Mechanism of self-excitation of terahertz plasma oscillations in periodically double-gated electron channels.

We develop a device model for a heterostructure device with an electron channel and with a periodic system of interdigitated gates. Using this model, we find the conditions of the self-excitation of plasma oscillations in portions of the channel. It is shown that the self-excitation of plasma oscillations in these devices and the terahertz emission observed in the experiments (Otsuji et al 2006 Appl. Phys. Lett. 89 263502; Meziani et al 2007 Appl. Phys. Lett. 90 061105; Otsuji et al 2007 Solid-State Electron. 51 1319) might be attributed to the electron-transit-time effect in the barrier regions.

[Colopleural fistula caused by recurrence of gastric cancer; report of a case].

Perforation of colon into the pleural space without diaphragmatic hernia is extremely rare. This report illustrates a case of pneumo-pyothorax caused by perforation of metastatic tumor of the transverse colon of a 67-year-old woman with a history of total gastrectomy and splenectomy for advanced gastric carcinoma 4 years before. The patient was admitted to our hospital presenting with fever and dyspnea, which subsided after a thoracic drainage. Cultures of drained effusion revealed Escherichia coli, Klebsiella and Bacteroides. An emergent laparotomy for treatment of mechanical ileus 2 weeks after her admission disclosed a tumor obstructing the splenic flexure of the transverse colon, and a double-barreled colostomy was made. Pathologic examination of the tumors obtained from colon, mesocolon and the parietal peritoneum revealed poorly differentiated adenocarcinoma that was the same as her primary gastric cancer.

Smooth muscle dysfunction in patients older than 54 years of age with objective evidence of arteriosclerosis.

OBJECTIVE: This investigation was designed to assess the relationship between flow-mediated vasodilatation (FMD) and nitroglycerin (NTG)-mediated vasodilatation (NMD) with atherosclerotic risk factors. METHODS: FMD and NMD were measured in 75 subjects including 57 patients with atherosclerotic disease (AAA/PAOD=30/27, age 72+/-7 years) and 18 controls. Brachial response to hyperemia and NTG were measured every minute after cuff deflation and NTG administration. RESULTS: In the 75 subjects, responses to NTG showed a sigmoid curve. Only 2 cases reached maximal diameter within 4 minutes after NTG, and 90% of the cases reached maximal diameter at 6 minutes or later (7.5+/-2.0 minutes). In patients with atherosclerotic disease, a multiple regression analysis showed higher FMD was associated with higher NMD, and higher NMD was associated with smaller vessel size, lower systolic blood pressure, higher FMD, lower carotid maximal IMT, lower serum levels of insulin, and lower HOMA-IR. CONCLUSIONS: In subjects older than 54, NMD measured at 3 or 4 minutes after NTG administration would underestimate the NTG-dependent vasodilatation. NMD measured with the maximal responded diameter was associated with atherosclerotic risk factors, and it is therefore considered to be an important parameter in patients with atherosclerotic disease.

[Consideration of surgical treatment for recurrence after the resection of hepatic metastases from colorectal cancer].

We considered treatment for recurrence following the resection of hepatic metastases from colorectal cancer. The subjects of this study were 15 of 29 patients who had undergone WHF arterial infusion following resection of hepatic metastases from colorectal cancer, in whom there was a recurrence. Of these 15 cases, 6 involved recurrence in a single organ (residual liver, 4; lung, 1; local area, 1), 7 involved two organs (residual liver and lung, 2; residual liver and local area, 2; residual liver and bone, 1; spleen and intra-abdominal lymph node, 1; intra-abdominal lymph node and peritoneum, 1) and 2 involved three organs (lung, bone and abdominal wall, 1; lung, peritoneum and distal lymph node, 1). Reresection was performed in all cases in which recurrence occurred in a single organ. For those cases in which recurrence occurred in two or more organs, reresection and infusion were performed in the 4 cases of recurrence in the residual liver and reresection was performed in the case of recurrence in the spleen and intra-abdominal lymph node (No. 16), the case of local recurrence and the case involving the abdominal wall. The 5-year survival rate of the 29 cases who underwent initial hepatic resection was 61.9%. Five years following resection, the recurrence rate in the residual liver was 38.3%. The survival rates following treatment for recurrence were 76.9, 51.3 and 25.6% for 1, 3 and 5 years, respectively. Of the 8 deaths which have occurred to date, only one was directly related to an increase in hepatic metastases. Following resection of hepatic metastases from colorectal cancer, WHF provides a high rate of prevention as well as a high survival rate. Furthermore, with regard to recurrence following WHF treatment, if the recurrence is in only one organ, there is the possibility of achieving effective treatment by reresection (WHF = 5-FU 1,000 mg/m2 5 hrs qw).

