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This study proposes a scheme to design control parameters for a data center facility with a vibration controller on its top floor and a secondary isolation device with its own vibration controller designed to protect vibration-sensitive computer equipment. The aim is to reduce the effects of acceleration and drift from an earthquake on computer servers placed on the isolation device that must operate during a seismic event. A linear elastic model is constructed and the evaluation function of the linear quadratic Gaussian (LQG) control is formulated. The relationship between the control parameters and the responses is examined, and based on the observations, a control parameter design scheme is constructed to reduce the responses of both the building and the computer server effectively.

Objective Crescent formation in the renal glomerulus is a typical manifestation of progressive glomerulopathy associated with fatal renal failure; therefore, its prevention is of clinical importance. Little is known about the pathogenic mechanism for crescent formation. This study was undertaken in an attempt to identify the events that are critical for crescent formation in immune complex crescentic glomerulonephritis (CGN) by analyzing a novel mutant strain of mice. Methods A spontaneous mutant strain of mice was isolated from the autoimmune-prone strain EOD, which stably develops fatal CGN. The mutant phenotypes were assessed histopathologically, hematologically, and immunologically. The mutation was searched for with positional cloning using microsatellite markers. Results Compared with wild-type EOD (WT-EOD) mice, mutant EOD (mut-EOD) mice showed marked improvement in CGN in conjunction with an improvement in spontaneous mortality. In WT-EOD mice, an inverse correlation between blood urea nitrogen concentration and blood platelet count and massive accumulation of platelets in the glomerulus were evident, suggesting that an accumulation of platelets in the glomerulus contributes to the progression of CGN. The mutant platelets showed an abnormal aggregation in response to collagen and thrombin, associated with a bleeding tendency in mut-EOD mice. Genetic analysis revealed a deleterious mutation in the cappuccino gene (cno), which encodes a protein that belongs to a complex called the biogenesis of lysosome-related organelle complex 1 and is profoundly involved in platelet function. Morphologic examination revealed a partial defect in dense body formation in the δ-granule of platelets. Conclusion The present findings suggest that platelet functions have a critical role in crescent formation in autoimmune GN.

The enhancing effect of p-Menthane-3,8-diol (MDO) on skin permeation of antipyrine (ANP) and indomethacin (IM) through Yucatan micropig skin in vitro was compared with 1-menthol. p-Menthane-3,8-diol is a metabolite of 1-menthol and has little odor. It is easy to combine the vehicle because of lower lipophilicity than 1-menthol. All formulations contained 40% (v/v) ethanol. The permeation of ANP increased with MDO about three times that without enhancer by increasing ANP concentration in the skin. However, the MDO effect was about a quarter that of 1-menthol. The permeation of IM with MDO was about 15 times that with no enhancer and it was almost the same as that with 1-menthol. The lag time of permeation was not significantly changed by MDO, which was not so in the case of 1-menthol. Skin concentration of IM increased about 11 times and six times with MDO and 1-menthol, respectively. MDO and 1-menthol partitioned to the skin relatively high concentrations, 5.9 and 2.5 mg/ cm3, respectively. The solubility of IM in the skin was improved by MDO, and consequently, the permeation of IM was enhanced.

A 38-year-old woman visited our hospital with edema on her face and conjunctivae. The underlying disease was not clarified, and she did not visit the hospital afterwards. She suffered from diarrhea, polyarthralgia, Raynaud's phenomenon, malar rash and hair loss in the subsequent two years, and was hospitalized because of hypoproteinemia. Her urine, liver and heart test results did not account for her hypoproteinemia. She was diagnosed as having protein-losing enteropathy (PLE) associated with SLE based on the 99mtechnetium-labeled human serum albumin scintigraphy findings, clinical findings and laboratory results of antinuclear and anti-Sm antibodies. This case report demonstrates a strong association between PLE and SLE because PLE was aggravated along with the appearance of SLE symptoms and PLE subsided with prednisolone treatment along with improvement of SLE.(Internal Medicine 40: 449-453, 2001)

