The morphology of the basilar artery and its branches was studied in 52 human brains with special reference to arterial anastomosis, and its course and distribution on the pontine ventral surface. The results were as follows:
1. Main trunk of the basilar artery
(1) The average maximum and minimum external diameter was 3.93 ± 0.76 mm and 3.14 ± 0.58 mm, and the average length was 35.0 ± 5.1 mm.
(2) Fenestration was observed in one case (1.9%).
(3) The shape of flexion was classified into three types: S-shaped (18 cases=34.6%), inverted S-shaped (29 cases=55.8%) and straight (5 cases=9.6%).
(4) The average angle of flexion was 32.5 ± 24.5°. A positive correlation was observed between age and the angle of flexion; the coefficient was 0.31.
2. Branches of the basilar artery
(1) The average number of branches from the main trunk of the basilar artery was 22.8 ± 3.94. The main trunk was divided into three equal portions: the rostral, intermediate and caudal. Of all the branches, 43.9% arose from the rostral portion, 33.3% from the intermediate portion and the remaining 22.8% from the caudal portion.
(2) Forty-eight percent of all the branches had an external diameter ranging from 0.35 mm to 0.55 mm, and this size was predominant in the branches from each of the three portions.
(3) Of all the branches, 45.4% had a diverging angle between 45°and 90°. This was the predominant range of diverging angle in the intermediate and rostral portions. In the caudal portion, however, the predominant diverging angle tended to range from 0° to 45°.
3. Arterial anastomosis, course and distribution on the pontine ventral surface
(1) Ninety-nine anastomoses were found on the pontine ventral suface in 42 cases. Fifty-seven anastomoses (57.5%) were found between pontine branches and 21 (21.3%) between a pontine branch and an anterior inferior cerebellar artery. More anastomoses were
Correspondence to Yoh Nishijima, Department of Anatomy, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113, Japan found in the median area than in the lateral area.
(2) A number of arterial distributions were observed along the basilar sulcus in the middle and lower parts, around the facial and vestibulocochlear radices and around the trigeminal radix. Many branches had a downward distribution along the basilar sulcus in the middle and lower parts, an outward distribution around the facial and vestibulocochlear radices, and a downward or outward distribution around the trigeminal radix.
(3) Of all the trigeminal radices, 55.8% were supplied only with pontine branches, 1.9% only with an anterior inferior cerebellar artery, and 36.5% with both of them.

抄録全体を表示

Xenografting can be accomplished by using encapsulated cells in the alginate microcapsule.
Using this technique, the experiment was made to investigate the stroma-promoting factors that were produced by the encapsulated differentiated (MKN-28) and undifferentiated (KATO-III) gastric cancerous cell lines.
Fibronectin (FN) in the medium was quantified by single culture with the human fibroblast cell line (CCD-32Lu) and coculture with CCD-32Lu and the encapsulated MKN-28 ro KATO-III.
Then following this procedure, each capsule including the gastric cancerous cells was subcutaneously transplanted into Wistar Rats. After 14 days, the surrounding tissues of the microcapsules were stained, and the localization of type III collagen, 4 and 6 chondroitin sulfate, and FN were observed by immunohistochemical stainings.
The concentration of FN in both single culture and coculture medium gradually increased, especially in the medium complemented with KATO-III and CCD-32Lu. The measured point after 48 hours demonstrated the obvious increase compared to the single culture and coculture medium.
Upon the histological comparison, it was found that the stromal proliferation around the tissue transplanted the microcapsules including MKN-28 or KATO-III were distributed more abundantly than the transplantation of microcapsules only. However, no difference was noted between the stroma of MNK-28 and KATO-III.
In conclusion, this study suggests that any stroma-promoting factor is produced by the gastric cancerous cells.

