Time-course Effects of Hyperglycemia on the Levels of Glucose Transporter (Glut) 4 mRNA in Cardiac and Skeletal Muscle from Streptozotocin-induced (STZ) Diabetic Mice In the present study, we studied the effect of diabetes mellitus on the gene expression of glucose transporter (Glut) 4 in cardiac and skeletal muscle by using streptozotocin (STZ)-induced diabetic mice. The levels of Glut 4 mRN A in the heart increased to 272.9 % over those of control mice on 1 week after STZ injection, although the levels decreased to 46.0 % at 6 weeks after STZ injection. The levels of Glut 4 mRNA in skeletal muscle had fallen to 47.4 % of the control value by only 2 weeks after STZ injection. However, we could not detect any change of Glut 4 mRNA in skeletal muscle up to 6 weeks after STZ injection. Insulin did not affect the gene expression of Glut 4 in cardiac muscle. Thus, the results indicate that reduced expression of Glut 4 mRNA in the cardiac muscle by prolonged hyperglycemia may be one factor causing diabetic cardiomyopathy.

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An experimental study on implants for defects in a long tubular bone was performed on adult beagle dogs using 3 types (LT, MT, Sinter) of β-tricalcium phosphate (β-TCP). LT and MT are porous solids baked at 1100℃ and 1200℃, respectively. Sinter is a dense solid baked at 1200℃. Implants were implanted into the defect of the proximal metaphysis of the tibia. The dog was sacrificed at 4, 8, 12, 24 and 48 weeks. Postoperative findings were studied radiologically, macroscopically and histopathologically. With regard to contact microradiography (CMR) in the porous solids, the rate of the area of β-TCP and new bone was measured by Nicon Cosmozone 1s. β-TCP showed good affinity to the newly formed bone in all three specimen groups. In the 24 th and 48 th week, the newly formed bone extended to the center of the porous solids in both LT and MT. The rate of the area of porous solid declined between the 8 th and 12 th week in LT, but there after stopped declining, while the rate in MT continued to decline even after the 12 th week and had dropped to 33 % by the 48 th week. It is concluded that MT proved to be the best biomaterial for a biodegradable implant to be replaced by new bone.

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This experimental study was performed on rats to investigate a suitable concentration level of sodium fluoride on bone metabolism. The experimental osteoporotic rats were divided into two groups; a sodium fluoride group and a non-sodium fluoride group. The sodium fluoride group was divided into three more groups according to the concentration level of sodium fluoride, Ippm, 5ppm, and 10ppm. Then, the rats of these four groups were respectively divided into a high calcium diet group and a control diet group. Microdensitometer was used to measure, dry weight and ash weight in the femur. The rate of trabecular bone areas was measured in the proximal epiphysis of the tibia. Histomorphometrial parameters were measured in the third and fourth coccyx. Results: Compared to the non-sodium fluoride group, the sodium fluoride group showed increase of trabecular bone in microdensitometer measurements, dry weight, and ash weight in the femur. The rate of trabeculor bone in the proximal epiphysis of the tibia and the value of the histamorphometry in the coccyx indicated the same result. Especially 1 ppm of sodium fluoride proved to be the most efficient value for increase of trabecular bone. This study concluded that around 1 ppm of sodium fluoride was the most suitable concentration level. This study also proved that a combined therapy of 1 ppm of sodium fluoride and calcium increased the volume of cortical and trabecular bone.

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Twelve Shigella strains, isolated from stool cultures of two domestic dysentery cases and ten imported cases in Japan in 1985-1990, possessed atypical serotypes that could not be classified into the established Shigella serotypes. These strains had the typical biochemical characteristics of S. dysenteriae (4 strains), S. flexneri (7 strains), or S. boydii (1 strain). Eleven strains of them were positive on the Sereny test with guinea pig eye for invasiveness; this indicates that they can cause a shigellosis in humans. The results of antigenic analyses showed that four S. dysenteriae strains had provisional S. dysenteriae serotypes E23507 (2 strains) or 19809-73 (2 strains), and one S. boydii strain was provisional S. boydii serotype E16553, which respectively reported by Gross and Shmilovitz. Seven S. flexneri strains possessed two kind of new type antigens ; 88-893 (5 strains) or 89-141 (2 strains): which are not included among the known S. flexneri type antigen I-VI.