The mechanism of stent thrombosis was evaluated by a flow chamber model. A Palmaz-Schatz stent was placed on glass surfaces coated with type I collagen in a parallel-plate flow chamber. Platelets were rendered fluorescent with mepacrine and whole blood was perfused through the chamber. Platelet thrombi formed around the implanted stents were continuously recorded by epi-fluorescent video-microscopy. Platelet thrombi appeared on the collagen surface within a few minutes in the absence of function blocking monoclonal antibodies. Antibody blocking vWF interaction with GP Ib alpha completely inhibited the platelet thrombi around the stent, but had no effect on platelet thrombus formation in the space between the stents and collagen, while both were inhibited by anti-GP IIb/IIIa. Our results suggest that two distinct mechanisms, one mediated by vWF interaction with GP Ib alpha occurring at high shear rates, and the other mediated exclusively by GP IIb/IIIa occurring at low shear rates, are involved in the process of platelet thrombus formation in the presence of stents.

We attempted to prepare a new griseofulvin formulation for topical application using N-methyl-2-pyrrolidone (NMP). Griseofulvin dissolves poorly in both water and oil, but dissolves in NMP to a concentration of about 100 mg/ml. A soybean oil-water emulsion with soybean lecithin and NMP as emulsifier and co-solvent, respectively, was prepared using a Microfluidizer, a high-pressure homogenizer. The size of the droplets in emulsion was about 200 nm, and the emulsion was stable for over 3 months. The skin permeation of griseofulvin through Yucatan micropig skin was studied in vitro using vertical type cells under donor phase open conditions. The permeation of griseofulvin from the NMP-water mixture (0-40%) into the skin tended to increase with increasing NMP concentration, although this finding was not statistically significant. Permeation from emulsion (oil phase, 20%; NMP 10-40%) was significantly higher than that from the water-NMP mixture. Permeation from the oil-NMP mixture was highest among the formulations investigated, and permeation from emulsion under donor phase closed conditions was significantly lower than that under open conditions. We believe that the evaporation of water from the emulsion after application to the skin was an important factor in skin permeation enhancement. When the emulsion containing 3% l-menthol was applied, a sufficient skin concentration (47 microg/cm3 in dermis) was obtained.

An 18-year-old woman was admitted to the medical center near her home with complaints of high fever and severe headache in June 1995. A diagnosis of adult-onset Still's disease was suspected and 50 mg/day of prednisolone was orally administered. In early April 1997, the patient suffered from sudden bilateral hearing loss and high fever. Pure tone audiogram taken at the same time showed an asymmetric bilateral neurosensorial hearing loss. A diagnosis of Cogan's syndrome was made. Administration of 60 mg prednisolone daily improved fever. Audiogram taken one month after administration of prednisolone showed improvement in the right ear. Monthly cyclophosphamide pulse therapy 700 mg combined with oral prednisolone was instituted. This combination therapy enabled the successful tapering of prednisolone without recurrence of hearing loss. Combined corticosteroid and pulse cyclophosphamide therapy would appear to be one effective regimen for Cogan's syndrome.

SummaryRecent investigations have revealed the crucial role of von Willebrand factor (vWF) in platelet thrombus formation under flow conditions. The plasma concentrations of vWF were measured together with various hemodynamic and hemostatic parameters in 51 cases of acute myocardial infarction. In 10 randomly selected cases, the plasma concentrations and distribution of multimers vWF were serially determined after reperfusion therapy by percutaneous transluminal coronary angioplasty (PTCA). The vWF concentration at the onset of the acute myocardial infarction was significantly higher than in an age-matched control group (vWF AG: 18.7 ± 1.2 µg/ml vs. 10.3 ± 0.5 µg/ml, p = 8.43×10− (12), mean ± SE). Simultaneous determination of hemodynamic and hemostatic parameters revealed that the only two parameters that were significantly correlated with the patients` plasma vWF concentrations were their pulmonary capillary wedge pressure (PCWP) and heart rate, suggesting a relationship between hemodynamic changes induced by the onset of myocardial infarction and the vWF plasma concentrations. Serial determinations revealed that the vWF concentrations had not changed 1 h after reperfusion therapy, but that they significantly increased by 24 to 72 h. The distribution of the larger multimers of vWF also increased in the acute and subacute phase. The vWF concentration and multimer distribution normalized 14 days after the onset of the myocardial infarction. Our findings suggest that the vWF concentration increased in acute myocardial infarction patients, possibly in association with the hemodynamic deterioration that occurs in acute myocardial infarction.