A novel transrepression pathway of c-Myc. Recruitment of a transcriptional corepressor complex to c-Myc by MM-1, a c-Myc-binding protein.

The protooncogene product c-Myc plays a role in transcription regulation both for activation and repression. While transactivation pathways of c-Myc either from the N-proximal or the C-proximal region that is linked to the chromatin remodeling complex have been identified, a transrepression pathway had been identified only from the C-proximal region via Max and Mad that recruit the histone deacetylase (HDAC) complex. We have reported that a novel c-Myc-binding protein, MM-1, repressed the E-box-dependent transcription activity of c-Myc (Mori, K., Maeda, Y., Kitaura, H., Taira, T., Iguchi-Ariga, S. M. M., and Ariga, H. (1998) J. Biol. Chem. 273, 29794-29800). To clarify the molecular mechanisms of MM-1 toward c-Myc, cDNAs encoding MM-1-binding proteins were screened by the two-hybrid method with MM-1 as a bait using a human HeLa cDNA library, and a cDNA encoding TIF1 beta/KAP1, a transcriptional corepressor, was obtained. MM-1 was found to bind to the central portion of TIF1 beta in vitro and in vivo, and these proteins were found to be colocalized in the nucleus. MM-1 and TIF1 beta complex in human HeLa cells was found to also contain c-Myc, mSin3, and HDAC1. Introduction of the C-terminal half of TIF1 beta as a dominant negative form abrogated the inhibitory activity of MM-1 toward c-Myc and greatly stimulated the transcription activity of c-Myc. Moreover, the inhibitory activity of MM-1 toward c-Myc was canceled by trichostatin A, an inhibitor of HDAC1. These results indicate that MM-1 is a connecting factor that forms a novel transcription repression pathway of c-Myc.

High incidence of diabetic nephropathy in early-onset Japanese NIDDM patients. Risk analysis.

OBJECTIVE: Because early-onset Japanese NIDDM patients (diagnosed before age 30 years) can develop diabetic end-stage renal failure (ESRF) in their thirties, this study was performed to elucidate the incidence and determinants for the development of diabetic nephropathy. RESEARCH DESIGN AND METHODS: The incidence of diabetic nephropathy and its relationship to baseline characteristics and long-term metabolic control were determined in 426 early-onset Japanese NIDDM patients who were followed for a mean of 6.8 years. RESULTS: Of these 426 patients, 41 developed diabetic nephropathy manifested by persistent proteinuria (incidence rate [95%CI]/1,000 person-years; 14.1 [10.4-19.1]). Among patients whose mean HbA1c (measured by a high-performance chromatography method that is standardized and comparable to the one used in the Diabetes Control and Complications Trial study) was around 7% or less, few developed nephropathy. The incidence of nephropathy increased with increasing mean HbA1c level in a dose-dependent manner (chi 2 trend = 49.9, P < 0.0001). Diastolic blood pressure and duration of diabetes at entry had significant predictive effects independent of metabolic control. CONCLUSIONS: The incidence rate of diabetic nephropathy in early-onset Japanese NIDDM patients is potentially high, similar to or higher than that in Pima Indian NIDDM or Caucasian IDDM patients of comparable age. Diabetic nephropathy in NIDDM patients aged in their thirties or forties is likely to be an early feature that leads to ESRF, and this would contribute to the marked increase in the number of new patients with diabetic ESRF in Japan. NIDDM is a serious disease if near-normal glycemia is not achieved.

[Quality of life and chemotherapy in terminal stage of gastrointestinal cancers].

A patient in the terminal stage of gastrointestinal cancer is continuously worried by physical and psychological suffering, and asks for treatment to alleviate pain. We have conducted an assessment of the quality of life (QOL) in the terminal stage of cancer, and found a deterioration in active factor and total score of QOL 3 months before death. We have provided active chemotherapy in the terminal stage with the informed consent of the patient. The therapy has aimed at relieving suffering, prolonging survival and maintaining QOL.

High glucose enhances the gene expression of interleukin-8 in human endothelial cells, but not in smooth muscle cells: possible role of interleukin-8 in diabetic macroangiopathy.

We examined the effect of high glucose concentrations on the production of interleukin(IL)-8, which seems to be important for the development of atherosclerosis, in cultured human aortic endothelial cells (AoEC) and smooth muscle cells (AoSMC). After incubating these cells with various concentrations of glucose for 2 days or 7 days, the IL-8 concentration in cell lysates was measured by enzyme-linked immunosorbent assay and the IL-8 mRNA expression was examined by Northern analysis. After 2 days' culture, 42.5 mmol/l glucose enhanced IL-8 mRNA expression in AoEC, but not in AoSMC, compared to 4 mmol/l glucose. After 7 days' culture, the IL-8 concentration in AoEC lysate and the expression of IL-8 mRNA were significantly increased by 20.5 mmol/l glucose, or 42.5 mmol/l glucose compared to 4 mmol/l glucose. On the other hand, the IL-8 concentration in AoSMC lysate was not affected by any glucose concentration and the expression of IL-8 mRNA in AoSMC was diminished by high glucose. These results suggest that the chemotactic gradient by IL-8 is established between arterial intima and media in response to high glucose levels in diabetic patients, and that it may be one of the key factors for SMC migration to the intima leading to diabetic macroangiopathy.

