．多発性肝転移のため根治術は困難であったが，腸閉塞予防のため右半結腸切除術を行った．同意が得られず化学療法は行わなかった．術後3カ月2日で原癌死した．大腸内分泌細胞癌は早期より肝転移，リンパ節転移，腹膜播種をおこしやすく極めて予後不良である．自験例では同意が得られず化学療法は行わなかったが，外科的治療だけでは根治は難しく，効果的な補助化学療法の確立が望まれる.

Adenosine 5′-thiophosphoimidazolide (Imp(S)A) was prepared from adenosine, thiophosphoryl trichloride and imidazole. It hydrolyzed four times more slowly than the corresponding adenosine 5′-phosphoimidazolide. Epimerization between the diastereomers of Imp(S)A took place more quickly than the hydrolysis of Imp(S)A in aqueous solution. The uranyl ion catalyzed polymerization of Imp(S)A in neutral aqueous solution yielded, preferentially, a series of 5′-thiophosphorylated 2′-5′ linked thiophosphate oligoadenylates with Rp configuration. The corresponding adenosine 5′-thiophosphobenzimidazolide (Bzimp(S)A) was prepared in a similar way, and Rp and Sp diastereomers of Bzimp(S)A were separated by HPLC. (Sp)-Bzimp(S)A was polymerized by the uranyl ion catalyst efficiently giving 2′-5′ linked (Rp)-thiophosphate oligoadenylates up to a hexamer with both high regio- and stereoselectivity. On the other hand, uranyl-ion catalyzed polymerization of (Rp)-Bzimp(S)A proceeded inefficiently, and 2′-5′ linked (Sp)-thiophosphate di- and triadenylates were formed with low stereoselectivity. The polymerization took place by an SN2 reaction pathway with inversion of the thiophosphoryl group of Imp(S)A or Bzimp(S)A. The mechanistic role of the uranyl ion in this regio- and stereocontrolled polymerization is described briefly.

In human skin transplanted to the back of three strains of immuno-deficient mice, the function of sweat glands of the human transplant was tested by intradermal application of pilocarpine, adrenaline, atropine+pilocarpine and VIP Sweat responses were observed in the former three substances, not VIP. Therefore, to re-examine the negative results on VIP, interactions of the sudomotor axon reflex (AXR) with putative local mediators were studied by drug iontophoresis. The state of thermoregulation seems to modulate the action of VIP as a possible co-transmitter facilitating AXR by raising skin temperature. The underlying VIP-induced vasodilation may involve both sudomotor and sensory axon reflex mechanisms.

A Paraisaria-like fungus isolated from a larva of a cerambycid beetle, Anopolophora oshimana, produced small obovoid conidia from multi-necked conidiogenous cells arising from synnematous conidiophores. In culture, the fungus produced curved Harposporium-like conidia in addition to obovoid conidia. When introduced into nematode-infested cultures, nematodes were infected after ingesting the curved conidia and infection typical of Harposporium, producing curved conidia from globose conidiogenous cells, resulted. Reinfection of beetle larvae by injection of hyphal bodies from pure culture and by contact with conidia from the original host showed pathogenicity to cerambycid larvae.

The entomopathogenic fungus, Cordyceps militaris, is considered to be an important factor in suppressing population explosions of the beech caterpillar, Quadricalcarifera punctatella. The number of fruit bodies produced by the fungus was counted in a natural beech forest and parasitism was evaluated by burying lab-reared pupae of the insect in the soil. Seasonal changes in infection rate in the ground and the corresponding number of fruit bodies were compared. The emergence curve of fruit body production exhibited an L-shape with a peak in late July. The fruit body of C. militaris lasts for about two weeks and appears from late July to early September. The rate of infection was found to change seasonally: it was highest in early August when the number of fruit bodies was at a peak, then decreased gradually until the following summer. From an epizootiological viewpoint, the results suggested that the fruit body plays a role in enhancing the infection rate of the fungus.

Three species of fungi endoparasitic in nematodes were obtained in pure culture for the first time. The fungi belong to Harposporium and Verticillium. Morphology of the fungi on corn meal agar was studied and infectivity proving Koch's postulates was achieved for each species. The infection method for Harposporium cycloides was shown to be by spore ingestion. Whilst all species were found to produce infection conidia in pure culture, both species of Harposporium produced accessory conidia and, in H. lilliputanum, arthroconidia were also formed.

