[Underlying cardiac disease in infective endocarditis].

Underlying cardiac lesions in 39 adult cases with infective endocarditis were studied. 18 cases (46%) of the patients had no evidence of preexisting cardiac disease and infection frequently involved aortic valve. The patients without preexisting cardiac disease and 4 patients with an intracardiac substitute including pacemaker lead and aortic valve prosthesis required a surgery during an active infective endocarditis.

[A case of tricuspid and mitral valve replacement for incomplete endocardial cushion defect].

A 56-year-old female who was diagnosed incomplete endocardial cushion defect, underwent closure of ostium primum defect and repair of mitral cleft 2 years ago. Mitral and tricuspid ring annuloplasty was done 9 months after the first operation because of an increment of mitral and tricuspid valve regurgitation. The Third operation, mitral valve replacement by mechanical valve and tricuspid valve replacement by bioprosthetic valve, was performed because of the gradually increased mitral stenosis and tricuspid regurgitation.

[A case of swallowed fish bone-induced esophageal perforation and mediastinitis treated with pedicled omental graft].

We experienced a case of 47-year-old man who suffered swallowed fish bone-induced esophageal perforation with purulent mediastinitis and underwent direct suture closure of the perforation and reinforcement with a pedicled parietal pleura four days after the onset. Postoperative esophageal suture insufficiency was occured and reoperation was performed two months after the first operation. The esophageal fistula was plugged with a pedicled omental graft successfully.

A new plasmid-encoded proteic killer gene system: cloning, sequencing, and analyzing hig locus of plasmid Rts1.

A new proteic killer gene system, hig, was identified on the plasmid Rts1. The hig locus consisting of a higA and higB is directly related to the temperature sensitive host cell growth conferred by Rts1. We proved that higB encoding presumably a 92-amino-acid polypeptide inhibited segregation of plasmid free cells, and higA encoding a 104-amino-acid polypeptide suppressed the higB function both in cis and in trans.

[The dose-response relationship in treatment of strabismus with botulinum toxin].

The dose-response relationship between botulinum toxin and the alteration of ocular alignment of 15 esotropia cases (ET) and 15 exotropia cases (XT) was evaluated. We began with a dose of 0.25 units (U) per injection and stepped it up to 2.

[Surgical correction of total anomalous pulmonary venous drainage: an adult case of successful repair].

Total anomalous pulmonary venous drainage (TAPVD) is a rare congenital cardiac anomaly. It occurs in only 1.5% of children born with congenital heart defects.

The origin of pattern reversal short latency visual evoked potential as determined by dynamic topography and the dipole tracing method.

The generator sites of the parietal P59 and occipital N26 components elicited by hemi-field pattern reversal stimuli were investigated. The topographic distribution of the occipital N26 component showed a paradoxical lateralization, whereas that of the parietal P59 component exhibited an anatomical lateralization. The equivalent dipoles of both occipital N26 and parietal P59 components were situated on the deep mesial surface of the functioning occipital lobe.

[A case of thymic squamous cell carcinoma successfully treated with curative resection].

A case of rare thymic squamous cell carcinoma was reported. A 46-year-old female was admitted to our hospital because of an abnormal shadow on chest X-ray. Chest CT showed anterior mediastinal tumor and histological diagnosis of squamous cell carcinoma was made by needle biopsy under CT guide.

Analysis of functional domains of Rts1 RepA by means of a series of hybrid proteins with P1 RepA.

The RepA protein of the plasmid Rts1, consisting of 288 amino acids, is a trans-acting protein essential for initiation of plasmid replication. To study the functional domains of RepA, hybrid proteins of Rts1 RepA with the RepA initiator protein of plasmid P1 were constructed such that the N-terminal portion was from Rts1 RepA and the C-terminal portion was from P1 RepA. Six hybrid proteins were examined for function.

[A case of primary mediastinal germ cell tumor, successfully treated with chemotherapy and curative resection].

A 20-year-old man was admitted to our hospital because of an abnormal shadow on chest X-ray Laboratory data revealed a high serum alpha-fetoprotein (AFP) and LDH level. Percutaneous needle biopsy of the tumor suggested primary mediastinal germ cell tumor. Curative resection was performed after three courses of combination chemotherapy (cis-platinum, VP-16, bleomycin and adriamycin).

[Incidence of acute idiopathic optic neuritis and its therapy in Japan. Optic Neuritis Treatment Trial Multicenter Cooperative Research Group (ONMRG)].

Data on the incidence of and treatment for acute idiopathic optic neuritis were obtained by questionnaire sent to departments of ophthalmology, university hospitals, and general hospitals throughout Japan. Inquiry was made as to the number of cases which developed idiopathic optic neuritis from April 1992 to March 1993 along with their clinical features. The response rate was 53.

Modulation of AP-1 activity by nitric oxide (NO) in vitro: NO-mediated modulation of AP-1.

To understand the role of nitric oxide (NO) in controlling the specific DNA-binding activities of transcriptional factors, we investigated the in vitro effect of the NO-donor sodium nitroprusside (SNP) on the AP-1 activity of cultured mouse cerebellar granule cells. A gel-mobility assay showed that SNP inhibited AP-1 activity in the presence, but not the absence of dithiothreitol (DTT). This DTT-dependent inhibition of AP-1 activity by SNP corresponded with the activation of the chemical reactivity of SNP with DTT, which can be monitored by the production of nitrite (NO2-).

[Reoperation after open mitral commissurotomy for mitral stenosis].