脱水により血液が濃縮され, 血漿蛋白濃度が上昇すると静脈血栓症の発症リスクが増加することが知られている. 血流下で形成される動脈血栓症の発症機序は, 血流のうっ滞下でのフィブリン生成による静脈血栓の発症機序とは異なり, 血小板が重要な役割を果たす. 動脈血栓の発症におよぼす血液濃縮の影響は明らかではない. われわれは, 血流下の血小板血栓の形成に重要な役割を演じる von Willebrand factor (vWF) 依存性の血小板凝集におよぼす血漿蛋白濃度の効果を検討した. 健常成人11名より, 1,000mlの等張水摂取前後に採血し, 多血小板血漿および乏血小板血漿を作成した. 多血小板血漿を乏血小板血漿にて希釈することにより血小板数を同一にした. vWF依存性の血小板凝集が惹起される10,800s-1, fibrinogen 依存性の凝集が惹起される1,200s-1, 両者の中間のずり速度下にて血小板凝集率を計測した. vWFと血小板膜糖蛋白GP Ibαの結合を抑制するモノクローン抗体 (LJ-Ib1) の効果を検討した. vWF依存性の血栓形成におよぼす血漿蛋白濃度の効果を確認するために, 健常成人より採血した血液から洗浄血小板浮遊液を作成した. 5mg/ml, 25mg/ml, 50mg/mlのウシ血清アルブミン (BSA) の存在下での, ずり速度下の血小板凝集率を計測した.飲水により血漿蛋白濃度は6.9±0.5g/dlから6.6±0.6g/dlに減少し, 10,800s-1のずり速度下の血小板凝集率は43.1±4.0%から50.4±5.4%に増加した (p

We investigated the characteristics and frequency of multiple primary neoplasms (MPNs) in patients with oral cancer. Of 327 patients with primary oral squamous cell carcinoma treated between 1974 and 1995, 59 (18.0%; mean age 65.5 years; 44 males and 15 females) exhibited MPNs. Most of the 59 patients had cancer of the mouth floor and most of their MPNs were in the gastrointestinal (GI) tract, namely in the esophagus, stomach, large intestine and liver. Since 1992, the use of routine upper GI examination in oral cancer patients has increased the detection rate of esophageal or stomach MPNs. We also examined for the presence of hepatitis C virus (HCV) antibodies (anti-HCV) in the serum of 30 patients and HCV RNA in 21 of the 59 patients with MPNs. In the oral cancer patients with MPNs, serum anti-HCV and HCV RNA were detected in 36.7% (11/30) and 28.6% (6/21), respectively, suggesting that HCV infection increases the risk of the development of MPNs. These results suggest that MPNs are frequently found in oral cancer patients and HCV infection should be considered to increase the risk of the development of MPNs in the patients.

Background: Ulcerative colitis is an intractable inflammatory colonic disease, and its etiology remains unclear. Saireito, a traditional herbal medicine, is widely used for treating ulcerative colitis in Japan. We analyzed the immunological characteristics of an oxazolone (OXZ)-induced colitis (OC) model and examined the effects of sareito on this model. Methods: OXZ was injected into the colon of BALB/c mice. Saireito was orally administered once a day for 3 consecutive days. Colitis was assessed by scoring the symptoms and macroscopic findings. The transcription patterns in the middle colon and spleen were analyzed with global transcriptome analysis and real-time polymerase chain reaction (PCR). Results: The above-mentioned scores were increased in the OC mice. The transcription levels of Th2 cytokines were significantly upregulated in the spleen and middle colon of the OC mice, whereas those of the Th1 cytokine interferon (IFN)-γ decreased in the spleen and increased in the middle colon. Saireito significantly ameliorated OC. In the middle colon of the saireito-treated mice, enhanced expression of Th2 cytokine mRNAs was markedly downregulated, while that of IFN-γ mRNA was further upregulated. In contrast, in the spleen, saireito had no effect on the transcription of either type of cytokine. After global transcriptome analysis, real-time PCR analysis revealed that saireito greatly downregulated the enhanced expression of the suppressor of cytokine signaling (SOCS)-3 mRNA in the middle colon of OC mice. Conclusions: Saireito exhibits inhibitory effects on OC by the induction of Th1-polarized immune responses in the mucosal immune system of the colon.