HRONIC GRANULOMATOUS disease (CGD) is a rare inherited disorder whereby phagocytes cannot generate superoxide anion and its derivatives to other active oxygen species that may be used for killing infectious agents. Patients with this disease have recurrent, life-threatening infections with catalase-positive bacteria and fungi.’ The superoxide generating system in phagocytes and B lymphocytes’ consists of a membrane-bound catalytic component, cytochrome bSs8, and cytosolic components that seem to be required for activation of the system. A functionally active enzyme complex is formed on stimulation of macrophages or neutrophils by assembly of the necessary components on the plasma membrane. This complex carries an electron from reduced form of nicotinamide-adenine dinucleotide phosphate to molecular oxygen to form superoxide anion, which is then released to the outside of the cells or inside the phagosomes.3 The catalytic component, cytochrome bSs8, is composed of two subunits, gp91- and p22-phox (phagocyte oxidase). Cytosolic components include p47- and p67-phox and a small guanosine-triphosphate binding protein Ra~-p21.‘“~ These five proteins were shown to be sufficient to support superoxide-generation in a cell free ~ystem.~.~ Any defect in the four “phox” proteins causes CGD, which occurs either as an X-linked or an autosomal di~order.~ The gene responsible for the former type of CGD codes for gp91-phox and genes responsible for the latter for p22-, p47-, and p67-phox. The mRNAs that code for allphox proteins have been cloned and sequenced and the genomic organizations rep~rted.~”~ It is known that p67-phox deficiency is rare in the United States,” Europe,*’ and Japan (manuscript in preparation). Mutations that cause this type of CGD are heterogeneous,’ in contrast to the cases in p47-phox deficiency, the majority of which seem to be accounted for by a common dinucleotide deleti~n,’~~~~ although some patients were heterozygous for this deletion and had a second missense rnutaion in the other allelle.’33’5 We found a homozygous AG dinucleotide insertion in one patient with p67-phox deficiency, which would bring about a frame shift into mRNA resulting in an early stop codon.26 de Boer et alZ7 reported that a mutation resulting in a nonconservative amino acid change in p67-phox

To analyze the phylogeny and molecular evolution of the entomophthoralean fungi, we deter? mined the small subunit nuclear ribosomal RNA gene sequences for four representative species of the En- tomophthorales and the trichomycete Smittium culi- setae (Harpellales) in the Zygomycota. Ten published reference sequences were added to this analysis. The phylogeny, inferred from the aligned 1480 positions and using the choanoflagellate Diaphanoeca grandis (Choanoflagellida) as an outgroup, divided seven zyg- omycete species into four clusters. The four species in the Entomophthorales were placed in two clusters, i.e., Basidiobolus ranarum in one cluster containing Chy? tridium, Spizellomyces and Neocallimastix, and the re- maining three species Conidiobolus coronatus, Entomo- phthora muscae, and Zoophthora radicans in another clus? ter containing Mucor. Glomus etunicatum is basal to ascomycetes and basidiomycetes, and Smittium culi- setae was placed close to the divergence of Entomo?

Nucleotides containing polyphosphate were prepared from nucleoside-5′-phosphorimidazolide and nucleotides or phosphoryl compounds by divalent metal ion catalyst such as Mn2, Cd2+ or Mg2+ in aqueous solution.

We present a prototype system for secure human-machine interaction, based on face and arm gesture recognition. A mobile robot mounted with two CCD cameras captures the scene continuously, and gets ready to follow the instructions, if it finds a familiar face in vicinity. Face matching is done by the elastic graph matching using the Gabor wavelet transform coefficients. Calculation of the coefficients and the matching algorithm are both implemented in hardware for better computational efficiency. The robot responds only to the commands from the authorized users. The commands are passed by arm gesture, recognized by the robot using a stereo vision based algorithm.

For sintered samples of Ba3+x Na1+xGd1−xNb10O30 (1 ⩾x ⩾ 0), the effect of the addition of gadolinium to barium sodium niobate (BNN,x = 1, tungsten bronze type) was examined by differential scanning calorimetry (DSC) and X-ray powder diffractometry. The volume change (i.e. especially the change ofc-axis length) at the ferroelectric phase transition temperature (Tc< 590 dg C) decreased with the increasing gadolinium content. This result suggests that the addition of gadolinium or other lanthanide elements to BNN is possibly effective to obtain an uncracked single crystal with the Czochralski technique. The DSC indicator method is useful to determine the relative magnitude of volume change atTc for the same type of sample series, a method which is much easier than the dilatometer method. The relation between the DSC peak area and the volume change of unit cell atTc is discussed from the thermodynamic viewpoint.

Ba2NaNb5,O15 and eighteen additional compositions in the NaNbO3-BaNb2O6 system from 60 to 85 mole % BaNb2O6 have been prepared and studied by X-ray powder diffraction. A calculated pattern has been used to aid in indexing the powder pattern of stoichiometric Ba2NaNb5O15(BNN-S). The lattice parameters of BNN-S have been determined from repeated measurements of 2 higher order reflections and are a=b=17.5994(8)Å and c=7.9771(9)Å. A comparison with the Powder Diffraction File (PDF) 34-210 indicates that the present data provide a more precise match to the unit cell, include additional weak reflections and cover a greater 2θ range. There is a tungsten bronzetype solid solution range from 60 to 75 mole % BaNb2O6.

