Characterization of two unique cholesterol-rich lipid particles isolated from human atherosclerotic lesions

The authors' laboratory, using histochemical methods, previously identified two types of cholesterol-containing lipid particles in the extracellular spaces of human atherosclerotic lesions, one particle enriched in esterified cholesterol and the other particle enriched in unesterified cholesterol. The authors isolated and characterized these lipid particles. The esterified cholesterol-rich lipid particle was a small lipid droplet and differed from intracellular lipid droplets found in foam cells with respect to size and chemical composition. It had an esterified cholesterol core surrounded by a phospholipid-unesterified cholesterol monolayer. Some aqueous spaces were seen within the particle core. Unesterified cholesterol-rich lipid particles were multilamellated, solid structures and vesicles comprised of single or multiple lamellas. The esterified cholesterol-rich particle had a density less than 1.01 g/ml, whereas the unesterified cholesterol-rich particle had a density between 1.03 and 1.05 g/ml. Both particles were similar in size (90% of both particles ranged in size between 40 to 200 nm in diameter) and had an unesterified cholesterol-to-phospholipid molar ratio of 2.5:1. The predominant phospholipid in both particles was sphingomyelin. The fatty acyl compositions of cholesteryl ester and phospholipid also were similar in both particles. Palmitate, oleate, and linoleate were the major fatty acids in the cholesteryl ester fraction, whereas palmitate, stearate, oleate, and linoleate were predominant in the phospholipid fraction. The origins and the role of these two unusual lipid particles in vessel wall cholesterol metabolism remain to be determined.

[Adult femoral shaft fracture treated with an intramedullary nail]

Femoral shaft fractures often happen, and usually indicate only one part of the traumatic injuries sustained by the body. Preoperative evaluation and management may be life-saving. The favored treatment of fracture itself is now intramedullary nailing. There were 144 adult cases treated with intramedullary nails and followed up for at least two years at Chang Gung Memorial Hospital from July 1981 to June 1984. The results revealed a high union rate 96.5% (139/144): closed method 100% (34/34), open method 95% (105/110). Significant complications requiring repeated annoying surgical reintervention were rare, only 4% (6/144), due to deep infection or nonunion. Bone union period was about four months. Range of motion of knee was also satisfactory. This study suggests enough benefit of the delayed closed intramedullary nailing in the management of femoral shaft fractures.

A retrospective cohort study of leukemia and other cancers in benzene workers

A retrospective cohort study was carried out in 1982-1983 among 28,460 benzene-exposed workers (15,643 males, 12,817 females) from 233 factories and 28,257 control workers (16,621 males, 12,366 females) from 83 factories in 12 large cities in China. All-cause mortality was significantly higher among the exposed (265.46/100,000 person-years) than among the unexposed (139.06/100,000 person-years), as was mortality from all malignant neoplasms (123.21/100,000 versus 54.7/100,000, respectively). For certain cancers, increased mortality was noted among benzene-exposed males in comparison with that among unexposed males; the standardized mortality ratios (SMR) were elevated for leukemia (SMR = 5.74), lung cancer (SMR = 2.31), primary hepatocarcinoma (SMR = 1.12), and stomach cancer (SMR = 1.22). For females only leukemia occurred in excess among the exposed. Risk of leukemia rose as duration to exposure to benzene increased up to 15 years, and then declined with additional years of exposure. Leukemia occurred among some workers with as little as 6 to 10 ppm average exposure and 50 ppm-years (or possibly less) cumulative lifetime exposure (based on all available measurements for the exposed work units). Among the 30 leukemia cases identified in the exposed cohort, the proportion of subjects with acute lymphocytic leukemia was substantially lower and the proportion with acute nonlymphocytic leukemias was higher than in the general population. During 1972 to 1981, the annual incidence of leukemia ranged from 5.83 to 28.33 per 100,000 with higher rates occurring in the interval 1977 to 1981 than in the earlier years of the study period.(ABSTRACT TRUNCATED AT 250 WORDS)

Kinetic evidence for human liver and stomach aldehyde dehydrogenase-3 representing an unique class of isozymes