The therapeutic efficacy of immunosuppressants for treating rapidly progressive glomerulonephritis (RPGN) with crescent formation remains controversial. SCG/Kj mice spontaneously develop RPGN-like symptoms, characteristic of crescentic glomerulonephritis and systemic small vessel vasculitis, associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA). We evaluated the "ameliorative", not prophylactic, effects of immunosuppressive agents, deoxyspergualin (DSG), cyclophosphamide (CYC) and prednisolone (PDN), on RPGN in these mice. DSG at intraperitoneal doses of 3 and 6 mg/kg, CYC at an oral dose of 12 mg/kg, or PDN at an intraperitoneal dose of 120 mg/kg was administered once a day for 21 days to female mice "at the onset of hematuria". A set of control SCG/Kj mice received only saline injections. DSG and CYC significantly prolonged survival, improved the proteinuria, hematuria and hyperuremia, and decreased the serum level of myeloperoxidase-ANCA. Moreover, DSG significantly suppressed the formation of crescents in glomeruli. PDN failed to affect any of the parameters. DSG might be useful for inducing remission in crescentic glomerulonephritis involved in RPGN.

By means of three isotope tracer techniques, proportion of direct runoff and characters of groundwater runoff were studied in the Iwami River drainage during a high runoff period for about 3 days, caused by a heavy rainfall of 85 mm for 17 hours. The proportion of direct runoff is 15% or less of the total runoff caused by the rainfall, while 65% of river water at the peak of runoff. Differences observed in the runoff manners among 18O, 2H, and 3H are interpreted as a result of preferential runoff of previous precipitations stored in some unsaturated zone above the saturated groundwater zone. Cl- content is not conservative as a tracer to study runoff mechanisms.

We attempted to clarify the usefulness of transesophageal echocardiography performed using a standardized Valsalva maneuver to detect the presence of a patent foramen ovale in Japanese patients with ischemic stroke. Four hundred ninety six patients with ischemic stroke who were admitted to the Yokohama City Brain and Stroke Center between September 1999 and February 2002 were enrolled for the study. All the enrolled patients underwent transesophageal echocardiography with contrast injection and color Doppler imaging. During the procedure, a standardized Valsalva maneuver was performed to induce right to left shunting through a patent foramen ovale. Other related structural abnormalities, such as atrial septal aneurysm and the Chiari network anomaly, were also detected by the test. Transesophageal echocardiography without the Valsalva maneuver revealed a functional right to left communication in only 8.2% of the ischemic stroke patients, whereas the procedure conducted using a standardized Valsalva maneuver to provoke shunting revealed a patent foramen ovale in 15.3% of the patients. The presence of an atrial septal aneurysm or the Chiari network anomaly was not sensitive or specific enough to predict the presence of a patent foramen ovale as diagnosed by transesophageal echocardiography using the standardized Valsalva maneuver. Our results suggest that the standardized Valsalva maneuver is a safe and useful technique to detect the presence of a patent foramen ovale, which is potentially known to be associated with paradoxical embolism.

A 53-year-old male was admitted because of pancytopenia and chronic subdural hematoma. Bone marrow was hypercellular with 97% blasts, which expressed CD10, CD19, CD20, and immunoglobulin mu and gamma chains on the cell surface and had chromosomal abnormalities including t(8 ; 22)(q24 ; q11). The patient was diagnosed as having Burkitt leukemia. Because hemiplegia and disturbance of consciousness developed rapidly, the patient was treated with an emergency drainage operation followed by Hyper-CVAD therapy and achieved a sustained complete remission. Dural infiltration of leukemic cells as well as thrombocytopenia was implicated in the pathogenesis of the subdural hematoma, which contained numerous blasts.

We report a case with pleomorphic carcinoma of the lung in a 70-year-old man. Pleomorphic carcinoma is characterized by a heterogenous composition that includes epithelial and mesechymal malignancies. In the present case, the tumor was composed of a mixture of unequivocal squamous cell carcinoma and spindle cell components resembling sarcomatous overgrowth. The spindle component did not include a heterologous mesenchymal element characterized by overt differentiation for bone, cartilage, neuron or muscle tissue. To evaluate a state of differentiation of the spindle cell component, we immunohistochemically examined expression of the antigens including vimentin, cytokeratin, sarcomeric actin, alpha-smooth muscle actin, S-100 protein, CD34, Factor VIII, and CD68. The results showed sole expression of vimentin in the spindle cell component, suggesting an immature state of the mesenchymal lineage. Furthermore, the spindle cell component of this case was genetically characterized by loss of heterozygosity (LOH) at a codon 234 of exon 7 of the p53 gene. This mutation causes an amino-acid replacement (Tyr to Cys), which was previously proven to attenuate p53 function. The present case may suggest a relation between somatic alteration of the p53 gene and histogenesis of pleomorphic carcinoma.