Publisher Summary The chapter discusses the collapse analysis of a three-dimensional (3D) steel frame by the fibered plastic hinge method. The accuracy of a new beam element proposed in combined bending and nonuniform torsion problem is examined using available experimental and numerical results for a steel space frame, with H-columns subjected to a constant vertical load and eccentric horizontal cyclic loading. The element is of the plastic hinge type. The formulation procedure is a combination of the modified incremental stiffness method, the updated lagrangian formulation, and the numerical integration of fiber stiffness about the sections at the plastic hinges. The use of the beam element makes it possible to evaluate the strain of the member caused by three-dimensional elasto-plastic deformation of a frame. Comparisons of the results by the proposed method with those of experiment are presented in the chapter, and the accurate numerical method demonstrated that the new element has a sufficient accuracy and reliability in the analysis of elasto-plastic cyclic behavior of the steel space frame which is forced to rotate about a vertical axis largely.

The heat spreader for the organic package in a flip chip assembly was investigated. The thermal management analysis, which is based on thermal simulation techniques and an experimental database, was applied to find suitable materials for the heat spreader. We successfully accomplished the simulation technique for the thermal management, which is consistent with the experimental results. We revealed that the critical stress in the die attach resin should be less than 2 kgf/mm/sup 2/ through this technique. We also revealed that the CTE of the heat spreader material should range from 8 to 16 ppm/K. This value of CTE supports the proposal that sintered Al-SiC is suitable as a heat spreader material for an organic package with flip chip assembly. Furthermore, the adhesive strength of Al-SiC with the resin is strong enough to be used as the heat spreader material.

We proposed here a new wavelet-based approach for Heart Rate Variability (HRV) analysis. In order to obtain the correct power for the LF and HF bands in the HRV signal, we decomposed the signal by the complex discrete wavelet transform (CDWT) and calculated the power by the square moduli of CDWT complex-valued components. We confirmed the effectiveness of our method by applying it to simulation data (sine wave) and experimental data.

Many studies for the ITS (intelligent transport system) have been done toward safe and smooth driving without traffic accidents. As one of the inter-vehicle communication systems, an inter-vehicle communication and ranging system using spread spectrum Technique called the Boomerang transmission system has been proposed. We report simulation results of the Boomerang transmission system against several interference waves. In these simulations, we compare hard-limiters, linear-amplifiers and soft-limiters using the sigmoid function as an amplifier method. From simulation results, we show the effectiveness of the Boomerang transmission system in some situations that several interference waves exist.

2',5'-Linked oligoadenylates (2-5A) are involved in the antiviral action of interferon. The 2-5A binds and activates 2-5A dependent RNase (RNase L), which degrades viral mRNA, resulting in the inhibition of protein synthesis. 2',5'-Linked phosphorothioate oligoadenylates with an Rp configuration bind to and activate the RNase L. On the other hand, 2',5' phosphorothioate oligoadenylate with an Sp configuration weakly binds to the RNase L and is devoid of the RNase L activation ability. Comparative circular dichroism (CD) and NMR studies are carried out to characterize the difference in properties between the two configurations of the 2',5' phosphorothioate oligoadenylates. 2',5' Rp-Phosphorothioate oligoadenylates showed CD spectra similar to those of the corresponding native 2',5' oligoadenylates, while the 2',5' Sp-phosphorothioate oligoadenylates exhibited a weaker CD band compared to the former two, indicating the weaker base-stacking interaction of the 2',5' Sp-phosphorothioate oligoadenylates. The temperature-dependent change in the CD revealed that 2',5' phosphorothioate oligoadenylates showed larger DeltaH(0) and DeltaS(0) values for the thermal transition of the conformation than the corresponding native 2',5' oligoadenylates. The NMR spectral assignment was accomplished by several NMR measuring techniques. The 2'-H of the ribose ring linked to the 2',5' Sp-phosphorothioate showed a higher field chemical shift of the proton NMR than that linked to the corresponding 2',5' Rp-phosphorothioate. 2',5' Rp- and Sp-phosphorothioate oligoadenylates possess a sugar conformation similar to that of the corresponding native 2',5' oligoadenylates.

Theoretically, en bloc resection of the hepatoduodenal ligament is considered to be the most radical procedure for advanced carcinoma of the biliary tract. However, this procedure involves perioperative difficulties such as hepatic ischemia, portal congestion, patency of reconstructed vessels, and high incidence of operative mortality, moreover, when it is combined with resection of the liver and/or pancreas. We developed several tactics in vascular reconstruction, hepatic resection, and pancreatoduodenectomy in order to decrease the operative morbidity and mortality. We preferred to anastomose the portal vein and hepatic artery separately to avoid total hepatic ischemia, and used the porto-systemic bypass during prolonged portal reconstruction. We resected the liver without vascular clamping to minimize hepatic ischemia, and employed the simplified method of pancreatojejunostomy. To date, we performed 4 hepatoligamentectomies and 4 hepatoligament-pancreatoduodenectomies with no operative mortality, although long-term survivors were not encountered. This procedure should be evaluated with more clinical experiences after its safety and indication was established.