抄録全体を表示

Little is known today about the long-term influence of the anti-cancer antibiotic, Adriamycin (ADR), on the cell cycle. With this in mind, the author used flow cytometry (FCM) to observe the changes with time in the cell cycle. The changes were examined every 24 hours for 14 days. Prior to this HeLa S3 cancer cells were cultured in three ADR concentrations -0.01 μg/ml, 0.1 μg/ml, 1.0μg/ml-. In the cell group exposed to the low ADR concentration of 0.01μg/ml for one hour, no noteworthy effect on the cell cycle was noted, and the cell count was slightly depressed as compared with the control group. In the group exposed to the moderate ADR concentration of 0.1μg/ml for one hour, the G₂ phase cells increased in number after 24 hours, but decreased on and after ten days, though there was an increase in the number of G₁ phase cells. In addition, the cell count, which had shown no growth till the eighth day, began to increase on and after the ninth day. In the cell group exposed to the high ADR concentration of 1.0μg/ml for one hour, complete G₂ block was observed on and after the 24th hour, with no subsequent change. The cell count also continued to decrease. The previous assumption that once G₂ block has been caused by ADR, the cell group dies, was again shown to be valid. It was also observed that in the group exposed to a moderate ADR concentration of 0.1μg/ml for one hour, the G₂ phase cells shifted to the G₁ phase, with an increase in the cell count and resumption of cell growth. This finding implies that the effect of an anti-cancer agent on the cell cycle becomes ineffective on the tenth day after administration. This should be taken into account when considering the timing of re-administration of an anti-cancer agent.

抄録全体を表示

Enterocolitis caused by methicillin-resistant Staphylococcus aureus (MRSA) has recently been recognized as one of the severe postoperative complications in surgery on the digestive organs. This disease often occurs in the early days after gastrointestinal operation, especially after gastrectomy. MRSA enterocolitis seems to occur when MRSA has first infected the naso-pharyngeal mucosa preoperatively, and then moved into the stomach, and subsequently proliferated in the higher pH gastric juices.
The aim of this experiment was to reveal the relationship between the acidity of gastric juices and bacterial growth in the stomach during the pre and post operative period in an effort to prevent of MRSA enterocolitis.
In vitro, MRSA was cultured for various periods at various pH values, and its proliferation was observed. MRSA did not grow in the culture at pH 1 at all, neither did it grow at pH 2 when cultured for more than 8 hours. This data shows the germicidal effect of high acidity in the stomach. Clinically, twenty patients with cancer in the digestive tract had the bacteria in their gastric juices examined in terms of acidity before and after operation. In cases with an increased pH level in the gastric juices after the operation, S. aureus including MRSA, was isolated frequently from the stomach. In vitro, incubation of MRSA with gastric juices collectd from those cases showed no development of MRSA when the pH was below 3.98.
In order to prevent the onset of MRSA enterocolitis, the remnant stomachs of ten patients with stomach cancer were filled with hydrochloric acid lemonade just after operative reconstruction. After this treatment, gram-positive organisms including S. aureus decreased in number in the stomach.
In conclusion, keeping the acidity of the gastric juices high is an effective means of reducing bacteria in the stomach. It is suggested that the administration of hydrochloric acid lemonade through a naso-gastric tube into the remnant of the stomach will reinforce the barrier inside the stomach against MRSA and will be very effective in preventing enterocolitis.

抄録全体を表示

Scabies has become a common disease, not sexually transmitted but transmitted in households. Although it is also known to cause an epidemic in hospitals for the aged patients or residential homes, no effective treatment was taken for it at the present time.
From January 1985 to December 1992, 424 patients with scabies (249 males and 175 females) visited the Dermatological clinic of Nippon Medical School Main Hospital. In these cases, only 13 patients (3.1%) were recognized as having STD. The sources of infestation were unclear in most cases where the disease was transmitted in households, which account for 38.5% of the patients. In 68 cases (16.0%), outbreaks of scabies in hospitals and residential homes affected the patients as well as the staffs and their families. The number of scabies cases which were infested in hospitals is increasing yearly. It is speculated that the hospitals for the aged patients and residential homes are becoming the main source of scabietic infestation.
Only 16.6% of the patients were previously diagnosed or suspected to have scabies by their family doctors. It seems that the diagnosis of scabies is extremely difficult for the general practitioner. A considerable number of the patients who had been diagnosed or suspected to have scabies changed their doctor or stop visting them. This is because an appropriate treatment is not available in most of medical facilities.
At the time of the first visit to our clinic, 93.6% of the patients was diagnosed or suspected to have scabies, and the mite was demonstrated in 63.2% of the patients. It is suggested that careful inspection of scabietic burrows and the skillful technique to demonstrate the mite are essential to establish the diagnosis of scabies.
Atopic dermatitis was the most common diagnosis of the patients who were misdiagnosed at the first time and later turned out to have scabies. These patients did have atopic dermatitis besides scabies.
After the treatment with benzyl benzoate with crotamiton, 70.3% of the patients were cured and up to 94.9% of the patients were over improved. We compared the therapeutic effect of phenothrin to that of benzyl benzoate. Benzyl benzoate had more antipruritic effect and a little more improvement of skin lesion than phenothrin. However, there was no significant difference between benzyl benzoate and phenothrin in the period of time until the skin lesion cleared. Phenothrin is considered to have an adequate therapeutic effect for scabies.