Substrate and coenzyme specificities of human liver and stomach aldehyde dehydrogenase (ALDH) isozymes were compared by staining with various aldehydes including propionaldehyde, heptaldehyde, decaldehyde, 2-furaldehyde, succinic semialdehyde, and glutamic gamma-semialdehyde and with NAD+ or NADP+ on agarose isoelectric focusing gels. ALDH3 isozyme was isolated from a liver via carboxymethyl-Sephadex and blue Sepharose chromatographies and its kinetic constants for various substrates and coenzymes were determined. Consistent with the previously proposed genetic model for human ALDH3 isozymes (Yin et al., Biochem. Genet. 26:343, 1988), a single liver form and multiple stomach forms exhibited similar kinetic properties, which were strikingly distinct from those of ALDH1, ALDH2, and ALDH4 (glutamic gamma-semialdehyde dehydrogenase). A set of activity assays using various substrates, coenzymes, and an inhibitor to distinguish ALDH1, ALDH2, ALDH3, and ALDH4 is presented. As previously reported in ALDH1 and ALDH2, a higher catalytic efficiency (Vmax/Km) for oxidation of long-chain aliphatic aldehydes was found in ALDH3, suggesting that these enzymes have a hydrophobic barrel-shape substrate binding pocket. Since the Km value for acetaldehyde for liver ALDH3, 83 mM, is very much higher than those of ALDH1 and ALDH2, ALDH3 thus represents an unique class of human ALDH isozymes and it appears not to be involved in ethanol metabolism.

Quality control of 99mTc-labeled dextran for lymphoscintigraphy

99mTc-labeled dextran has been suggested as a lymphoscintigraphic agent. However, quality-control results from previous studies have been controversial. In this study, the optimal concentration of stannous ion and pH value were determined to obtain maximal labeling. Paper and thin-layer chromatography showed total labeling efficiency as high as 98.4%. Anthrone test of the supernatant of the segments from thin-layer chromatographic strip was performed. Colorimetric determinations verified that dextran was found in the same locations as the peak radioactivity.

[The vector analysis of the anteroposterior relationship among the apical bases and the incisors]

Using the lateral cephalometric radiographs, the points A, B, maxillary incisor tip (U) and mandibular incisor tip (L) were projected onto the Frankfort horizontal plane and the projected points were defined as a, b, u and 1, respectively. According to the principle of the vector analysis, the vector formula ab - ul = au - bl can always stand irrespective of how the locations of the points a, b, u and 1 vary. The vectors ab, ul, au and bl represent the anteroposterior linear relationship between the upper jaw and the lower jaw, the upper incisor and the lower incisor (overjet), the upper jaw and the upper incisor, and the lower jaw and the lower incisor, respectively with reference to the FH plane. The lateral cephalometric radiographs taken from a total of 863 class I subjects, including 422 males and 441 females, were submitted for the study. The four vector values were obtained from the tracing of each radiograph and the mean values were computed according to sex and age. If a positive value was given to the vector ab, it denoted that point "a" was anterior to point "b", while a negative value denoted that "a" was posterior to "b". Both sexes of the subjects were divided according to their ages into junior primary (JP, 6-8 years), senior primary (SP, 9-11 years), junior high (JH, 12-14 years), and senior high (SH, 15-18 years) groups. No substantial or significant mean difference of each vector between the males and the females in each age group was noted. The mean values of the vector ab were 7.4, 6.8, 6.1 and 4.7 mm in JP, SP, JH and SH groups, respectively with the male and the female data pooled together. This indicates that there was a gradual catching up tendency of mandibular versus maxillary growth. The mean values of the vector ul were 1.4, 2.8, 2.9 and 2.8 mm in each successive age group, respectively showing that the overjet was rather constant with age except in the youngest group. The corresponding mean values were -0.4, -3.9, -5.2 and -6.1 mm for the vector au and -6.3, -8.0, -8.4 and -8.0 mm for the vector bl in JP, SP, JH and SH groups, respectively. The data indicate that both upper and lower incisors were relatively more upright in the youngest group when compared with the other age groups. In the remaining groups the upper incisors exhibited a tendency of gradual labial tipping with age, whereas the lower incisors kept stable in the procumbency.(ABSTRACT TRUNCATED AT 400 WORDS)

Epidural anesthesia for major abdominal surgery complicated by muscular dystrophy--a case report

Anesthesia for patients with muscular dystrophy is a great challenge to the anesthesiologists. A 56-year-old female with muscular dystrophy was diagnosed as having colon cancer. Since surgical intervention was indicated, epidural anesthesia with double catheters was performed. The entire anesthetic course was uneventful. Based on the experience obtained, it is concluded that epidural anesthesia offers a good alternative to general anesthesia for major abdominal surgery complicated by muscular dystrophy.

High resolution 1H-NMR studies of Des-(B26-B30)-insulin; assignment of resonances and properties of aromatic residues

The assignments of 1H resonances of the eight aromatic residues of Des-(B26-B30)-insulin are reported, based on pH titration, selective spin decoupling and its 500 MHz 1H two-dimensional (2D)-COSY spectrum. The pK values of the three tyrosines A14, A19 and B16 are 10.84, 11.27 and 10.40, respectively. Tyrosine A19 is buried in a hydrophobic environment, while Tyrosine B16 is exposed in a relatively hydrophilic state. Among the three phenylalanines, the ring proton resonances of Phe-B25 undergo abnormal upfield shifts, probably due to the ring currents of the nearby Phe-B24 and Tyr-B16. From this study of the low-field region of 1H-NMR spectrum of Des-(B26-B30)-insulin, we conclude that this molecule probably maintains the major structural features of insulin in aqueous solution, but there are some readjustments of the peptide conformation.