There is a genetic problem in living donor liver transplantation, involving Wilson's disease, because the majority of donors have a kinship relationship. Recently, it was reported that the serum ceruloplasmin level is insufficient in some persons with one allele mutation. The recipient was a 13-year-old male child, and the donor was a 22-year-old woman, who was his sister by a different father. The gene analysis for Wilson's disease (ATP7B gene) was preoperatively carried out by the amplification refractory mutation system-PCR. Homozygous and heterozygous deletion of 2871 cytosine (C) were detected in the recipient and donor, respectively, in the ATP7B gene. Serum ceruloplasmin level was sufficient in the donor. The right hepatic lobe graft was transplanted to the recipient. Immediately after the liver transplantation, the copper metabolism improved to increase the serum ceruloplasmin levels up to the normal range, and decrease the urinary copper excretion. However, the serum ceruloplasmin levels gradually decreased below the normal base line, although the urine copper levels continued to be low without any clinical symptoms. We should perform gene analyses and confirm the serum ceruloplasmin levels in donors before living donor liver transplantation for Wilson's disease, to screen for their impairment of copper metabolism. After living donor liver transplantation for Wilson's disease, we should carefully follow-up the transition of serum ceruloplasmin levels in the recipient.

Oxygen free radicals have been implicated in the genesis of traumatic brain injury and brain edema (BE). Recent studies have suggested that hydroxyl radical can initiate lipid peroxidation, thus producing lipid-free radicals that may become important sources of singlet oxygen. L-histidine, a singlet oxygen scavenger, potentially can be used to treat BE. In this study we investigated the effects of L-histidine and D-histidine on BE following cryogenic injury in rats. Male Wistar rats were anaesthetized with chloral hydrate. Vasogenic BE was produced by a cortical freezing lesion. Generation of singlet oxygen from photoactivation of rose bengal was studied by electron spin resonance (ESR). Animals were separated into four groups: sham rats (n = 5), saline-treated rats (n = 10), L-histidine treated rats (n = 6) and D-histidine treated rats (n = 7). Each agent (100 mg/kg) was administered intravenously at 30 minutes before lesion production. Animals were sacrificed at 24 hours after lesion production and the brain water content was determined by the dry-wet weight method. L-histidine had no effect on rectal and brain temperature. Election Spin Resonance studies demonstrated that L-histidine is a singlet oxygen scavenger. L-histidine but not D-histidine significantly attenuated BE following cryogenic injury (p0.05). In conclusion, L-histidine is useful in the treatment of traumatic BE.

The clinical outcome of hepatopancreatoduodenectomy (HPD) carried out in 14 patients in our institute was evaluated retrospectively. In principle, HPD is performed in patients with far-advanced biliary carcinoma extending from the level of the liver to pancreas directly or via metastatic lymph nodes around the head of the pancreas. However, the survival periods after surgery did not improve, contrary to expectations. Curative surgery was not achieved in most patients who underwent HPD, even if resection of the portal vein or hepatoduodenal ligament was performed during surgery. Severe lymphatic, vascular, and neural involvement along the hepatoduodenal ligament existed in those patients. In addition, it is possible that they already had micrometastases to other organs based on a study of the pattern of recurrence after surgery. Quality of life did not appear to improve unless the patients survived more than one year. These findings suggest that HPD may be appropriate for patients in earlier disease stages than those in our series to achieve longer survival. However, HPD is associated with high rates of postoperative complications and operative mortality, especially after pancreatoduodenectomy with liver resection involving more than right hepatectomy. We need to establish the appropriate indications for HPD and improve the safety of the procedure.

Three cases with a pituitary cystic mass that spontaneously disappeared were discussed. Common characteristics of these 3 cases were presence of headache, cystic mass, spontaneous disappearance, and no recurrence. Based on clinical course, MRI findings such as cystic mass with ring enhancement, no calcification, and displacement posteriorly of the normal pituitary gland, and previous reports, these 3 cases were diagnosed as an equivocal Rathke's cleft cyst. We suggested that operative indication in an equivocal Rathke's cleft cyst, even though it was symptomatic, should be decided after sufficient follow-up, because there may be a possibility of spontaneous reduction or disappearance like our cases.