Between 1975 and 1993, 16 of 95 patients who received open mitral commissurotomy for mitral stenosis required reoperation for recurrent mitral lesions with a mean duration of 11 years after the initial operation at Kawasaki Medical School Hospital. The mitral lesions necessitating reoperation involved restenosis in eight, stenoinsufficiency in six and regurgitation in two. In 13 patients, mitral commissure was well separated, and the mitral restenosis and regurgitation were caused by progressions of valvular and subvalvular lesions.

[A case of hypertrophic obstructive cardiomyopathy (HOCM) complicated by infective endocarditis (IE) and mitral regurgitation (MR)].

The case of a 56-year-old man who underwent mitral valve replacement due to HOCM complicated by IE and MR is reported. Preoperative 2D echocardiographic assessment of the mitral valve revealed systole anterior motion (SAM) and vegetation, and color flow Doppler echocardiographic examination revealed severe mitral regurgitation. The left ventricular out-flow tract gradient decreased from 140 mmHg preoperatively to 60 mmHg postoperatively.

[Spectral analysis of electromyograms in the strabismus cases--before and after botulinum toxin injection].

An examination was made on the mechanism of botulinum toxin injection into extraocular muscles with the use of the power spectrum. Four cases of esotropia (11-16 years) were treated with 0.5 to 3.

Cloning of Chinese hamster DNA topoisomerase I cDNA and identification of a single point mutation responsible for camptothecin resistance.

A camptothecin-resistant (DC3F/C-10) Chinese hamster cell line that contains a catalytically altered and camptothecin (CPT)-resistant DNA topoisomerase I (top 1) (Tanizawa, A., and Pommier, Y. (1992) Cancer Res.

[Coronary reoperation--report of 16 cases].

Between January 1975 and July 1992, coronary artery reoperation was performed in 16 of 333 patients who had undergone primary bypass grafting. The interval between the operations ranged from 2 to 147 months. Reoperation was done within one year in two patients, within one to five years in five patients and after more than five years in nine patients.

[An adult case of anomalous origin of left coronary artery from pulmonary trunk: left coronary artery blood flow after closing of origin of left coronary artery].

An adult case of anomalous origin of left coronary artery from pulmonary trunk was reported. The catheterization studies revealed significant amount of left to right shunt in the pulmonary trunk and anomalous origin of left coronary artery from pulmonary artery with well developed and marked tortuously dilated collaterals from the right coronary artery. During surgery, blood flow waveforms of the LAD was measured using pulsed Doppler velocimeter.

Autoregulation of the stability operon of IncFII plasmid NR1.

The stb locus of IncFII plasmid NR1, which mediates stable inheritance of the plasmid, is composed of an essential cis-acting DNA site located upstream from two tandem genes that encode essential stability proteins. The two tandem genes, stbA and stbB, are transcribed as an operon from promoter PAB. Using PAB-lacZ gene fusions, it was found that the stb operon is autoregulated.

Function of the N-terminal half of RepA in activation of Rts1 ori.

The RepA protein of the Rts1 plasmid, consisting of 288 amino acids, is a trans-acting protein essential for replication. A mutant repA gene, repA delta C143, carrying a deletion that removed the 143 C-terminal amino acids of RepA, could transform, but at a low frequency, an Escherichia coli polA strain, JG112, when repA delta C143 was cloned into pBR322 with Rts1 ori in the natural configuration. The transformation was less efficient without the dyad DnaA box in the ori region, and no transformation occurred at 42 degrees C, characteristic of Rts1 replication.

[Coronary bypass surgery using arterial conduit and its pitfall].

Three patients with spasm of internal mammary arteries and gastroepiploic artery immediately after coronary bypass surgery were reported. On completion of the revascularization, all patients could not be weaned from cardiopulmonary bypass. The flow velocity waveforms of the arterial grafts measured by pulsed Doppler velocimeter showed only small systolic component without diastolic flow and the palpation revealed profound spasm partially in the arterial conduits.

[Choice of conduit in coronary bypass surgery].

Since 1987, arterial conduits have been used in 78 of 130 cases receiving coronary bypass surgery, including 25 treated by arterial conduits alone. The use of arterial conduits was mainly indicated to the anterior descending coronary artery (LAD), but the saphenous vein had to be used in 39 percent, 47 of 120 cases receiving bypass grafting to the LAD for various reasons including a combination of multiple obstructive arteriosclerosis, multiple bypass graftings in the aged, unstable angina, emergency operation and no suitable artery for a conduit as indicated by preoperative angiography. Hereafter, arterial conduits for coronary bypass grafting to LAD should be used in many more cases to the best possible advantage.

[The influence of increase in heart rate on coronary flow dynamics in the patients with aortic stenosis].

To clarify the causative factors responsible for the development of effort angina in aortic stenosis, the influence of an increase in heart rate by atrial pacing and isoproterenol infusion on the phasic left coronary flow velocity waveforms were studied using a pulsed Doppler velocimeter during cardiac surgery. Coronary flow velocity waveforms in aortic stenosis was characterized by a slowly increased diastolic inflow and an elongation of the time from the onset of diastole to the diastolic peak velocity. An increase in heart rate by pacing brought about a marked decrease in diastolic coronary flow since the slowly increasing diastolic flow was cut with the onset of following systole.

Transcription of the stability operon of IncFII plasmid NR1.

The stability (stb) locus of IncFII plasmid NR1 is composed of an essential cis-acting DNA site located upstream from two tandem genes that encode essential stability proteins. The stb locus was found to be transcribed from a promoter site just upstream from the first gene, stbA. This promoter was active for transcription both in vivo and in vitro and was located within the region that includes the essential cis-acting site.