Glycosaminoglycans (GAGs) level in joint fluid have been investigated in various joint diseases as a joint maker. However, there are very few studies of normal joint fluid providing a baseline for a better understanding of altered GAGs level in pathological joint fluid. We investigated GAGs level in knee joint fluid for 25 healthy young volunteers with a mean age of 27.5 years (range: 18 to 36 years) . Biochemical evaluations included the concentration of hyaluronic acid (HA) , chondroitin 4-sulfate (C4S) and chondroitin 6-sulfate (C6S) , and the C6S/C4S ratio. The unsaturated disaccharides derived from HA by Morgan-Elson methods, and those from CS were measured with high performance liquid chromatography. The mean HA concentration was 3.4± 0.6 mg/ml. The mean concentration of C4S and C6S, and C6S/C4S ratio were 19.0± 4.9 nmol/ml, 125.5± 44.4 nmol/ml and 6.5± 1.1 respectively.

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Background: Left ventricular remodeling (LVR) process is one of the important secondary sequele after acute myocardial infarction (AMI) . However, little is known about the relationship between LVR and angiotensin converting enzyme (ACE) gene polymorphism as well as endothelial nitric oxide synthase (ecNOS) gene polymorphism.
Methods: Coronary angiography and left ventriculography were performed within 24 hours and 30± 7 days after AMI onset. All consecutive 24 patients (57± 6 years) had acute anterior MI with one vessel disease of left anterior descending artery and successful revascularization therapy during acute phase. Patients were divided into three groups according to the change of end-diastolic volume index (EDVI)(Δ EDVI=EDVI 1 month-EDVI within 24 hrs) ; LVR (+)(Δ EDVI>7.0 ml/m², n=5) , LVR (-)(Δ EDVI<-7.0 ml/m², n=13) , and LVR (+/-)(-7.0<Δ EDVI<7.0 ml/m², n=6) groups. The polymorphisms of ACE and ecNOS gene were determined with PCR method after an extraction of genomic DNA from peripheral leukocytes.
Results: There were no significant difference among three groups as to baseline characteristics, including coronary risk factors, medications, serum CPKmax and patency of infarct-related artery. The incidence of DD genotype of ACE gene is significantly higher in LVR (+) than in the other two groups (0.60; 0; 0, respectively, χ ²=13.150, p<0.01) . The incidence of D allele of ACE gene is also significantly higher in LVR (+) than in the other two groups (0.70; 0.17; 0.19, respectively, χ ²=10.221, p<0.01) . Δ EDVI of DD genotype was significantly greater than in the other two groups (DD genotype=30.1± 18.1; ID genotype=-13.0± 27.4; II genotype=-8.2± 11.5ml/m², respectively, p<0.05) . There was no significant difference in ecNOS gene polymorphism among three groups. By stepwise regression analysis, the significant independent predictors of Δ EDVI were EDVI within 24 hrs and DD genotype (F=16.88 and 8.641, respectively, p=0.0024) .
Conclusion: These results showed that left ventricular dilatation is related to DD genotype of ACE gene after successful reperfusion therapy of anterior AMI. Thus, renin-angiotensin system may play an important role in left ventricular remodeling after AMI.

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1) Objective: We examined the clinical usefulness of two techniques of Angio Computed tomography (CT) , namely, CT arteriography (CTA) and CT during arterial portography (CTAP) , for the diagnosis of early hepatocellular carcinoma (HCC) and early advanced HCC.
2) Materials and Methods: The subjects were six patients with a total of seven lesions: three had one early HCC lesion each, and three had four early advanced HCC lesions between them. There were five men and one woman, aged 61~73 years (mean: 65 years) . A catheter was inserted into each inguinal artery according to Seldinger's method, and the results of CTA and CTAP were compared with those of conventional CT.
3) Results: Visualization of tumor borders, arterial blood feeding areas, and portal blood flow areas gave results equal to or better than those of conventional CT.
4) Conclusions: A combination of CTA and CTAP is useful for the diagnosis of early HCC and early advanced HCC.