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An experimental study of remodeling of defects of articular cartilage was carried out by imbedding β-tricalcium phosphate (TCP) into the knee joints of 35 beagle dogs. Three kinds of TCP were prepared according to the rate of porosity (30%, 50%, 70%). After holes of 3.2 mm diameter were bored into the surface of the medial condyle of the femur in the dogs, cylindrical TCP were inbedded. The dogs were divided into a control group (non-imbedded) and three other groups with different levels of porosity in the imbedded TCP (30%, 50%, 70%). Between the 4 th week and 24 th week after the surgery, the dogs were investigated radiologically and histologically. Hyaline cartilage-like tissue were observed in some areas of fibrocartilage at 8 weeks and covered the defect at 24 weeks. As a result, the surface had become flat and smooth. In terms of TCP porosity levels, that with 50 % porosity showed the best remodeling, and excellent trabecular formation under the cartilage. From this study, it was concluded that TCP with 50 % porosity is an adequate material to reconstruct defects of articular cartilage.

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The tissue expression of c-erbB-2 protein, NCC-ST-439 and Type IV collagen in 95 primary breast cancers was investigated, and its relations with clinicopathological characteristics and prognosis were studied. Expression of the c-erbB-2 protein was found, in 24 cases (25.3%). In node negative patients, positive expression of c-erbB-2 protein showed a worse prognosis than the others. Concerning the first relapse site, a relationship between c-erbB-2 protein and distant metastasis was suggested. Expression of the NCC-ST-439 was found in 55 cases (57.9%), Type IV collagen was found in 41 cases (43.4 %), and positive expression showed a tendency of a worse prognosis than the others. The cases with positive expression of c-erbB-2 protein, NCC-ST-439 and Type IV collagen showed a 62.5 % highly recurrent rate. The tissue expression of c-erbB-2 protein, NCC-ST-439 and Type IV collagen is an important prognostic factor in breast cancer, especially it was thought that c-erbB-2 is useful for recurrent forecasts in node negative patients.

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We analayzed the morphological findings such as a frequency of back to back and the relationship between vessel and gland of hyperplastic Ieasions in endometrium using three dimensions reconstruction method (3-D reconstruction method). The histological diagnosis of these materials which had been used in this study were as follows ; 10 cases of normal proliferative endometrium, 14 cases of adenomatous hyperplaseia (ADH), 3 cases of atypical hyperplasia (ATH) and 10 cases of well differentiated adenocarcinoma (WDA). The finding, which was not observed in these lesions except for WDA, was the gland which combined more than four portions in one gland with back to back. Although the number of vessel in a low power field was 39.9 in ADH, 46.3 ATH and 12.7 WDA, the number of vessel combined with gland increased in WDA compared with hyperplasias. The finding, which was not observed in these lesions except for WDA, was the vessel which combined more than two glands. In 3-D reconstruction, a distortion of gland increased in WDA than hyperplasias, and the finding crowded many glands around the vessel was only detected in WDA. From these results, the appearance of vessel which directly combined with cluster of epithelial cells was comfirmed to be an important finding for the diagnosis of WDA in cytology.

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Retrospective study concerning the situation of lymph node metastasis was made in 276 patients with primary esophageal carcinoma that underwent esophagectomy and lymph node dissection with right thoracotomy and laparotomy, and the results were as follows. 1. Lymph node metastasis were not recognized in cases of up to the level of intraepithelium (ep) and muscularis mucosae (mm) invasion. 2. Lymph node dissection is necessary as much as possible in the cases of submucosal (sm) invasion and over. 3. There was no significant difference between the preoperative irradiation group and the no irradiation group concerning the incidence of jumping metastasis in patients with group 3 lymph nodes metastasis and over. 4. In patients of group 3 lymph nodes metastasis and over, the situation of lymph node metastasis localizing only in one region would be a posibility of long survival, and as a combined therapy, radiation therapy was effective.

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Hyperventilation is known to induce angiographically coronary artery spasms in patients with vasospastic angina pectoris. The usefulness of hyperventilation test (HV) on thallium-201 myocardial single photon emission computed tomography (SPECT) was investigated in 25 patients with vasospastic angina pectoris, 37 with atherosclerotic angina pectoris, 32 with previous myocardial infarction, and 44 with atypical chest pain syndrome. In patients with vasospastic angina pectoris, the presence of coronary spasm was detected by more than 2 degrese of defect score after HV test (85.6% of diagnostic accuracy). The positive rate of HV-SPECT was significantly higher in patients with resting angina pectoris than in patients with typical exertional angina pectoris (59% VS 22%, respectively). HV-SPECT was positive in 53% patients with previous myocardial infarction. However, after the treatment of oral nifedipine, 53% of positive HV-SPECT turned negative. Thus, coronary vasospasm may be involved in pathophysiology of atherosclerotic coronary heprt disease, an atypical chest pain syndrome as well as vasosatic angina pectoris. HV-SPECT is a sensitive method for inducing spastic phenomenon of the coronary artery.