Multimodality evoked potentials in children with moyamoya disease

Twenty Japanese children with Moyamoya disease were investigated by examining the multimodality evoked potentials (BAEPs, FVEPs and SSEPs). BAEPs were abnormally prolonged wave I-III and wave III-V in each one (10%). FVEPs were abnormal in 6 (30%), included prolonged latencies, reduced amplitudes and poor waveform in one each, and delayed latencies as well as reduced amplitudes in three. FVEPs significantly correlated with intellectual deterioration (p less than 0.01). SSEPs were abnormal in 13 (65%) significantly more frequent than BAEPs and FVEPs (p less than 0.01); reduction of N20 in 7, delayed latencies of N13-N20 in 4, and both delayed latencies and reduced amplitudes of N20 in two. These findings correlated well with the neurologic deficits, CT findings and EEG findings in this progressive cerebrovascular disease (Moyamoya disease) in children.

[Hypothermic effect of intracerebroventricular injections of taurine on endotoxin-induced fever in rabbits]

Taurine (Tau) was infused by intracerebroventricular (icv) injection 20 min after iv endotoxin (ET). Cerebrospinal fluid was taken from the posterior cisterns at 0, 60, 210 and 390 min after Tau infusion. The concentrations of cAMP and PGE2 in the samples were determined by radioimmunoassay. In the control groups, an equivalent isotonic saline (NS) (non-pyrogenic) instead of Tau or ET was used respectively. The rectal and ear skin temperatures of the rabbits in a non-fasting state were recorded automatically. Tau icv 1.0 mg/50 microliters, followed by the slow infusion of Tau 0.06-0.22 mg/(kg.min) for about 20 min into rabbits, caused sedation and peripheral vasodilation (rise in ear skin temperature), and initially blocked the rise in rectal temperature induced by ET (iv, 1 micrograms/kg). The results for the control groups were significantly different from those of the ET + Tau group. In the ET + NS group, the fluctuations in concentrations of PGE2 and cAMP paralleled the change in rectal temperature, but in the ET + Tau group, the changes in PGE2 and cAMP concentrations were similar to those of the ET + NS group, even though the fever was initially inhibited. There were no changes in the concentrations of these mediators in the NS + Tau group.

Human stomach alcohol and aldehyde dehydrogenases (ALDH): a genetic model proposed for ALDH III isozymes

Isozyme phenotypes of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) from human gastroendoscopic as well as surgical gastric biopsies were determined by starch gel electrophoresis and agarose isoelectric focusing. gamma gamma ADH isozymes were expressed predominantly in the mucosal layer of the stomach, whereas beta beta isozymes were in the muscular layer. In the 56 gastroendoscopic mucosal biopsies examined, the homozygous ADH3 1-1 phenotype was found in 75% of the samples, and the heterozygous ADH3 2-1 phenotype in 25%. Accordingly, the gene frequencies of the alleles ADH1/3 and ADH2/3 were calculated to be 0.88 and 0.12, respectively. Using a modified agarose isoelectric focusing procedure, gastric ALDH I, ALDH II, and up to five ALDH III forms could be clearly resolved. The ALDH III isozymes accounted for more than 80% of the total ALDH activities in gastric mucosa and exhibited Km values in the millimolar range for propionaldehyde at pH 9.0. Forty-five percent of the 55 gastroendoscopic biopsies studied lacked ALDH I isozyme. The complex gastric ALDH III isozyme phenotypes seen in these biopsies fall into three patterns. They can be interpreted by a genetic hypothesis, based on a dimeric molecule, in which there are two separate genes, ALDH3a and ALDH3b, with the ALDH3b locus exhibiting polymorphism. The homozygous phenotypes ALDH3b 1-1 and ALDH3b 2-2 were found to be 4 and 76%, respectively, and the heterozygous ALDH3b 2-1 phenotype 20%, of the total. Therefore, the allele frequencies for ALDH1/3b and ALDH2/3b were calculated to be 0.14 and 0.86, respectively. Several lines of biochemical evidence consistent with this genetic model are discussed.

Late infantile Krabbe leukodystrophy: MRI and evoked potentials in a Japanese girl

A Japanese girl showed deterioration in development from the age of 13 months. At the age of 16 months, there were mild spastic diplegia, increase in cerebrospinal fluid protein to 61.5 mg/dl and deficient galactosylceramidase I. Magnetic resonance imaging (MRI) demonstrated a high signal intensity with increased T2 in the centrum semiovale. Short latency somatosensory evoked potentials (SSEPs) showed a prolonged N13-N20 interpeak latency followed by abolition of N20. Brainstem auditory evoked potentials (BAEPs) were normally followed by prolonged interpeak latencies of wave I-V. This may be the first report of what we consider to be the late infantile form of Krabbe disease with MRI and evoked potential examinations.

