Observational Evidence for Stochastic Shock Drift Acceleration of Electrons at the Earth's Bow Shock.

The first-order Fermi acceleration of electrons requires an injection of electrons into a mildly relativistic energy range. However, the mechanism of injection has remained a puzzle both in theory and observation. We present direct evidence for a novel stochastic shock drift acceleration theory for the injection obtained with Magnetospheric Multiscale observations at the Earth's bow shock. The theoretical model can explain electron acceleration to mildly relativistic energies at high-speed astrophysical shocks, which may provide a solution to the long-standing issue of electron injection.

Percutaneous transluminal angioplasty using a pull-through technique for hepatic arterial occlusion at the time of port-catheter implantation.

We report a successful percutaneous transluminal angioplasty using a pull-through technique for the treatment of a hepatic arterial occlusion caused by iatrogenic subintimal dissection during the percutaneous placement of a port-catheter system.

[Coil embolization for incidental aneurysms in patients with chronic renal failure: midterm clinical results of two cases].

In spite of recent advances in perioperative management, the risk of neurosurgical intervention for patients with chronic renal failure is still considered too high. In this study, coil embolization for incidental aneurysms in such patients is demonstrated in reference to midterm results. A 42-year-old woman with a history of hemodialisis for 7 years presented with subcortical hemorrhage in her right frontal lobe. The magnetic resonance angiography (MRA) demonstrated a distal anterior cerebral artery aneurysm, but it was considered to be unrelated to the hemorrhage. Two and a half months after the hemorrhage the aneurysm was embolized with interlocking detachable coils. Thirty months after embolization, the angiogram revealed the coil compaction and the recanalization of the aneurysm neck. However, 54 months after embolization, the figure of the embolized aneurysm and neck remnant was the same as the previous findings. A 69-year-old woman with a history of hemodialisis for 5 years suddenly experienced left hemiparesis. Computed tomography revealed cerebral infarction in the right frontoparietal white matter. In addition, a left middle cerebral artery aneurysm was unexpectedly found on the MRA. Five months after the onset of the attack, the aneurysm was embolized with a Guglielmi detachable coli. An angiogram obtained 24 months after the embolization showed the aneurysm to be almost completely obliterated. In considering the therapeutic risks and benefits for incidental aneurysms of patients with chronic renal failure, intra-vascular surgery could be recommended as a less invasive treatment.

[Two cases of intravascular lymphomatosis diagnosed antemortem by transbronchial lung biopsy].

Patient 1 was a 71-year-old man who had been admitted to our hospital with high-grade fever. Chest computed tomographic (CT) images revealed clear peripheral and high-density central areas. Abnormal laboratory findings included elevated LDH and hypoxemia. Interstitial pneumonia was suspected, and transbronchial lung biopsy (TBLB) confirmed the diagnosis of intravascular lymphomatosis (IVL). The patient succumbed before completion of chemotherapy. Patient 2 was a 65-year-old man admitted with high-grade fever. Abnormal laboratory findings included pancytopenia, hypoxemia, and elevated levels of LDH and soluble interleukin-2 receptor. Chest CT images revealed diffuse, mildly dense areas in the upper fields of both lungs. TBLB specimens yielded a diagnosis of IVL. Complete clinical remission was obtained with CHOP multiagent chemotherapy. Although IVL is usually diagnosed at autopsy, in these 2 cases an antemortem diagnosis was made on the basis of TBLB findings. Also, multiagent chemotherapy achieved a complete clinical remission in Patient 2.

New technique using intraductal ultrasonography for the diagnosis of bile duct cancer.

We investigated the extent to which BDca can be visualized and diagnosed via a percutaneous fistula using IDUS. IDUS was performed in 42 cases, including 15 of normal bile ducts; 12 of choledocholithiasis, and 15 of BDca. The depth of invasion of the BDca was diagnosed with a 93% accuracy rate by visualizing the EP or MA or both. The infiltration of BDca into the surrounding organs was clearly visualized and diagnosed with an accuracy of 100% in the RHA, 93% in the PV, and 93% in the pancreas. These accuracy rates were higher than those obtained by computed tomography or angiography. We believe, therefore, that IDUS should be further studied as a diagnostic modality for staging malignancy in the biliary field.

1 alpha,25-dihydroxy vitamin D3 modulation of HLA-DR mRNA induced by gamma-interferon in cultured epithelial tumor cell lines.

Using three cultured epithelial tumor cell lines, we investigated and analyzed the effects of gamma-interferon (gamma-IFN) and 1 alpha,25-dihydroxy vitamin D3 (1,25-(OH)2D3) on the levels of HLA-DR (alpha) mRNA and HLA-DR (beta) mRNA by Northern blot analysis. After treatment with gamma-IFN alone, the levels of the mRNA increased. Treatment with both gamma-IFN and 1,25-(OH)2D3 at the same time resulted in a significant decrease in the levels of mRNA in K-TL-1, IK-TL-2, and M-TL cells as compared to those induced by gamma-IFN alone.

