Long-term results of mitral valvuloplasty for mitral regurgitation

From July 1979 to February 1995, 126 patients, including 4 reoperations, aged between 6 months and 77 years underwent mitral valve repair for mitral regurgitation. The patients were divided in two groups, 46 patients aged less than 16 years in pediatric age group and the other 80 patients in a dult group. The methods consisted of asymmetric annuloplasty (Kay-Reed method) in 98 patient, Carpentier-Edwards ring annuloplasty in 14, quadrangular resection of the posterior leaflet with annuloplasty in 9, and chordal and leaflet repair in 5. There was no hospital nor late death in pediatric age group. Three hospital deaths and one late death were in adult group. Follow-up was 96% complete and totaled 812.1 patient years. Reoperations underwent in 3 pediatric patients and 9 adults. At 15 years' follow-up, freedom from reoperation was 91.5 +/- 4.7% in pediatric age group and 67.1 +/- 12.7% in adults. Freedom from event was 63.5 +/- 12.1% in adult group. These results suggest that mitral repair with Kay-Reed method in pediatric age group is favorable for long-term. In contrast, indications for mitral reconstraction with other methods including ring annuloplasty should be extended for aged patients with severely dilated annuls and degenerated leaflets.     

Cowden's disease with a defined genetic alteration--chromosomal duplication at 15q11-q13

Cowden's disease, multiple hamartoma syndrome, is a dominantly inherited disorder characterized by multiple hamartomas of ectodermal, endodermal, and mesodermal origin and also by a high incidence of malignant tumors. Despite many efforts to identify the genetic alterations responsible for the syndrome, the molecular mechanism remains unclear. We report a case of Cowden's disease in which karyotype analysis revealed a small duplication (about 1 Mb) at 15q11-q13. This part of the genome is a region that is deleted in the Prader-Willi/Angelman syndrome and is a "hot spot" of chromosomal duplication.     

日本应用预应力混凝土预制件建造公路防灾构筑物的情况

本文介绍了日本公路工程利用预应力混凝土预制件修建防灾构筑物的情况。防灾构筑物可分为:防雪灾和防落石、塌方两种。也可分为预防工程和防护工程构筑物,如防风雪掩道、防雪崩栅栏、防雪崩安全隧道、防雪崩栏杆、防落石、防塌方安全隧道和防落石栏杆,以及用FRP的吊栅栏、用泡沫苯乙烯的悬臂梁防落石栏杆等。     

A P1-based physical map of the region from D17S776 to D17S78 containing the breast cancer susceptibility gene BRCA1

BRCA1, a breast and ovarian cancer susceptibility locus, has been isolated and maps to 17q21. A physical map of the BRCA1 region which extended from the proximal boundary at D17S776 to the distal boundary at D17S78 was constructed and consists of 51 sequence tagged sites (STSs) from P1 and YAC ends, nine new short-tandem repeat (STR) polymorphic markers, and eight identified genes. The contig, which spans the estimated 2.3 Mb region, contains 29 P1s, 11 YACs, two BACs, and one cosmid. Based on key recombinants in two linked families, BRCA1 was further localized to a region bounded by D17S1321 on the proximal side and D17S1325 on the distal side. Within this estimated 600 kb region, the contig was composed completely of P1s and BACs ordered by STS-content mapping and confirmed by DNA restriction fragment fingerprinting.     

Measurement of urinary lactoferrin as a marker of urinary tract infection

The usefulness of the measurement of urinary lactoferrin (LF) released from polymorphonuclear leukocytes and of an immunochromatography test strip devised for measuring urinary LF for the simple and rapid diagnosis of urinary tract infections (UTI) was evaluated. Urine specimens were collected from apparently healthy persons and patients diagnosed as suffering from UTI. In the preliminary study, the LF concentrations in 121 normal specimens and 88 specimens from patients (60 with UTI) were quantified by an enzyme-linked immunosorbent assay. The LF concentration was 3,300.0 +/- 646.3 ng/ml (average +/- standard error of the mean) in the specimens from UTI patients, whereas it was 30.4 +/- 2.7 ng/ml and 60.3 +/- 14.9 ng/ml in the specimens from healthy persons and the patients without UTI, respectively. Based on these results, a 200-ng/ml LF concentration was chosen as the cutoff value for negativity. Each urine specimen was reexamined with the newly devised immunochromatography (IC) test strip to calculate the indices of efficacy. Based on the cutoff value, it was calculated that the sensitivity, specificity, and positive and negative predictive values of the IC test were 93.3, 89.3, 86.2, and 94.9%, respectively, compared with the results of the microscopic examination of the urine specimens for the presence of leukocytes. The respective indices for UTI were calculated as 95.0, 92.9, 89.7, and 96.6%. The tests were completed within 10 min. These results indicated that urine LF measurement with the IC test strip provides a useful tool for the simple and rapid diagnosis of UTI.     

Calcite Prisms from Mollusk Shells (Atrina Rigida): Swiss‐cheese‐like Organic–Inorganic Single‐crystal Composites

Biogenic single‐crystal composites, such as sea urchin spines and calcitic prisms from mollusk shells, contain organic macromolecules inside of inorganic single‐crystal matrices. The nanoscale internal structure of these materials, however, is poorly understood, especially how the biomacromolecules are distributed within the crystals without significantly disrupting the crystalline lattice. Here, annular dark‐field scanning transmission electron microscopy and electron tomography reveal, in three dimensions, how biomacromolecules are distributed within the calcitic prisms from Atrina rigida shells. Disk‐like nanopatches, whose scattering intensity is consistent with organic inclusions, are observed to be anisotropically arranged within a continuous, single‐crystalline calcite matrix. These nanopatches are preferentially aligned with the (000l) planes of calcite. Along the crystallographic c‐axis, there are alternating organic‐rich and ‐poor regions on a length scale of tens of nanometers, while, in the ab plane, the distribution of nanopatches is more random and uniform. The structural features elucidated in this work have relevance to understanding the structure–property relationships and formation mechanisms of biominerals, as well as to the development of bio‐inspired strategies to extrinsically tune the properties of single‐crystals.     