Dysregulation of apoptosis is one of the likely underlying mechanisms of neointimal thickening, a disorder in which proinflammatory cytokines may influence the function of vascular smooth muscle cells (VSMCs) and contribute to atherogenesis. One of these cytokines, tumor necrosis factor-alpha (TNF-alpha), induces 2 possibly conflicting pathways, 1 leading to the activation of nuclear factor-kappaB (NF-kappaB) and the other leading to caspase-mediated apoptosis. We investigated whether specific inhibition of NF-kappaB affects TNF-alpha-dependent apoptosis in human VSMCs. To inhibit NF-kappaB activation specifically, we constructed a recombinant adenovirus vector expressing a truncated form of the inhibitor protein IkappaBalpha (AdexIkappaBDeltaN) that lacks the phosphorylation sites essential for activation of NF-kappaB. The IkappaBDeltaN was overexpressed by adenoviral infection and was resistant to stimulus-dependent degradation. Electromobility gel shift and luciferase assays demonstrated that overexpression of IkappaBDeltaN inhibited NF-kappaB activation induced by TNF-alpha or interleukin-1beta (IL-1beta). In cells overexpressing IkappaBDeltaN, TNF-alpha dramatically induced apoptosis, whereas IL-1beta had no effect. The induction was suppressed by treatment with a selective inhibitor of the caspase-3 family, Z-DEVD-fmk, and the overexpression of IkappaBDeltaN induced TNF-alpha-mediated caspase-3 and caspase-2 activity. These results indicate that overexpression of IkappaBDeltaN induces TNF-alpha-dependent apoptosis by efficient and specific suppression of NF-kappaB and upregulation of caspase-3 and caspase-2 activity in human VSMCs. Our findings suggest that adenovirus-mediated IkappaBDeltaN gene transfer may be useful in the treatment of disorders associated with inflammatory conditions, such as the response to vascular injury and atherosclerosis.

Cholangiography is the most fundamental and reliable examination for diagnosis of the extent of bile duct carcinoma. Hepatic angiography is also informative for diagnosis of vascular invasion. However, an accurate understanding of three-dimensional biliary and vascular anatomy at the hepatic hilum is not easily gained by conventional cholangiography and angiography. We have performed three-dimensional cholangiography and angiography (3D-CGAG) using rotational DSA (Advantx ACT) and a 3D spinning digital imaging system in 29 patients with hilar cholangiocarcinoma, etc. 3D-CGAD provides clear three-dimensional visualization of the biliary tract and blood vessels affected by bile duct cancer, and useful information on optimal resection. Of 13 patients with hilar cholangiocarcinoma undergoing resection, curative resection was carried out in 11 (85%). 3D-CGAG is considered to be an indispensable imaging modality for evaluation of the extent and staging of hilar cholangiocarcinoma.

We report a case of a patient with traumatic carotid cavernous fistula (CCF) caused by transnasal-transsphenoidal surgery, who was successfully treated using detachable coils. A 47-year-old man was admitted to our hospital because of severe headache. He was confirmed to have a nonfunctioning pituitary adenoma with presellar-type sphenoid sinus. Cerebral angiography initially disclosed no vascular lesions. A transnasal-transsphenoidal adenomectomy was performed. When the anterior wall of the sphenoid sinus was dissected with a chisel, the chisel deeply stuck into the posterolateral part of the sinus. Profuse arterial bleeding was observed through the sphenoid sinus. The bleeding was stopped easily by compression and packing with bone wax. The operation was continued, the sellar floor was opened widely and the tumor was removed subtotally. The medial wall of the cavernous sinus was intact. Histological examination revealed a pituitary adenoma. Immediately after surgery, the patient noticed a bruit. He developed chemosis and abducent palsy on the right side. Cerebral angiography displayed a high-flow CCF, which was attributed to the carotid artery injury caused by the transnasal-transsphenoidal surgery. The CCF disappeared after two-staged embolization using detachable coils, 1st transvenous and 2nd transarterial. Ten months later, cerebral angiography showed persistent occlusion of the fistula, and the patient experienced no tumor recurrence. It is suggested that drilling is a safer procedure than using a chisel for dissection of a sphenoid sinus with incomplete pneumatization. Endovascular treatment using detachable coils proved useful to manage the CCF, an unusual complication of transsphenoidal surgery.

Recent clinical trials with experimental immunotherapeutic agents for sepsis have not proven their overall benefit yet although some studies suggested significant effect of these antisepsis therapies. This review article summarizes the results of these trials, their analysis, lessons learned from past failure, and future perspectives for immunotherapies as anti-sepsis treatments.