A 57-year-old man was referred to our hospital because of elevated ALP. CT and MRI scans together with abdominal angiography showed multiple masses in his abdomen and portal vein obstruction. A diagnostic laparoscopic examination revealed a tumor of 3 cm x 3 cm near the portal vein and para-aortic lymphadenopathy. Histopathological examination of the tumor showed abnormal follicles with poorly formed germinal centers, scattered large spindle cells with proliferation of small lymphocytes, and hypervascular interfollicular tissue. The spindle cells were positive for follicular dendritic cell markers CD21, CD35, and epithelial membrane antigen. The diagnosis was made of a follicular dendritic cell (FDC) tumor in Castleman's disease (CD) of the hyaline-vascular type. Although the portal vein was obstructed by the FDC tumor, blood flow to the liver was retained by collateral vein. The patient did not show any response to four courses of CHOP therapy and died of obstructive jaundice, biliary tract infection and sepsis. So far, 17 cases of FDC tumor complicating CD have been reported, with a poor prognosis in all cases.

Background : Thrombocytopenia is recognized as one of the most common complications when the patients with severe heart failure are treated with cardiotropic phosphodiesterase (PDE)-3 inhibitors. To understand the mechanism of the onset of this complication, we focused on the effects of various PDE-3 inhibitors and its stable metabolite of acetylamrinone on platelet aggregation occurring under physiological shear stress conditions. Method : Blood specimens were obtained from eight apparently healthy adult donors. Platelet-rich plasma was separated after anticoagulation by citrate. The effects of PDE-3 inhibitors of amrinone and olprinone, as well as the stable metabolite of the former of acetylamrinone, on platelet aggregation induced by its exposure to a shear rate of 1200 and 10,800 s −1 were determined by optically modified cone-plate viscometer. Results : Both olprinone and amrinone inhibited platelet aggregation at 10,800 s −1 in a dose-dependent manner with the IC 50 value of 14±1 and 61±8 μM (mean±S.D.), respectively, while amrinone significantly inhibited platelet aggregation at 1200 s −1 only at highest concentration tested (100 μM). Contrary to the effects shown with PDE-3 inhibitors, acetylamrinone did not inhibit platelet aggregation at all. Moreover, it even enhanced the aggregation at 1200 s −1 when used with 5 μM. Conclusions : Our results demonstrate possible contribution of the enhancing effects of acetylamrinone on platelet aggregation occurring under blood flow conditions, which reduced the platelet count when occurring in real circulation, to the higher incidence of thrombocytopenia in patients treated with amrinone.

3-l-Menthoxypropane-1,2-diol (MPD) is a derivative of l-menthol, which has an enhancement effect on drug permeation through skin. In this study, the effect of MPD on drug permeation through skin was compared with that of l-menthol. MPD or l-menthol at final concentrations of 3% in 40% ethanol was added to the drugs indomethacin or antipyrine and each mix then applied to Yucatan micropig skin in vitro. Drug concentrations in the skin were higher in the presence of either MPD or l-menthol, however, only l-menthol shortened the lag time of permeation. MPD enhanced the skin permeation of the drugs only by increasing the skin concentration of the drugs. In contrast, l-menthol enhanced the skin permeation of the drugs by increasing both the skin concentration and the diffusion rate in skin. The infrared (IR) spectra and X-ray diffraction patterns of stratum corneum after treatment with MPD did not differ from those of intact stratum corneum. A change in the IR spectra of stratum corneum after treatment with l-menthol was observed at the CH band, and the peaks representative of the lipid structure in the X-ray diffraction patterns decreased in intensity. These results suggest that l-menthol, but not MPD, disrupts the intercellular lipid structure of stratum corneum. Thus, MPD is expected to be a moderate skin permeation enhancer.