Cessation of spermatogenesis in juvenile spermatogonial depletion (jsd/jsd) mice

Several lines of evidence have suggested that decreases in postsynaptic inhibition may have a role in epileptogenesis in cortical structures. However, other studies have suggested that GABAergic inhibition is spared, or even augmented in some forms of post-lesional epilepsy. In the studies described here, inhibitory events were recorded in two models of post-lesional chronic epileptogenesis. (i) As previously reported (D.A. Prince and G.-F. Tseng. J. Neurophysiol. 69: 1276-1291. 1993), epileptiform activity develops in slices from partially isolated rat neocortical islands 2-3 weeks after the initial in vivo lesion. In this model of post-traumatic epilepsy, large amplitude polyphasic inhibitory postsynaptic currents (IPSCs) in layer V pyramidal neurons are associated with each interictal epileptiform field potential. The frequency of spontaneous IPSCs as well as miniature IPSCs was significantly increased in neocortical slices from the epileptogenic chronically injured cortex versus controls. Immunocytochemical reactions for parvalbumin and calbindin, calcium binding proteins present in subgroups of GABAergic neurons, showed an increased staining of both neuropil and somata within the epileptogenic tissue. Immunoreactivity for glutamic acid decarboxylase (GAD) and GABA also appeared to be increased in the neuropil. (ii) Cortical microgyri resembling human malformations were produced by freeze lesions made transcranially in P0 rat cortex (K.M. Jacobs, M.J. Gutnick, and D.A. Prince. Cereb. Cortex, 6: 514-523. 1996). The boundary between the four-layered microgyrus and surrounding cortex become epileptogenic within about 2 weeks, as judged by evoked extracellular field potentials and cellular activities. Epileptogenesis in the surrounding cortex is not altered when the microgyrus itself is isolated by transcortical cuts. Patch-clamp recordings from layer V neurons in the epileptogenic zone showed that spontaneous IPSCs are larger and more dependent on glutamatergic synapses than in control neurons. The amplitudes of polysynaptic IPSCs evoked by threshold stimulation were also larger than in control cells. Although evaluation of inhibitory events in these models is still incomplete, results to date suggest that GABAergic inhibition may be enhanced in epileptogenic areas associated with chronic cortical injury. Sprouting of axonal arborizations of pyramidal cells onto interneurons, upregulation of GABAergic neurons, and perhaps sprouting of inhibitory axons that make increased numbers of contacts onto pyramidal cells may all contribute to the increased inhibitory drive. Results in these models do not support the disinhibitory hypothesis of chronic epileptogenesis.     

Optimization of fluorine passivation of stainless steel surfaces

The optimum conditions for the fluorine passivation of 316L stainless steel are described. The direct fluoridation products formed at temperatures of 320°C or lower are composed solely of FeF₂ , while those which were formed at the temperatures of 330°C or higher have a compound-phase composition of FeF₂ and FeF ₃. At a critical temperature (400°C for 316L stainless steel) of the thermal modification process, FeF₃ is converted to FeF₂ and disappears completely as the temperature rises. Meanwhile, CrF₃ is formed at a certain temperature (440°C for 316L stainless steel). The two-phase composition gets further crystallized as the thermal modification temperature rises. As the crystal growth induces the cracks on the fluoridated film, it is very difficult to form a satisfactory passivation film from the two-phase composition by thermal modification. It is confirmed that excellent passivation film has been obtained from the single-phase composition by the optimum fluoridation following the optimum thermal modification     

Inhibition in a microgravity environment of the recovery of Escherichia coli cells damaged by heavy ion beams during the NASDA ISS phase I program of NASA Shuttle/Mir mission no. 6

OBJECTIVE: To explore whether there are different disease patterns of rheumatoid arthritis (RA) in women and men. METHODS: We studied 55 male case patients and 110 female control patients who developed RA between 1970 and 1985 and who resided and received medical care in Olmsted County, Minnesota, for at least 10 years after the diagnosis of RA. Case and control patients were matched for the date of first diagnosis. The pattern and extent of joint involvement, the frequency of joint surgeries, and the presence and type of extraarticular manifestations were determined by retrospective chart review. RESULTS: Incidence rates in women were variable and age dependent, whereas the risk in men older than 36 years was constant over their lifetime. Erosive disease was more frequent in men than in women (72% versus 55%, respectively; P < 0.05) and tended to occur earlier (47% versus 31% for erosive disease within the first 4 years of RA). Although male sex was correlated with a higher risk of bony erosions and an accelerated course of RA, structural consequences of joint destruction were more pronounced in women. Joint surgery was performed more frequently in women (50%) than in men (27%) (P = 0.01). In particular, the frequencies of arthroplasties and arthrodeses of hand and foot joints were different (34 procedures in women versus 1 procedure in men; P < 0.001). Sex influenced the risk as well as the pattern of organ involvement in RA. Nodules and rheumatoid lung disease were typical manifestations in men (P = 0.001 and P < 0.001, respectively), whereas women typically developed sicca syndrome (P = 0.05). Despite differences in disease aggressiveness and disease pattern, there was little difference in the medical therapy in the men compared with the women. CONCLUSION: RA is a heterogeneous disease with variations in phenotype. Sex-associated factors influence disease severity as well as disease pattern. Because sex-related effects influence treatment goals, treatment responses, and side effects, they should be considered in clinical study design and analysis as well as in the treatment decisions for individual patients with RA.