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To determine the factors in coronary anatomy associated with the development of new asynergy during chronic phase in the non-infarcted zone (NIZ) of left ventricle (LV) in patients (pts) with a first single vessel anteroseptal infarction (AS-MI), using Sheehans's Center-line method for analysis, the left ventriculograms underwent in 69 pts with AS-MI before discharge were evaluated. To measure the severity of regional wall motion abnormality in NIZ, a deviation from mean normal wall motion in 100 segments of left ventricle was calculated and expressed as SD/Chord (by Sheehan, 1986) In pts with -SD or less of SD/Chord in NIZ (remodeling group), the infarct-related lesions (IRL) were located more frequently proximal to the first diagonal branch (D1) than in pts with +SD or more of SD/Chord (9/14 vs 3/13, P <0.05). But there was no significant difference between the two groups in the length of LAD, the degree of the residual stenosis, the amount of collateral flow, or the frequency of the location of IRL proximal or distal to the septal branch. In pts with remodeling, LVEF was lower, and LVE-SVI and LVEDVI were larger than in pts without remodeling (LVEF : 33% vs 65%, P <0.01; LVE-SVI: 71 ml/m^2 vs 27 ml/m^2, P <0.01; LVEDVI: 102ml/m^2 vs 79ml/m^2, P <0.01). conclusion: In pts with a single vessel AS-MI, the location of infarct-related lesion, proximal or distal to D1, might be the important predictor for left ventricular remodeling.

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It has been reported that perioperative blood transfusion affects adversely for the survival of cancer patients. In order to evacuate homologous blood transfusion and shorten the term of blood storage, we investigated autologous blood donation and transfusion using recombinant human erythropoietin (rHu-EPO). We collected enough volume of autologous blood in a short period and avoided homologous blood transfusion for elective surgery of rectal cancer. We conclude that it is useful in donating autologous blood using rHu-EPO for patient with rectal cancer before surgery.

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A 44 years old female was found to have abnormal lesion in the right lower lung by chest X-ray examination which was done for her faculty health examination on the 3, February, 1992. She was referred to our Institution for operation of the pulmonary lesion by her family physician. She was told that she would not have any blood products in her hospital stay on account of her religious belief. Surgical indication was reconfirmed because of the tumor had the possibility of malignancy. Prior to the operation, the meetings were held together with the patients, family and doctors in reference to the informed consents which were drown up with signature of the persons concerned. To avoid blood transfusion before, during and after operation, several special preparations were scheduled. On the 8, April, 1992 under general intubation anesthesia, the mass was extirpated from right lower lobe following confirmed benign by frozen section. Pathology was reported chondromatous hamartoma. Postoperative course was uneventful. The problems of surgical treatment in Jehovah's witness rejected the blood transfusion are discussed also.

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A case of HTLV-1 associated myelopathy (HAM) combined with smoldering type of adult T-cell leukemia (ATL) was reported. A 61-year-old woman noticed erythematosus eruption of the lower limbs at the age of 55. The patient's white blood cell count was normal, except for 1 % atypical lymphocytes. Anti HTLV-1 antibody was detected in her serum. She began to have gait disturbance at the age of 56. Hypesthesia below the neck and urinary retention gradually appeared at the age of 59, and slowly progressed. A biopsy specimen of the eruption showed infiltration of lymphocytes into upper dermis. From these findings, a smoldering type of adult T-cell leukemia was diagnosed at the age of 60. She was treated with PUVA therapy and ointment of corticosteroid and her skin almost cleared. Neurological examination revealed spastic tetraparesis, sensory disturbance below the neck. Anti HTLV-1 antibody was increased in cerebrospinal fluid. Thus, she was diagnosed as suffering from HAM. She responded to oral administration of prednisolone. The combination of HAM and ATL is extremely rare and only 7 cases including our case have been reported. HLA haplotype of this patient was A2 Bw67 Cw3 DR2/A11 Bw61 Cw7 DR9. A characteristic of HLA haplotype in this case was the presence of Cw3 which is associated with acute type of ATL. Among 4 cases in which HLA haplotypes were examined, Cw3 was detected in two.

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A 56 years-old male complaining of one month of intermittent fever and abdominal distention was admitted. Ultrasonography and CT scan revealed massive ascites and splenomegaly. Laparoscopy showed cirrhotic liver and numerous yellowish-white nodules on the peritoneum. Tuberculous bacilli were cultured from nodules obtained by biopsy. After starting the administration of anti-tuberculous drugs, the patient became afebrile and ascites disappeared. The second laparoscopy revealed disappearance of nodules. Laparoscopy was useful for the diagnosis and evaluation of the treatment of tuberculous peritonitis in the patient.

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