抄録全体を表示

Aromatic nitro- and amino-compounds (ANA) are notorious methemoglobin forming substances. From 1987 to 1993, the author surveyed the exposure level to ANA and health status of workers in a chemical industry where they synthetize nitrophenol and anisidine from chloro-nitrobenzene. The ANA exposure indicator was the diazo-reaction positive substance in the worker's urine (Dz) and the biological effect of ANA was monitored through the methemoglobin concentration in the blood (MHb). The following results were obtained from the survey.
1. Both the Dz and MHb values tended to become lower between 1987 and 1993.
2. The MHb levels of the workers were a little higher than the control levels, and the difference between the values was statistically significant (p<0.01); both levels were, however, within the normal range.
3. The MHb value was estimable from a mathematical model:
MHb=(k1-k2/a)×DU×CH, where k1 and k2 were constants and a, DU and CH indicated the activity of glutathion S transferase in erythrocytes (GST), DZ in urine and blood hemoglobin concentration, respectively. The correlation coefficient of the multiple regression was statistically significant (R²=0.263, p<0.01). This model suggets that the biotransformed fraction of ANA in the pulmonary uptake site, the lung, could not penetrate into erythrocytes or act as an MHb former. The model seemed to be consistent and valid when urinary DZ values were less than 1.0 (mg/mg creatinine) and MHb values were less than 2.0 (mg/ml blood). Thus, the upper limit of normal levels for MHb can be considered to be 2.0 (mg/ml blood), or 12-1.6% of total hemoglobin in blood.
4. The significance of the uptake sites, i.e., lung, skin etc., was discussed with refer-ence to the evidence obtained from the longshoremen cases, who were percutaneously exposed to chloronitrobenzene in 1984.
5. Hemolysate solutions from the blood of workers were applied to isoelectric focus-ing electrophoresis (IEF), and Hb species of different valencies were separated; intermediate MHbs, where the heme iron in one of the components of Hb, i.e., in the α or β chain was oxidized and MHb where both the α and β chain heme iron oxidized and Hb X and Y, were separated and easily discernible. The correlation matrix was calculated using the data relevant to IEF and other indicators; MHb estimated spectrophotometrically, GST activity of erythrocytes, Hb and urinary DZ vale. The statistical procedure of principal component analysis was applied to the matrix, and two major principal components were extracted from the calculation. One of the components is relevant to the redox state of erythrocytes explained by MHb and Hb (X, Y) levels in the IEF pattern, and the other is relevant to detoxication by GST. The intermediate MHb values separated by IEF correlated to both of the components.

抄録全体を表示

Congenital heart disease and the coronary artry lesions of children suffering from Kawasaki disease were evaluated by cardiovascular angiography using a newly developed rotary three-dimensional digital angiography method, and the usefulness of the device was examined. This method enable the observation of lesions from 144 directions within a 180 degree range depicting an image from potimal directions. In addition, the radiation exposure during one angiography was about one fifth of that of conventional cineangiography.
With regard to the lesions of the coronary artery, identification of the localization of the stenotic lesions were made possible, especially at bifurcations, or the stenotic lesions overlapping with other bifurcations or coronary artery aneurysms as well as the structure at the ostium of the left and right coronary arteries, which were difficult to identify using conventional coronary artery angiography.
For the case of patient ductus arteriosus or major aortopulmonary collateral artery (MAPCA), separation and imaging of the overlap with other blood vessels through the three-dimensional observation became possible. This method is effective for the evaluation of the site, direction and morphology of these arteries.
With regard to stenosis of the right ventricular outflow tract, the morphology and the degree of stenosis could be evaluated more accurately than by conventional cineangiography. In addition, the images matched well with the operative findings. This method was also effective for the diagnosis and evaluation of the stenosis at the main pulmonary artery and stenosis of the bifurcation of the right and left pulmonary arteries overlapping with the main trunk of the pulmonary artery.
The problem with this method is that it cannot be used for the quantitative evaluation of the cardiac function because it cannot take images from multiple directions at the same time or cannot take temporal images from one direction.