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It has been reported that circulating anti-p53 antibodies (p53-Ab) in the serum are detected in some cancers. To investigate the usefulness of detecting p53-Ab, we measured the circulating p53-Ab in comparison with squamous cell carcinoma antigen (SCC-Ag) in patients with esophageal carcinoma. Serum specimens from 46 esophageal cancer patients (42 squamous cell carcinomas, 3 mucoepidermoid carcinomas and 1 basaloid squamous carcinoma) and 13 healthy subjects were studied. Serum p53-Ab was measured by an enzyme-linked immunosorbent assay. Surgically resected specimens from 43 patients were immunohistochemically stained for p53. Serum SCC-Ag was measured by a radioimmunoassay. The results were analyzed with the clinical data and outcome. Serum p53-Ab was detected in 13 (28%) of the 46 patients, but not in any of the healthy subjects. The positive rate was 0% (0/6) in stageI, 60% (3/5) in stage IIA, 30% (3/10) in stage IIB, 29% (7/24) in stage III and 0% (0/1) in stage IV. There was no difference in the outcome between the p53-Ab-positive and p53-Ab-negative patients. Immunohistochemically, 30 (70%) of the 43 specimens stained positively for p53. Serum p53-Ab was detected in 43% (13/30) of the patients with tumors which stained positively for p53. There was a close correlation between positivity for p53 immunostaining and positivity for p53-Ab (p<0.01) . An elevated level of SCC-Ag was found in only 13%of the patients, and most patients positive for SCC-Ag already had advanced disease with lymph node metastasis and invasion to the adventitia. In conclusion, serum p53-Ab was detected in Japanese esophageal cancer patients at a frequency similar to that reported in Western countries. Serum p53-Ab may be a potentially useful molecular marker for detection and screening of esophageal cancer. Further studies of a large population may be required to elucidate the true diagnostic usefulness of measuring the serum p53-Ab.

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Laser scanning confocal fluorescence microscopy techniques were used to study the localization of von Willebrand factor (vWf; Factor VIII-related antigen) and thrombomodulin (transmembrane receptor for thrombin) in the microvascular endothelial cells in the normal human lung. Tissues were obtained from lobectomy specimens resected for solitary nodules (7 adenocarcinomas and 4 hamartomas) from 11 patients. The plasma membranes of the capillary endothelial cells in the alveolar zones (A-zones) showed red linear fluorescence for thrombomodulin. However, their cytoplasm was mostly unreactive for vWf. The microvessels which were located in the connective tissue (C-zones) , including peribronchial, and subpleural areas and large vascular walls, consistently demonstrated band-like green fluorescence for vWf in their cytoplasm, and their plasma membranes usually lacked reactivity for thrombomodulin. Only a limited number of peribronchial capillaries measuring<10μm in diameter showed a mosaic-like appearance, in which red fluorescence along the plasma membranes was found together with green fluorescence in the subjacent cytoplasm. In the juxtaalveolar (J-zones) microvessels located along the borders between A- and C-zones, and measuring up to 40μm in diameter, the endothelial cells showed a mosaic-like pattern of distribution of the two antigens. However, the localization of thrombomodulin in the J-zone microvessels was separate and independent from that of vWf. The thrombomodulin-reactive cells were directly connected to the alveolar capillary endothelial cells. Heterogeneous patterns of distribution of thrombomodulin and vWf suggest that topographic differences of endothelial function occur to maintain a balance of coagulation and anticoagulation in the normal human lung.

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During the influenza epidemic of 1998-1999, we observed two elderly patients with influenza-like symptoms who had evidence of acute myositis with elevated serum enzymes. Influenza A infection was confirmed serologically in either case. The present cases suggest that it is important to distinguish influenzal myositis from other forms of myopathy in the elderly patients.

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We report a 28-year-old male patient with a pituitary insufficiency after a simple fracture of the sella turcica. He was injured by a long nail that punctured the lower jaw. No fracture other than that of the sella turcica was detected. An endocrinological examination revealed both anterior and pituitary dysfunction and diabetes insipidus that continued for about two months.

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