[Surgical treatment of ventricular septal defect associated with Down syndrome].

Twelve patients with ventricular septal defect with Down syndrome (Down group) underwent cardiac surgery. As they had pulmonary hypertension (Pp/Ps > or = 0.5), we chose twenty patients who had pulmonary hypertension (Pp/Ps > or = 0.5) with ventricular septal defect without Down syndrome as control group. After cardiac surgery, Pp/Ps in Down group decreased significantly from 0.81 +/- 0.14 to 0.48 +/- 0.25 (p < 0.01). Cardiac index (l/min/m2) between 24 hours after operation was 3.3-3.8 in Down and 4.1-4.8 in control group (NS). Oxygenation index (mmHg) between 24 hours after operation was 211-266 in Down and 230-314 in control group (NS). Eleven out of 12 patients in Down group had good operative result. One patient was complicated with post-operative pulmonary hypertensive crisis. Low output syndrome and death were not encountered in Down group. We were satisfied with operative results and encourage surgical treatment for ventricular septal defect with Down syndrome.

[Oxalate as a promoter in calcium oxalate nephrolithiasis].

Oxalate transports on membranes of red blood cell, intestinal epithelium and proximal tubule cell were reviewed, and the new findings about oxalate transport across these membranes are reported. Red blood cell oxalate influx rate in a group of recurrent calcium oxalate stone formers was significantly higher than that of a control group. In the red blood cells of mammals, the band 3 protein transports oxalate. Although abnormal influx rate of red blood cells might be recognized as an expression of somatic cell abnormality of oxalate transport in some recurrent stone formers, the band 3 protein is not related to oxalate transport in both kidney and intestine. The study using brush border membrane vesicles suggested the presence of Na-oxalate co-transport. In humans, sodium intake increased the oxalate/creatinine ratio of urine. This indicated that excessive sodium intake might be a risk factor of stone formation. Further study of oxalate transport of both kidney and intestine will be required to elucidate an etiology of calcium oxalate nephrolithiasis.

[Mucosubstance and lectin histochemistry of DMH induced colonic tumor in rats].

Histo-pathological appearances of DMH-induced colonic tumor in Wistar rats were sequentially observed upto the 35th week after the drug administration. In our series, 28 tumors were successfully induced in the colonic mucosa of 19 out of 64 rats treated with DMH, and they were histologically diagnosed as adenocarcinoma. However, there were differences in the histo-pathological findings of the carcinoma between the distal colon and the proximal colon in rats. That is, the slowly growing type of well differentiated adenocarcinoma was likely to originate from the proper mucosa in the distal colon, while in the proximal colon the rapidly growing type of tumor did from atypical glands in the lymphoid follicles. Therefore, it was suggested that histogenesis and growing processes of the carcinoma were differed in the distal colon from that in the proximal colon in rats. Second, epithelial mucosubstances and lectin-binding properties of these lesions were examined histochemically. There were differences in the lectin-binding patterns of UEA-I and PNA between carcinomas and/or atypical glands in the lymphoid follicle and normal background mucosa in rat colon. In the UEA-I staining, almost all tumors were positively stained except for one case, and in the well differentiated type a positive staining was discernible at the cell apex and secretory product in tumors, while in the undifferentiated type, it was seen at the cytoplasma and secretory product. From these histopathological and histochemical studies it may be concluded that these lectins is likely to be useful as tumor markers for the large bowel, and also effective for a diagnosis of minute carcinoma in the large bowel.

[Usefulness of combining a immunological fecal occult blood test (latex method) with a chemical test (guaiac method)].

A combination tests, using the latex and guaiac methods, has been carried out in 123 patients with a gastrointestinal disease and in 38 controls. The latex method was positive in 8% of the 38 controls, in 84% of 32 colorectal carcinoma patients, in 42% of 24 colonic polyp patients, in 22% of 9 gastric carcinoma patients, and in 22% of gastric ulcer patients in an active phase of their illness, whereas the guaiac method was positive in 39%, 81%, 58%, 78%, and 89% in the same order, respectively. From the above, a combination of both methods was found useful for the screening of hemorrhage in the gastrointestinal tract.

[MRI of the paranasal sinus mucopyocele].

Seven cases of the paranasal sinus mucopyocele were examined by MRI. All of the mucopyocele in our series were clearly demonstrated on MRI using long SE pulse sequence as high signal intensity. However, the degree of signal intensity was varied based on the contents of the mucopyocele. We can detect the mucopyocele as a three dimensional image by MRI, however, CT was necessary for evaluating the bone destruction caused by mucopyocele.