The Wilms tumor gene (WT1) has been reported to be a prognostic factor and a marker for the detection of minimal residual disease (MRD) in acute leukemia. Using competitive polymerase chain reaction procedures, we examined the expression of the WT1 gene in acute leukemia patients with several tumor-specific DNA markers, including bcr/abl, PML/RAR alpha, and AML1/MTG8. A strong correlation was observed between the levels of WT1 and PML/RAR alpha expression. However, AML1/MTG8 transcripts were detected at all stages of the disease even when the expression level of WT1 gene was low. From these findings, we concluded that monitoring the WT1 expression level is a useful means of determining the effectiveness of chemotherapy, and that WT1 is an effective marker for the detection of MRD, especially in acute myeloid leukemia patients with AML1/MTG8.

The incidence of metastatic brain tumors is increasing because of the recent progress in the detection and management of primary cancer. However, metastatic skull tumors from cancers associated with giant subcutaneous mass lesions are rare. We present four patients with metastatic skull tumors: two from hepatic cancer, one from lung cancer, and one from mamma cancer. In these patients, plain skull X-ray and bone CT showed osteolytic lesions. Angiograms revealed a tumor stain fed by abnormal vessels from the external carotid artery. MRI demonstrated masses with marked homogeneous enhancement with the "dural tail sign" in the dura adjacent to the tumors in three skull tumors from hepatic and mamma cancers, and a mass with slightly enhancement without the "dural tail sign" in a skull tumor from lung cancer. At surgery, hemorrhagic well-demarcated tumors were totally removed. The histological diagnosis was skull metastases from cancers in all cases. In cases with the "dural tail sign" on MRI, no tumor cells were seen in the inner layer of the dura and the dura adjacent to the tumors. It is possible that the "dural tail" is due to increased vascular permeability of the dural vessels. The recurrence of these skull tumors was not observed during the follow-up period. Surgical treatment for the metastatic skull tumors from cancers may be indicated to prevent deteriorating neurological symptoms affecting the quality of life.

Micro-pressure-suction-irrigation system (MPSIS), introduced by Luedecke et al, is an instrumentation for the direct transnasal pituitary procedure. We improved this system for use in Japan. The irrigation system can effectively clean the operating field by one-hand manipulation and dissect tumor tissue by its rapid flow. The pressure of suction and irrigation can be adjusted respectively by a device in the handpiece. The MPSIS is applicable to different stages of intervention because it is equipped with separate tips of various diameters, lengths and angles. This system is especially useful in combination with a micromirror or an endoscopy for direct inspection of the eccentric tumor sites such as the cavernous sinus, the upper part of the planum sphenoidale, or the posterior suprasellar regions. The use of the MPSIS helps to avoid injury to normal tissue structures, and prevents tiny soft microadenoma from being lost during preparation. We have proved the suitability and usefulness of the MPSIS in 23 surgical interventions for transnasal microsurgery of pituitary adenomas.

The oculocerebrorenal syndrome of Lowe (OCRL) is a rare X-linked disorder with features of congenital cataracts, Fanconi syndrome of the renal tubule, and mental retardation. The OCRL1 gene has been positionally cloned and shown to encode a phosphatidylinositol 4,5-biphosphate-5-phosphatase. OCRL is thus thought to be an inborn error of inositol polyphosphate metabolism. We analyzed the gene in two Japanese OCRL patients and their families by DNA sequencing and mismatch polymerase chain reaction (PCR) followed by restriction digestion. A novel nonsense mutation (C1399T) replacing the glutamine of codon 391 (Gln 391 Stop) was identified in exon 12 in 1 patient and also in his mother. A novel missense mutation (C1743G) was identified in exon 15 in the second patient. his mother and maternal grandmother. The missense mutation predicts a substitution of serine for arginine (Ser 505 Arg) in a domain highly conserved among the inositol-5-phosphatase family. Our observations expand the range of OCRL1 mutations that cause Lowe syndrome, and will be useful for genetic counseling in these two families.

In our previous study we showed that rebamipide attenuated gastric erosions and active oxygen species released only from the gastric mucosa and not from circulating leukocytes after thermal injury. This study was designed to examine whether rebamipide affects the potential of active oxygen generation from circulating leukocytes, and attenuates microcirculatory disturbance caused by thermal injury to skin. Rats were anesthetized and a 30% full skin-thickness dorsal burn was inflicted. Microvascular images and leukocytes were observed using in vivo microscopy. Endothelial damage was assessed by monastral blue B deposits. Active oxygen species were measured by the chemiluminescence method. Rebamipide (100 mg/kg) decreased leukocyte rolling and monastral blue B deposits in venules but did not improve arteriolar contractions 15 min after thermal injury. These results suggest that rebamipide preserves gastric microcirculation possibly through inhibition of leukocyte adhesion and endothelial damage caused by thermal injury to skin.