Platelets, which can adhere to damaged vascular surfaces and release bioactive substances upon activation, may play important roles in regulating local inflammatory responses. We focused on the surface translocation of CD40 ligand (CD40L) molecules when the platelets are exposed to a high shear stress.Blood specimens were obtained from eight apparently healthy adult donors. The number of CD40L molecules appearing on the surface of platelets after exposure of platelet-rich plasma to a shear rate of 10,800 s(-1) was determined by quantitative flow cytometry.The number of anti-CD40L IgG molecules bound per platelet increased from 15+/-80/platelet before to 355+/-122/platelet after exposure of the platelets to a shear rate of 10,800 s(-1) (p0.01), but not after their exposure to the relatively low shear rate of 1200 s(-1). This shear-induced platelet surface translocation of CD40L, mediated by the von Willebrand factor (VWF)-GP Ibalpha interaction, was enhanced in the presence of a low concentration of epinephrine (100 nM), which by itself, however, could not cause platelet activation. Our results demonstrate that fluid force induces the appearance of CD40L on the surface of platelets, and also that this phenomenon is enhanced in the presence of a low concentration of epinephrine, corresponding to that released by sympathetic stimulation.

The hyoid bone is movable and anatomically protected by the mandibule andcervica vertebrae. Hyoid bone fractures are therefore very rare.We recently encountered a case of hyoid bone fracture which required tracheotomy andopen reduction of the upper jaw fracture.The patent was a 44-year old male, who was strongly hit in the face by a flying tileduring typhoon No.19. A discussion of the literature is also presented.

Objective. Psychological stress has an influence on natural killer cell (NK) activity, which plays a central role in protection against microbial infection and cancer. Anxiety concerning cancer is a typical type of psychological stress observed in patients and is associated with various diseases. In this study, we examined whether anxiety about cancer reduces the NK activity or quality of life (QOL), or both, of outpatients. Patients and methods. NK activity was determined by means of a 4-hour 51chromium-release assay, and a QOL questionnaire by the World Health Organization called QOL-BRIEF was also used. One hundred forty-four patients were asked a variety of questions about anxiety with respect to cancer and pain on their first visit to the outpatient clinic of our Department of Oral Surgery. Results. The NK activity in patients with anxiety about cancer was significantly lower (P

Recent investigations have suggested that von Willebrand factor (vWF) plays a crucial role in platelet thrombosis under flow conditions. The effects of plasma obtained from 15 patients with acute myocardial infarction and 10 patients with the chest pain syndrome as controls, on shear-induced vWF binding to platelets and subsequent platelet activation, as evidenced by microparticle release, were investigated by quantitative flow cytometry. Platelet-rich plasma was obtained from a 38-year-old healthy male volunteer with blood type O. Stored plasma from either the acute myocardial infarction or control patients was then added to the freshly prepared platelet-rich plasma in equal volumes. The mixtures were then exposed to specific shear rates in an optically modified cone-plate viscometer. The number of vWF molecules bound to the platelet surface and the number of microparticles released from the platelets were then measured by quantitative flow cytometry using an FITC-conjugated anti-vWF monoclonal antibody. The shear-induced increase in vWF binding to the platelet surface was enhanced in the presence of plasma from patients with acute myocardial infarction (acute myocardial infarction plasma). The shear-induced release of microparticles from platelets was enhanced from 889+/-134 in the presence of control plasma to 1045+/-222 in the presence of the acute myocardial infarction plasma (p

This report describes two arterial anomaly cases in the celiaco-mesenteric region, which were encountered in two Japanese male cadavers in the dissecting room at Kurume University School of Medicine in 1999. In these cases, the usual celiac trunks were not identified, and the hepato-mesenteric and the gastro-splenic trunks were independently arising from the abdominal aorta. Moreover, in the first case, the common hepatic artery passed ventral side of the portal vein and divided into the hepatic proper and the gastroduodenal arteries. This type of arterial anomaly belongs to the Type V of Adachi's classification and the Type IV' of Morita's classification. In the second case, the common hepatic artery passed dorsal side of the portal vein and divided into the hepatic proper and the gastroduodenal arteries. This type of arterial anomaly belongs to the Type VI of Adachi's classification and the Type IV' of Morita's classification.

