Large defects in the trachea after the resection of a tumor is a problem for respiratory surgeons. We examined the use of an autograft made from the right upper lobe bronchus to repair a large tracheal defect.
The bronchial wall was obtained by right upper lobectomy. A bronchial graft was formed by cutting and trimming the shape of the bronchial wall. We transplanted the autograft to the defect which was made by resecting the wall of the trachea, as large as six cartilage rings in length and one-third of the total circumflex length. After these procedures, the autograft was wrapped with mediastinal fat tissue (10 dogs) or by omentum (11 dogs) .
The transplantation of an autograft obtained from the right upper lobe bronchus successfully repaired a tracheal defect with mediastinal tissue or omental flap wrapping. However, the severe suturing complications were avoided by use of the omental flap.
We demonstrated the usefulness and safety of transplantation of an autograft obtained from the right upper lobar bronchus, and omental flap wrapping to repair a large defect of the trachea in dogs. Clinically, such a graft could be obtained from the distal healthy bronchi which would generally be abandoned along with the central malignant lesion, or it could be obtained by a minor additional surgery such as middle lobectomy. One advantage of this technique was that no immunosuppressive drugs were necessary.

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A total of 32 male jewellery workers who had been exposed to the fumes and dust of lead for the previous 10 to 25 years and 22 controls matched for age and economic status were compared with respect to lipid peroxidation, antioxidant levels and copper, zinc status in relation to lead toxicity. Effects of ascorbic acid on these parameters were also noted. Blood haemoglobin, serum copper, zinc and vitamin E, and red cell superoxide dismutase were found to be diminished, with no changes observed in red cell glutathione peroxidase and serum glutathione reductase. Lipid peroxidation product levels were very high. Ascorbic acid supplement, an antioxidant, could partially restore the serum copper and zinc levels and red cell superoxide dismutase, leading to a significant decrease in the mean blood lead concentration of jewellery workers. Dietary supplementation with ascorbic acid can complement other efforts to prevent lead exposure and reduce lead toxicity.

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We previously reported the identification of a novel gene, Bdm 1 (brain development-related molecule 1), that was up-regulated during postnatal brain development. We describe here the characterization of BDM1 protein in the brain. Antibody was raised against a synthetic peptide corresponding to the C-terminal part of the predicted BDM 1. Western blotting using this antibody revealed two forms of BDM1, 63 kDa and 64 kDa in size, very different to the 38 kDa size predicted from the open reading frame of a Bdm1 cDNA. The 64-kDa protein was detected during embryogenesis and the intensity of this band gradually decreased after birth. In contrast, the intensity of the 63-kDa band increased after birth. In vitro transcription and translation of Bdm 1 cDNA produced a 38-kDa protein. When brain extracts were treated by glycopeptidase A, Western blotting of these samples also revealed a 38-kDa band, suggesting that BDM 1 is modified by attachment of sugar chains. Cell fractionation of the embryonic brain demonstrated that BDM 1 was distributed mainly in the cytosolic fraction. Cytoplasmic distribution of EGFP-BDM 1 was also observed after transfection of an expression construct into PC12 cells. Thus, BDM 1 is expressed in the brain in a developmentally regulated manner.

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Unique gene rearrangements affecting the c-myc and c-fos oncogenes were detected at the genomic DNA level in one IgA κ type multiple myeloma among 15 cases of multiple myeloma. The c-myc locus, which maps to chromosome 8g24, showed a rearranged and amplified 20kb band in an EcoRI restriction digest. The c-fos oncogene, which maps to 14g24, showed a rearranged and amplified 8.0kb band in a BamHI restriction digest, together with a rearrangement and amplification of Ig heavy chain Cμ DNA, which maps to 14g32. These results suggested abnormalities in both chromosomes 8q and 14q. To date, rearrangements of the c-fos gene have not been reported in multiple myeloma. The results obtained here agree with previous reports of diverse karyotypic abnormalities in multiple myeloma.

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We evaluated vascular endothelial growth factor (VEGF) expression in cultured rabbit corneal cells (epithelium, stromal cells and endothelium) following exposure to linoleic acid hydroperoxide (18: 2-OOH/LHP) . Tissues were isolated from the superior quadrant of rabbit cornea, transferred to a 6-well dish, cultured to 80% confluence in Rabbit Corneal Cell Growth Medium 2 (RCGM2) or Dulbecco's Modified Eagle Medium (DMEM) with 10% fetal bovine serum (FBS), respectively, and harvested at passage 2 or 3. Each specimen was maintained in 2% FBS for 24 hr, then LHP was added to the medium at concentrations ranging from 10^-10M to 10^-4M. Twenty-four hours later, VEGF was measured in the medium using an immunoassay kit. LHP at 10^-5M increased VEGF in stromal cells from a basal level of 1106 to 2300 pg/mg protein. A minor increase by LHP was observed in epithelial cells and endothelial cells at 10^-8M. These data extend our previous report of VEGF up-regulation in the LHP-induced, non-inflammatory neovascular corneal rabbit model. Stromal cells are thought to be the main source of this angiogenic cytokine.

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Infection is an important cause of asthma attack. We evaluated the effect of low-dose and long-term erythromycin (EM) therapy in 14 children with bronchial asthma who had recurrent lower respiratory tract infection caused by PRSP, H influenzae, or B catarrhalis. The patients were 2 to 8 years of age and all had clinically severe attack. Seven of them had IgE antibodies specific to house dust and mite antigens. Four of them had examined IgG2 subclass antibodies to pneumoccocal capsule polysaccharides and all of them had a deficiency. All of them were given 10-20 mg/kg/day of EM orally and we evaluated clinical efficacy at 6 months. A total of 12 (85.7%) patients had reduced frequency of asthma attack episodes and in 3 the bacterial lower respiratory tract infection was eradicated. These results suggest that low-dose and long-term EM treatment may be very effective for childhood bronchial asthma associated with recurrent bacterial infection.