[Fulminant interstitial pneumonia associated with polyarteritis nodosa].

A 54-year-old man was referred to our hospital because of fever, abdominal pain, hematemesis, and dyspnea on exertion. Laboratory examination on admission revealed elevations of WBC count and CRP. a low serum complement level, hypoxemia, and microhematuria. A chest X-ray film and a CT scan showed bilateral interstitial pneumonia and cardiomegaly. Angiography showed microaneurysms in peripheral branches of the superior mesenteric artery, the hepatic artery, and the right renal artery. Examination of a specimen of the right quadriceps muscle revealed arteritis with fibrinoid necrosis in a small artery, which was consistent with polyarteritis nodosa (PN). A specimen obtained by transbronchial lung biopsy before treatment showed interstitial mononuclear cell infiltration and edema. PN with interstitial pneumonia was diagnosed and the patient was treated with 1 g of methylprednisolone for 3 days, followed by 60 mg of prednisolone and 100 mg of cyclophosphamide daily. The interstitial pneumonia progressed. Despite a second trial of steroid pulse therapy in addition to mechanical ventilation and various kinds of antibiotics, the patient died of respiratory failure on the 35th hospital day. A specimen obtained by transbronchial lung biopsy 3 days before death revealed proliferation of fibroblasts, mononuclear cell infiltration in the interstitium, and hyaline membrane formation in air spaces. No evidence of infection was found. Interstitial pneumonia associated with PN had been considered to be quite rare, but recently some cases resembling the present case have been reported. We believe that interstitial pneumonia associated with PN might not be rare, and the present case shows that it can be fulminant.

[Use of the the ED046 kit to analyze serum KL-6 in patients with pneumonitis].

KL-6 is a mucinous glycoprotein expressed on Type 2 pneumonocytes, and serum levels of KL-6 are reported to be abnormally high in patients with interstitial pneumonia. A new assay kit for serum KL-6 (ED046) was used in the evaluation of patients with pneumonitis. To clarify whether KL-6 is a useful marker of pneumonitis activity, 649 subjects were studied, including 185 healthy controls, 187 patients with 3 types of interstitial lung diseases, and 277 patients with 4 types of non-interstitial lung diseases. The serum KL-6 level was significantly higher in the patients with pneumonitis (1285 +/- 1196 U/ml) than in the patients without pneumonitis (307 +/- 232 U/ml). The KL-6 level was also significantly higher in patients with clinically active pneumonitis (1708 +/- 1338 U/ml) than in those with inactive pneumonitis (820 +/- 796 U/ml) (p < 0.0001). Serum KL-6 levels correlated significantly with serum c-reactive protein, lactic dehydrogenase, and PaO2 values. These results suggest that the ED046 assay is useful for measuring KL-6 as a marker of pneumonitis activity.

[Amlexanox has an acute bronchodilator effect in patients with aspirin-induced asthma (AIA)].

Recently, we have reported that a nebulized solution of sodium cromoglycate (SCG) (Intal), a well known antiallergic agent, has an acute bronchodilator effect in patients with aspirin-induced asthma (AIA). Amlexanox is an antiallergic agent, with a structure similar to that of SCG. Therefore, we investigated the acute bronchodilator effect of amlexanox administered orally to adult asthmatics, focusing on a comparison between AIA and non-AIA patients. Fifteen patients participated, 8 having AIA and 7 non-AIA. After performing spirometry during remission, they were administered either amlexanox or placebo using a randomized double-blind protocol. Spirometry was then performed at 30, 60, 90 min, 2 h, and 3 h after administration. The placebo used was lactose. In the AIA group, FEV1 was significantly improved after administration of amlexanox. However, FEV1 was significantly decreased after placebo administration. On the other hand, in the non-AIA group, FEV1 was not changed after administration of either of the drugs. From these results, we conclude that amlexanox has an acute bronchodilator effect only in AIA patients.

[Quantitative and qualitative alterations of plasma lipoproteins in obesity].