This report describes an arterial anomaly case in the celiaco-mesenteric region, which was encountered in a Japanese male cadaver in the dissecting room at Kurume University School of Medicine in 1999. In this case, the usual celiac trunk was not identified, and the hepato-spleno-mesenteric and the gastro-phrenic trunks were independently arising from the abdominal aorta. In addition, the common hepatic artery divided into the left hepatic, the right hepatic, and the gastroduodenal arteries simultaneously, then, the accessory gastric artery arose from the left hepatic artery. This type of arteral anomaly belongs to the Type III of Adachi's classification and the Type II of Morita's classification.

In the oral region, granular cell tumors often occur in the tongue, but rarely in the buccal mucosa. A case of a granular cell tumor in the right buccal mucosa of a 74 year-old female is described. An elastic-hard solid mass about 1 cm in diameter was palpated under the right buccal mucosa. It was well-defined from the proximal tissues and adhered to part of the buccal mucosa. As a result of a biopsy, the diagnosis of a granular cell tumor was made. The tumor was resected together with the surrounding tissues under local anesthesia. Histopathological examination revealed large tumor cells with eosinophilic, PAS-positive fine granules under the hyperplastic epithelium. The granular cells stained negatively with PTAH, but positively with S-100 protein. Electron microscopic observations revealed a number of lysosomes of various sizes and densities within the cytoplasm of the tumor cells.

On being treated with trifluoroacetic anhydride, N-isopropenyl-N-methyl-α-(methylsulphinyl)acetamide (4a) underwent cationic alkene cyclisation to give the six-membered lactams (6) and (7), whereas the N-but-2-enyl (4b) and N-(3-methylbut-2-enyl) derivatives (4c) afforded the five-membered lactams (8) and (9), and (10), respectively. A similar treatment of the N-prop-2-enyl derivative (4d) gave only the Pummerer rearrangement product (12), which, on further treatment with trifluoroacetic acid, afforded the five-membered lactams (13) and (14). On the other hand, N-but-2-enyl-α-chloro-N-methyl-α-(methylthio)acetamide (5b), when treated with stannic chloride or silica gel, or when heated without solvent, gave the lactam (8). Treatment of N-prop-2-enyl derivative (5d) with stannic chloride yielded the lactams (14) and (15). The cyclisations of N-alk-3-enyl derivatives (4e), (4f), and (5e) giving seven-membered lactams are also described.

Internalization of antibodies by endothelial cells via fibronectin implicating a novel mechanism in lupus nephritis. Background One of the crucial events in lupus nephritis is the glomerular deposition of immunoglobulins (Igs), of which pathogenic properties have been proposed mostly to be either type IIor type III allergic reactions. Some of IgG3-producing hybridoma clones established from an MRL/MpTn- gld/gld (MRL/gld) lupus mouse generate wire loop-like lesions in glomeruli resembling lupus nephritis when injected into SCID mice. These clones are useful for analyzing the mechanisms of glomerular deposition of antibodies in lupus nephritis at the monoclonal level. Methods Glomerular lesions of SCID mice injected with the hybridoma clones, 17H8a or 1G3 as control were analyzed by light and electron microscopy. Interaction of the antibodies with human glomerular endothelial cells (HGECs) and human umbilical vein endothelial cells (HUVECs) in vitro was studied by fluorescence microscopy, electron microscopy, and flow cytometry. Results Both antibodies did not show any antigen specificity for mouse glomeruli. The glomerular lesions generated by 17H8a, but not by 1G3, contained electron-dense deposits not only in subendothelial regions but also in the cytoplasm of endothelial cells, suggesting internalization of the 17H8a antibodies by endothelial cells. In cell culture studies, internalization of only 17H8a antibodies by HGECs and HUVECs was observed, but the antibodies did not have antigen specificity for both types of endothelial cells. The internalization by HUVECs was mediated by actin polymerization, and it was inhibited by RGDS (Arg-Gly-Asp-Ser) tetrapeptide, antihuman fibronectin and antihuman integrin β 1 monoclonal antibodies. Conclusion The interaction between particular antibodies and endothelial cell surface integrins via fibronectin may be involved in their subsequent internalization by endothelial cells leading to antibody deposition in glomeruli. This may be one of the mechanisms of glomerular injury in lupus nephritis.