抄録全体を表示

The dobutamine (DOB) stress body surface mapping tests were carried out to detect myocardial ischemia in 23 patients who had Kawasaki disease previously. Eight of 23 patients (group A) had coronary stenosis of 75% or more diameter reduction in major coronary arteries without sufficient collateral flow, as shown by the coronary angiography, but without myocardial infarction. Nine patients (group B) showed no ischemic change exercised ²⁰¹Tl myocardial scintigram. Six patients (group C) had myocardial infarction due to Kawasaki disease.
ST segment potential mapping (0.04 sec after the J point in QRS) and ST-T Isointegral mapping were performed using CVM-3000 system (87 leads), and the following calculations were made: number of leads with horizontal or down-sloping ST depression of 0.10 mV or more, lasting 0.08 sec (nST); row number of the minimum lead in the Isointegral map (Imin); number of positive leads on the seventh row in Isointegral mapping (I-7); number of positive leads on the first row in Isointegral mapping (I-1) and I-7/I-1 ratio. Based on these calculations the criteria for detecting myocardial ischemia (nST≤2, Imin≤2, I-7/I-1≥1) were created and their usefulness was tested using findings of coronary angiography and exercised ²⁰¹Tl myocardial scintigram as the golden standard.
For the diagnosis of ischemic lesion, the DOB stress body surface mapping test in group A had higher specificity (nST: 100%, Imin: 89%, I-7/I-1: 100% vs. 78%) and higher sensitivity (75%, 50%, 63% vs. 38%), than those by the Treadmill test, while ischemic changes were not detected in group C by this test. From these results it is concluded that it is useful in evaluating ischemic heart disease in children who can not perform Treadmill exercised test adequately.

抄録全体を表示

In order to clarify the molecular basis of the heterogeneity of rat hemoglobins, two DNA clones containing the genes for adlut type β-globins were isolated from a rat genomic DNA library. The results obtained in the present experiments are summarized as follows.
1) Clone λ Rg β59 contained the gene for an adult rat β-major globin, IIβ, while clone λ Rg β45 contained the genes for two adult rat β-minor globins, IIIβ, and Oβ, respectively.
2) The entire nucleotide sequences of these genes were determined, indicating that the genes are all composed of 3 exons and 2 introns, and code for 146 amino acid residues. The genes exhibited structural features typical to known expressed β-like globin genes, implying that they are all functional.
3) The predicted amino acid sequences completely agreed with the amino acid sequences of IIβ, IIIβ and Oβ globins, respectively, which we isolated in a separate experiment.
4) Sequence comparisons of three rat globin genes with one another and with the known mouse β-major and β-minor globin genes showed the occurrence of interesting homologies between two species from evolutional aspects.
5) Southern hybridization analysis of the genomic DNA implies that a number of β-like globin genes other than the present ones exist in the rat genome.

抄録全体を表示

Gaucher disease is the most prevalent lysosomal storage disease. Although the efficacy of the macrophage-targeted human placental glucocerebrosidase is well known, it is still difficult to develop definitive guidelines regarding the appropriate therapy schedule. We describe an 8-year-old Japanese boy with Gaucher disease who had avascular necrosis of the right femoral head without deterioration of hematological variables during low-dose enzyme replacement therapy (12-13 IU/kg). This case demonstrates that continuous normal hematological findings may not preclude progression of other aspects of Gaucher disease in some patients during enzyme replacement therapy.

抄録全体を表示