Oxygen-derived free radicals (FRs) are critical mediators of ischemia/reperfusion injury. Inflammatory cytokines have been shown to play important roles in tissue injury. To examine the relationship between FRs and interleukin-1 (IL-1) in hepatic ischemia/reperfusion injury, we used interleukin-1 receptor antagonist (IL-1ra) to block endogenous IL-1 production in a rat model of hepatic ischemia/reperfusion.Female SD rats were subjected to 30 min of hepatic ischemia followed by reperfusion. The animals were divided into two groups, control group and IL-1ra-treated group, according to the rinse solution. In both groups, FR production, histological changes, and interactions between leukocytes and endothelial cells were analyzed in the course of reperfusion.In the control group, production of FRs increased significantly after 60 min of reperfusion. After 60 and 180 min of reperfusion, histological examination showed atrophy and degeneration of hepatocytes. Hepatic microcirculation demonstrated a marked increase in the number of leukocytes adherent to endothelial cells and of injured cells after reperfusion. In the IL-1ra-treated group, IL-1ra pretreatment markedly reduced FR production after 60 min of reperfusion, the number of leukocytes adherent to endothelial cells, and tissue injury.These data clearly show an important role for IL-1 in the induction of FR production, leukocyte adhesion, and tissue injury after hepatic ischemia/reperfusion injury.

The inflammatory cytokines interleukin (IL) 1 and tumor necrosis factor (TNF) may play an important role in hepatic ischemia-reperfusion (I/R) injury. To study the role of IL-1 in hepatic I-R injury, we investigated the effect of pretreatment with IL-1 receptor antagonist (IL-1ra) on the production of IL-1, TNF, histological findings in the liver, and the survival rate for 7 days. Rats were subjected to 90 min of partial liver warm ischemia by clamping the vessels of the left and middle lobes. In the IL-1ra-treated group, IL-1ra was given 5 min before liver ischemia was induced. IL-1alpha and TNF levels were determined in blood and liver at 0, 30, 90, and 180 min after reperfusion. In a second experiment to determine the effect of IL-1ra pretreatment on survival rate, after 90 min of partial liver ischemia, the right lateral and caudate lobes were excised, leaving only the ischemic lobes. In both groups, IL-1alpha was undetectable in blood, but increased in liver tissue. TNF increased in both blood and liver tissue as reperfusion time increased. Histological evidence of tissue injury was minimal in the IL-1ra-treated group. Furthermore, in the IL-1ra-treated group, the production of TNF decreased in both blood and liver tissue compared with the nontreated group. Survival rates in the IL-1ra-treated and nontreated group were 80% and 30%, respectively. The data demonstrated that the production of IL-1 and TNF increases in hepatic I-R injury and that pretreatment with IL-1ra protects the liver from ischemic insult, indicating an important role for IL-1 in I-R injury.

The cytosolic 67-kD protein in phagocytes (p67-phox) and B lymphocytes is one of essential components of the superoxide-generating system in these cells, and its defect causes an autosomal recessive type of chronic granulomatous disease (CGD). We performed mutation analysis of p67-phox mRNA from a CGD patient who lacks the protein and found an in-frame deletion from nucleotide 694 to 879, which corresponds to the entire sequence of exons 8 and 9. This sequence encodes one of two Src homology 3 domains and a part of proline-rich domain in p67-phox and lack of these domains seem to have influenced stability of this protein. To know causative reason for the deletion, we analyzed genomic DNA for p67-phox using two sets of primers that covered exons 8 and 9 with adjacent introns. The DNA fragments from the patient were shown to be same in length as those from control. However, the single-strand conformation-polymorphism analysis of the fragments showed that a patient's specimen that included the splice junction of exon 9 exhibited different mobility from the control. By sequencing of the fragment, a homozygous G to A replacement at position +1 of intron 9 was found to be a sole mutation, which reduced the matching score of the splicing sequence to the consensus calculated according to the formula proposed by Shapiro and Senapathy (Nucleic Acids Res 15:7155, 1987). The reduced matching score at the splice doner site (5' splice site) of intron 9 and the original low matching score at the acceptor site (3' splice site) of intron 7 may explain the skipping of exon 8 and 9, and another predicted mechanism is discussed on the basis of Shapiro and Senapathy's hypothesis.

The objective of this study was to find out what index is appropriate to evaluate obesity, by measuring body fat using bioelectrical impedance analysis (BIA). Subjects in this study were 74 women, aged 44 to 73, living in Tokushima prefecture. The means +/- standard deviation (SD) of Broca index, Body mass index (BMI) and body fat were 103 +/- 14.3%, 23.0 +/- 2.8 kg/m2 and 28.1 +/- 5.5%, respectively. In addition, their clinical data such as blood pressure, glutamate-pyruvate transaminase activity (GPT), triglycerides (TG) and fasting blood sugar (FBS) were within normal ranges. When compared with correlation between obesity indices (Broca index or BMI) and height, there was a negative correlation between Broca index and height (= -0.447). Furthermore, the number of obese subjects estimated by Broca index was less than that of obese subjects estimated by BMI. Although both Broca index and BMI showed higher correlations with body fat estimated by BIA, BMI (r = 0.927) showed a higher correlation compared to that of Broca index (r = 0.875). These results suggest that BMI is a reliable index to evaluate the body fat.

