Osteochondral lesions of the proximal phalanx of the great toe: a report of two cases

OBJECTIVE: To establish whether diltiazem reduces subcutaneous calcinosis (SCC) in patients with systemic sclerosis (SSc), and whether this calcinosis is related to other signs or symptoms. METHODS: 47 patients with SSc were evaluated and divided into two groups according to the presence or absence of SCC. RESULTS: Among the 12 patients with SCC who were treated with diltiazem and had sequential hand radiographs (differential time between the two radiographs: 7.8+/-4 years), there was a slight radiological improvement in three patients only. More patients with SCC had anticentromere antibodies than patients without (p = 0.003), fewer had anti-Scl 70 antibodies (p = 0.01), more had telangiectasia and giant capillaries ( p + 0.04 and 0.048 respectively), and SCC patients had significantly fewer capillaries at the nailfold (p = 0.03). CONCLUSION: These results do not clearly indicate that diltiazem is effective in calcinosis associated with SSc. Among the patients with SSc, those who also had SCC exhibited a distinctive autoimmune profile and more severe cutaneous capillary injury than those without SCC.     

Joining of NiAl to iron-based alloys by reactive casting

Nickel monoaluminide, NiAl, is exothermically synthesized from elemental liquids of aluminum and nickel and is simultaneously joined to iron-based alloys, such as carbon steels and stainless steels, by the reactive casting method, which is based on the pouring of the elemental liquids onto the base material. The exothermic reaction between the aluminum and nickel liquids produces extremely superheated NiAl liquid. Heat of the NiAl liquid is transferred to the base material, and the contact surface is melted to a depth depending on both the preheating temperature of the base material and the thickness of the NiAl produced. After solification on the base material, NiAl is strongly joined to the base material, showing a joint strength exceeding the inherent strength of NiAl. The high joint strength is attributed to a very fine, rodlike eutectic structure at the joint interface that consists of a mixture of β-NiAl and γ-iron with an interrod spacing of approximately 100 nm.     

Differences of resected hepatocellular carcinoma with hepatitis B or C virus

BACKGROUND/AIMS: The purpose of this study was to clarify the clinicopathologic differences of hepatocellular carcinoma associated with the hepatitis B versus the hepatitis C virus. METHODOLOGY: One hundred and sixty-eight patients with resected hepatocellular carcinoma were tested for viral hepatitis. Ten (6%) had both the hepatitis B surface antigen and antibodies to the hepatitis C virus. Thirty-three (20%) had neither marker. Sixteen (9%) had only the hepatitis B surface antigen (group B), and 109 (65%) had only antibodies to the hepatitis C virus (group C). We compared groups B and C clinicopathologically. RESULTS: The mean tumor diameter was larger in group B than in group C (6.3 cm vs 3.4 cm), while group B patients were younger than group C (48 yrs vs 62 yrs, p<0.0001). Poor liver function, histologic cirrhosis and chronic active hepatitis were frequently found in group C. The 1- and 2-year tumor-free survival rates following surgery in group B were 67% and 33%, and those in group C were 73% and 49%. The 1-, 2-, and 3-year survival rates following surgery in group B were 78%, 68%, and 0%, while those in group C were 92%, 83%, and 76% (p=0.0189). CONCLUSIONS: Hepatocellular carcinoma with concomitant hepatitis B viral infection was found to present as larger tumors in younger patients with less severe liver dysfunction. Hepatocellular carcinoma with concomitant hepatitis C viral infection was often detected in follow-up studies when it was small.     

A homologue of Saccharomyces cerevisiae Dpm1p is not sufficient for synthesis of dolichol-phosphate-mannose in mammalian cells

Dolichol-phosphate-mannose (Dol-P-Man) serves as a donor of mannosyl residues in major eukaryotic glycoconjugates. It donates four mannosyl residues in the N-linked oligosaccharide precursor and all three mannosyl residues in the core of the glycosylphosphatidylinositol anchor. In yeasts it also donates one mannose to the O-linked oligosaccharide. The yeast DPM1 gene encodes a Dol-P-Man synthase that is a transmembrane protein expressed in the endoplasmic reticulum. We cloned human and mouse homologues of DPM1, termed hDPM1 and mDPM1, respectively, both of which encode proteins of 260 amino acids, having 30% amino acid identity with yeast Dpm1 protein but lacking a hydrophobic transmembrane domain, which exists in the yeast synthase. Human and mouse DPM1 cDNA restored Dol-P-Man synthesis in mouse Thy-1-deficient mutant class E cells. Mouse class E mutant cells had an inactivating mutation in the mDPM1 gene, indicating that mDPM1 is the gene for class E mutant. In contrast, hDPM1 and mDPM1 cDNA did not complement another Dol-P-Man synthesis mutant, hamster Lec15 cells, whereas yeast DPM1 restored both mutants. Therefore, in contrast to yeast, mammalian cells require hDPM1/mDPM1 protein and a product of another gene that is defective in Lec15 mutant cells for synthesis of Dol-P-Man.     