In order to clarify lipoprotein abnormality in mild to moderate obesity (BMI > or = 25), plasma was separated by table top ultracentrifugation into VLDL (chylomicron), IDL, LDL and HDL. Chol, TG and ApoB were determined in each fraction by enzymatic and sensitive Latex method. The data were analysed according to glucose intolerance and hyperinsulinemia (HI). In obese subjects, irrespective of glucose intolerance, Chol, TG & ApoB levels were high in plasma, and an increase in VLDL (Chol, TG & ApoB), IDL (Chol & ApoB), LDL (Chol & ApoB), and a decrease in HDL-Chol were observed. These levels were also abnormal in nonDM particularly with HI. In DM, HI did not seem to affect hyperlipidemia. Correlation between Chol, TG and ApoB in three ApoB containing lipoprotein subfractions was noted in obesity. The ratio of Chol/ApoB and TG/ApoB in LDL was significantly lower in obesity implying that LDL particles were smaller in size. Half of nonDM patients had HI, and only 29% of DM patients had HI, and both groups had almost the same lipoprotein abnormality. Hyperlipidemia was severe in nonDMHI(+) compared to nonDMHI(-). Therefore, in hyperlipidemia of obesity, hyperinsulinemia plays a role in nonDM and hyperglycemia in DM. Insulin resistance seems to be an important factor in DM. Although the mechanism may be different, the consequence of hyperlipidemia is similar. Increased numbers of ApoB containing lipoproteins and smaller size of LDL are the characteristic features of hyperlipidemia in mild to moderate obesity. Because these quantitative and qualitative changes appear to be linked to an increased risk for premature arteriosclerosis, intensive therapy should be recommended even in mild to moderate obesity.

[Differentiating effect of oral administration of retinol palmitate (Chocola-A) for an aged AML (M3) with severe complications].

A 74 year-old woman, who had been diagnosed as AML (M3) in poor condition, was treated with Retinol Palmitate (Chocola-A, 150,000 unit/m2 per os, after informed consent. An increase of white blood cells (neutrophil) counts was observed after 7 days. After 4 weeks, WBC counts were increased to 20,700/microliters (neutrophil counts 6,400/microliters) Maturation tendency of leukemic cells was also proved in the bone marrow. In vitro studies showed that morphological differentiation was recognizable in cultured leukemic cells treated with 10(-6)M all-trans retinoic acid after 6 days, but not in controls. Responses in the NBT reduction test were slightly less than in the clinical study. The administration of Retinol Palmitate may be a new regimen to treat AML (M3) in aged patients in poor condition.

[Case of adult primary varicella pneumonia].

We report a case of adult primary varicella pneumonia. A 34-year-old man was admitted to our hospital with fever, dry cough and eruptions. He had no history of chicken pox and his sons had contracted varicella 2 weeks before the onset of his symptoms. Chest X-ray showed diffuse nodular shadows in both lungs. The diagnosis of primary varicella pneumonia was made based on family history, typical eruptions and high titer of antibody against Varicella zoster virus. An electron micrograph indicated this case to be primary varicella pneumonia with fibrosis and edema of interstitial spaces and the presence of virus-like particles in cells. The patient was treated with antibiotics, an antiviral agent and immunoglobulin. The clinical symptoms and diffuse nodular shadows resolved with this treatment.

[Clinical evaluation of multiple exostoses (17 cases) on bone scintigraphy].

17 patients with multiple exostoses were examined on bone scintigraphy. Inheritance was recognized on seven patients (41%). Onset age of 15 patients was under 20 years old and 10 patients were under 10. The number of lesions was 211 and they were usually recognized at metaphyses of long bones. The degree of accumulation was classified into four grades; 0 (not increased), 1 (slightly-mild), 2 (moderate) and 3 (strong). 153 lesions (73%) did not show definite increased activity (Grade 0, 1). Grade 3 included 14 lesions and they tended to be strongly calcified on X-P. This disease was said to transform into chondrosarcoma in 10 to 20%. Transformation was said to occur preferably in adults at heavily calcified lesion or one which showed irregularly thick hyaline cartilage. Such lesions showed more increased accumulation than normal bones. In our cases three cases were resected for this reason but turned out to be benign histologically. One case showed malignant transformation. On this case a large malignant tumor replaced the parent bone and bone scan showed the cold lesion. Bone scintigraphy was considered to be useful to evaluate the biological activity of multiple exostoses.

[The prognostic significance of esophageal carcinoma based on various irradiation methods].

From 1975 to 1987, 170 unresectable esophageal carcinomas were curatively irradiated. Ninety-eight cases were treated with conventional fractionation and a small field, 32 cases to a large T-shaped field, and 40 cases with conventional 50-60 Gy doses followed by 14-28 Gy of low-dose rate telecobalt therapy (LDRT: 1 Gy/hr, 4-7 Gy/day). The one-year, three-year and five-year survival rates in all cases were, 33%, 9% and 5%, and in LDRT groups, 37%, 15% and 8%, respectively. The survival rate and the local cure rate in the LDRT group were a little better than the others. The prognosis of T-shape group was proven to be the same as conventional group.