In human skin transplanted to the back of 3 strains of immuno-deficient mice the function of the eccrine sweat glands of the human transplant was tested by topical intradermal application of pilocarpine, adrenaline and atropine + pilocarpine. Sweat responses were observed in pre-selected fields of observation by means of video macroscope. The iodine starch reaction served as an indicator for the appearance of sweat sport and permitted the evaluation of areas wetted by sweat in the field of observation. Among 9 animals tested, the hybrids between the CB-17-scid mouse and the BALB/cA-nu mouse (BALB/cA-nu,scid) seemed to exhibit the most consistent sweating response to local pharmacological stimulation. According to histological examination, eccrine sweat glands were preserved in human skin transplanted into the back skin of the BALB/cA-nu,scid mouse strain. The heterologous, human skin graft provides a novel model permitting, independent of the normal sweat gland innervation, the analysis of molecular receptors of sweat gland cells by which the actions of natural transmitters and pharmacological agents are transduced.

An aneurysm ruptured during superselective catheterization into the posterior cerebral artery for a left temporal arteriovenous malformation. The rupture may have been caused by stretching and displacement of the basilar and posterior cerebral arteries while the microcatheter with guide wire was advanced.

The purpose of the present study was to determine the pattern of microcirculatory disturbance to investigate the causes of gastric mucosal blood flow depression in the early period after thermal injury. Male Wistar rats were anesthetized and a 30% full skin-thickness dorsal burn was inflicted. Active oxygen species (AOS) generated by circulating leukocytes were measured by chemiluminescence. Contraction of arterioles and venules was observed by intravital microscopy, and rolling or sticking of leukocytes in venules was counted using fluorescence microscopy. AOS generation by circulating leukocytes was diminished and arteriolar contraction and increases in rolling or sticking leukocytes in venules were observed 15 min after thermal injury. Decreased AOS generation by circulating leukocytes, contractions of arterioles, and increased rolling or sticking of leukocytes in venules was observed in the early period after thermal injury. Arteriolar contraction may explain decreases in mucosal blood flow. Moreover, decreased AOS generation by circulating leukocytes does not obviate the potential participation of leukocytes in microcirculatory disturbances, because rolling or sticking leukocytes were increased significantly 15 min after thermal injury.

Alpha-Adenosine analogs of 2'-5'Oligoadenylates (alpha 2-5 A) were synthesized by uranyl ion-catalyzed oligomerization of alpha-adenosine-5'-phosphorimidazolide in aqueous solution. alpha-Anomeric 3'-5'oligoadenylates were simultaneously formed in the oligomerization reaction. Physicochemical and biochemical properties of the resulting alpha 2-5 A were studied by spectroscopic and enzymatic method.

Two cases of trochlear nerve neurinoma without Recklinghausen's disease are described. A 60-year-old male had a left-side sensory disturbance and a hemiparesis. Computed tomography (CT) scan and magnetic resonance image (MRI) showed a cystic enhancing mass in the right tentorial incisura. A 57-year-old male had a gait disturbance and a left-side facial numbness. CT scan and MRI showed a solitary enhancing mass in the right tentorial incisura. These tumors were subtotally removed, and the intraoperative diagnosis of two patients was trochlear nerve neurinoma. Unique clinical manifestations of trochlear nerve neurinoma are discussed with a brief review of 11 cases reported in the literature.

To clarify the ability of cold tolerance of Syrian hamsters (Mesocricetus auratus) during the nonhibernating state as compared with Wistar rats, hypothermia was induced by acute cold exposure at 0°C with ice packs. On skin insulation, the back skin was better than the abdominal skin in both species, and Wistar rats was superior to Syrian hamsters. Minimal temperature in the abdominal cavity of Syrian hamsters in nonhibernation (7.22±0.31°C) was significantly lower than 17.11±0.39°C of Wistar rats. Blood proteins on SDS-PAGE 18hr after acute cold exposure changed as follows: 17.5, 19, 35 and 43 kDa proteins increased and 32 and 40 kDa proteins decreased. A little change occurred in proteins of the brain and kidney of Syrian hamsters.

Amino acid metabolism under surgical stress, injury or infection was reviewed from the literature. The glucose-alanine cycle in coupling with branched chain amino acids (BCAA) metabolism plays a central role for gluconeogenesis, in such a catabolic state. Glutamine is as important as alanine for sparing glucose and furthermore for intestinal repair. Changes in plasma amino acid concentration and clearance following hepatectomy are described, and effects of BCAA solution are evaluated. It was suggested that BCAA improved the Fischer ratio by increasing, not only plasma BCAA level, but also AAA clearance.