Influence of left ventricular wall thickening on myocardial injury in aortic valve replacement

We retrospectively examined the influence of left ventricular wall thickening on myocardial injury in aortic valve replacement. Thirty-five patients who underwent aortic valve replacement in our hospital between January 1995 and July 1997 were studied. We divided these patients into 3 groups: group N (left ventricular thickness (LVT) < or = 10 mm), group H (10 < LVT < or = 15 mm), and group S (LVT > 15 mm). All patients of group S had aortic stenosis. CK and CK-MB were significantly higher and the cardiac index was significantly lower in group S than in the other groups. Intra-aortic balloon pumping was required for 50% of patients in group S, and a total dose of catecholamine above 10 micrograms/kg/min was also required for 50% of patients in this group. In the other groups, these percentages were significantly lower. Myocardial protection and postoperative care were difficult for patients with severe left ventricular hypertrophy with LVT over 15 mm in this study. Left ventricular wall thickness was a more important factor in determining difficulty with intraoperative myocardial protection than was left ventricular mass.     

A cellular automata model considering diversity associated with HIV infection

The diversity of human immunodeficiency virus (HIV) in vivo has been reported. In this article, we propose a cellular automata (CA) model describing the interactions between the immune system and HIV, and examine the effect of the diversity of these interactions. The novel aspects of our CA model are that it not only considers four states (HIV, virgin, dead, infect) but also the diversity exhibited by both HIV and T cells. We simulated maximum diversities for these states by simulating CA on a computer. The model revealed that increased diversity had the effect of increasing the HIV population and simulation steps. In addition, we observed that the CA model accurately reflects the occurrence of infection, incubation period, and the development of AIDS. The CA model demonstrated that the diversity of the virus is the major factor affecting the success rate of the escape of HIV from the immune response. This work was presented in part at the 10th International Symposium on Artificial Life and Robotics, Oita, Japan, February 4–6, 2005     

Blunt traumatic rupture of right ventricle and pericardium

A 60-year-old man was transferred to our hospital for blunt trauma of the chest suffered in a traffic accident. He had a weak pulse, and cardiopulmonary resuscitation was continued in the ambulance. Chest roentgenography revealed left hemothorax, and echocardiography revealed pericardial bleeding. He was immediately transported to the operating room, because of severe hypotension due to massive bleeding from the chest drainage tube. Median sternotomy was performed under stand-by cardiopulmonary bypass. There was projectile bleeding from the anterior wall of the right ventricle. The site of rupture was sutured with felt strip. A tear in the pericardium was also present at the apex. Postoperative recovery was uneventful. Fulda et al. reported that the incidence of combined pericadial and cardiac chamber rupture was 8% for those patients suffering blunt chest trauma, and that the rate of survival was less than 15% for blunt heart rupture. We have reported here successful repair of combined rupture of the right ventricle and pericardium.     

Increased serotonin release across the coronary bed during a nonischemic interval in patients with vasospastic angina

BACKGROUND: Platelet activation and coagulation abnormality have been observed during coronary spasm. It is crucial whether platelet activation occurs even during a nonischemic period. HYPOTHESIS: This study was designed to determine whether platelets might be activated across the coronary bed during a nonischemic interval in patients with vasospastic angina. METHODS: Plasma levels of serotonin, 6-keto-prostaglandin F1 alpha, and catecholamines in the aorta and the coronary sinus were simultaneously measured in 16 patients with vasospastic angina and 13 control patients with nonischemic heart disease. RESULTS: None of these patients showed myocardial ischemia during sampling. The difference in transcardiac plasma levels of serotonin in patients with vasospastic angina was significantly higher than that in controls (1.48 +/- 1.08 ng/ml vs. 0.07 +/- 0.12 ng/ml, respectively, p < 0.001). Coronary sinus plasma norepinephrine levels in these two groups were almost the same (204.8 +/- 110.8 pg/ml vs. 190.4 +/- 131.6 pg/ml, respectively). The ratio of 6-keto-prostaglandin F1 alpha in the coronary sinus and the aorta was not different between the two groups (1.17 +/- 0.96 in patients with vasospastic angina vs. 1.15 +/- 0.68 in controls). CONCLUSIONS: These data suggest that platelet activation across the coronary bed should be ascribed to endothelial dysfunction. Lack of compensatory enhancement of prostacyclin production might be concerned with dysfunction of coronary endothelial cells in these patients.