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Pancreatic cancer is one of the most devastating malignant tumors and the development of an effective novel modality of treatment is awaited.
We studied the mechanism of growth-inhibition of 5-fluorouracil (5-FU) on human pancreatic cancer cells focusing on p53 status and expression of bcl-2 family genes. COLO-357 cells with wild-type p53 gene and T3M4, Panc-1 and AsPC-1 cells with mutant p53 gene were used. Growth of COLO-357 and T3M4 cells was inhibited by the treatment with relatively low concentrations of 5-FU, and growths of Panc-1 cells was suppressed by treatment with relatively high concentrations of 5-FU under serum-supplemented conditions. In contrast, 5-FU had no effect on growth of AsPC-1 cells. While DNA fragmentation in COLO-357 cells was induced by a low concentration of 5-FU and then declined with higher concentrations of 5-FU, in T3M4 cells DNA fragmentation was gradually induced with increasing concentrations of 5-FU. Expression of bax mRNA and protein was enhanced by 5-FU in COLO-357 cells. Although expression of bc1XS mRNA was enhanced by 5-FU in both COLO-357 and T3M4 cells, Bc1XS protein was not detected on Western blotting. Increased expression of bax was associated with increased inhibition of cell growth by 5-FU in pancreatic cancer cells with a wild-type p53 gene and bc1XS may play a role in the growth-inhibitory effect of 5-FU on pancreatic cancer cells both with wild-type and mutant p53 genes. Therefore, gene-therapy targeting Bc1X for pancreatic cancer may be effective. AsPC-1 cells provide a useful tool for the study of mechanisms of resistance to chemotherapy.

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The clinical outcome of aneurysmal subarachnoid hemorrhage (SAH) is influenced by many variables. The purpose of this study was to determine the prognostic factors of patients diagnosed as having cerebral aneurysmal SAH. Medical records of 231 patients (86 men and 145 women), diagnosed with aneurysmal SAH at some time during an 8-year period between January 1991 and December 1998, were investigated retrospectively. All patients were diagnosed with SAH by computed tomography (CT), and the presence of an aneurysm was diagnosed by conventional cerebral angiography. Sixteen of the 231 patients died prior to surgery. Surgical clipping or wrapping of the aneurysm was performed on 181 patients; 149 (82.3%) were 69 years of age or younger, and 32 (17.7%) were 70 years of age or older. In the total 231 patients, favorable outcome and mortality rate was 60.6% and 23.4%, respectively. In operated cases, favorable outcome and mortality rate was 70.2% and 15.5%, respectively. One hundred and sixty-six patients (91.7%) underwent early surgery (Day 0, 1, 2 or 3), and 15 (8.3%) underwent delayed surgery. During surgery, 86.5% patients classified as grade I-III showed favorable clinical outcomes, in contrast to 44.3% of patients classified as grade N and V. A total of 42.6% of patients over 70 years old had favorable outcomes. In conclusion, risk factors of aneurysmal SAH identified by this retrospective analysis were : Age 70 years or older, a poor grade according to Hunt and Hess upon admission, rebleeding of the aneurysm and symptomatic vasospasm.

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We analyzed cefotaxime-resistant Gram-negative bacillus isolated at Showa University Hospital between October 1996 and September 1998 for strains producing extended-spectrum β-lactamase. By measurement of the minimum inhibitory concentration (MIC) of cefotaxime, 51 strains out of 579 isolates of Serratia marcescens (S. marcescens), 4 strains out of 1756 isolates of Klebsiella pneumoniae (K. Pneumoniae), and 2 strains out of 1007 isolates of Enterobacter cloacae (E. cloacae) were identified as cefotaxime resistant. The MIC measurement at high concentrations of Ampicillin, Ceftazidime, Cefmetazole, Cefaloridine, Latamoxef, Imipenem, and Aztreonam revealed various antibiotic sensitivity patterns. To identify the mechanism of resistance, we examined whether the blaIMP and SHY-related genes were present in bacteria showing a high resistance to cefotaxime. The blaIMP gene was detected in 20 strains of S. marcescens, one strain of K. pneumoniae, and one strain of E. cloacae, suggesting that the blaIMP gene has widely penetrated many types of Gram-negative bacteria. The SHY-related gene was detected in one strain of S. marcescens, three strains of K. pneumoniae, and two strains of E. cloacae. We also conducted genome analyses using pulsed-field gel electrophoresis following restriction-enzyme digestion of the entire bacterial genome DNA. The SpeI-cutting patterns revealed that the 41 S. marcescens strains shared 12 identical genome patterns. This high number of shared genome patterns demonstrates the wide prevalence of resistance-gene transmis-sion between bacteria, and indicates that steps are needed to prevent cross-infection of bacteria in hospitals.

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Pulmonary aspergillosis and lung cancer rarely occur simultaneously. We report a 51-year-old male with cavitary lung carcinoma, in which aspergillus fumigatus was detected in the resected lung. The patient underwent a left upper lobectomy and lymph node dissection at the diagnosis of cavitary lung carcinoma. Microscopic examination revealed the wall of the cavity to be poorly differentiated squamous cell carcinoma, and a cavity containing a dark yellowish-gray mass to be branching septate hyphae consistent with Aspergillus. We consider from this and other reported cases that careful examination and observation are necessary in cases with pulmonary cavitary lesion, even if the cavitary lesion has been diagnosed as aspergillosis.

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