Etiological types and clinical and epidemiological features of acute viral hepatitis in Xi'an in China

The etiological types and some features of 163 in-patients with acute viral hepatitis in Xi'an in China are reported. Hepatitis A (HA) accounted for 89.2% in the age group 0-15 years, whereas hepatitis B (HB) mainly occurred at the age of 16 to 30 and non-A, non-B hepatitis 31 to 50. This is different from the age distribution in western countries. The cause of the difference is discussed. The transmission factors of NANB hepatitis might be different from those of HA and HB. Fever was more often seen in HA than in HB and NANB, while the maximal bilirubin was higher in HB than in NANB. Hepatic dysfunction of all three types of hepatitis seemed to be closely associated with the age of the patients. Of ten cases with fulminant hepatitis, none was due to hepatitis A; nine were adults.

Leukaemia in benzene workers: a retrospective cohort study

A retrospective cohort study was conducted in 233 benzene factories and 83 control factories in 12 cities in China. The benzene cohort and the control cohort consisted of 28,460 benzene exposed workers (178,556 person-years in 1972-81) and 28,257 control workers (199,201 person-years). Thirty cases of leukaemia (25 dead and 5 alive) were detected in the former and four cases (all dead) in the latter. The leukaemia mortality rate was 14/100,000 person-years in the benzene cohort and 2/100,000 person-years in the control cohort; the standardized mortality ratio was 5.74 (p less than 0.01 by U test). The average latency of benzene leukaemia was 11.4 years. Most (76.6%) cases of benzene leukaemia were of the acute type. The mortality due to benzene leukaemia was high in organic synthesis plants followed by painting and rubber synthesis industries. The concentration of benzene to which patients with a leukaemia were exposed ranged from 10 to 1000 mg/m3 (mostly from 50 to 500 mg/m3). Of the 25 cases of leukaemia, seven had a history of chronic benzene poisoning before the leukaemia developed.

Brainstem auditory evoked potentials in children with neurodegenerative diseases

We assessed the usefulness of brainstem auditory evoked potentials (BAEPs) for differentiating types of degenerative diseases in children. The findings of BAEPs were abnormal in one out of two with polioencephalopathies and in seven of the eight with leukoencephalopathies, showing prolonged interpeak latencies of waves I-III, I-V or disappearance of wave components. On the other hand, normal responses were observed in four with corencephalopathies and one with spinocerebellopathy. The serial BAEPs in eight patients had deteriorated with progression of the clinical symptoms. These data on 16 children suggest that BAEPs are indeed a useful tool for monitoring pathophysiologic processes of neurodegenerative diseases.

Cerebrovascular occlusive disease with and without the moyamoya vascular network in children

Clinical features of cerebrovascular occlusive disease with the moyamoya network (group 1: twenty-nine children) and those without this network (group 2: nine children) are reported herein. Group 1 was characterized by female preponderance, recurrent and transient ischemic attacks, progression of mental deterioration, rebuild-up after hyperventilation on EEG and wide-spread lesions on CT scan. Group 2 had one or two attacks which led to a rather long-lasting hemiplegia but not to mental deterioration, rare rebuild-up findings on EEG and unilateral focal lesion on CT scan. Precipitating factors for ischemic attacks included deep breathing, changes in body temperature or sleep-waking transition were present in both groups. Etiology in some children was considered to be congenital.

Cerebral arteriovenous malformations in children

Differences in clinical features of arteriovenous malformations (AVM) in six children with ruptured AVM (RAM) and three with unruptured AVM (URAM) are herein reported. The age at onset ranged from the neonatal period to 8 yrs in cases of URAM and 10 to 12 yrs in those with RAM. The children with RAM had a sudden onset of intracranial hemorrhage, except for one with prodromal symptoms such as vertigo or headache. The clinical features of URAM were chronic mild symptoms such as a certain degree of delayed development, focal neurologic signs or increased intracranial pressure in addition to macrocephalus and cranial bruit. CT scan revealed an evenly enhanced AVM and dilatation of ventricles in cases of URAM. The RAMs were angiographically relatively small while the URAMs were large.

Colorectal cancer and schistosomiasis

The risk of colorectal cancer is known to be increased in patients with long-standing schistosomal colitis. A retrospective review of clinical data and surgical specimens from 60 patients with schistosomal granulomatous disease of the large intestine but without carcinoma demonstrated that 36 of them had mild to severe grades of colonic epithelial dysplasia. This was either focal or diffuse in distribution and occurred in flat mucosa, in pseudopolyps, or in regenerating epithelium at the edges of ulcers. These dysplastic changes are regarded as the pathological basis for the malignant potential of schistosomal colitis, and they resemble the changes found in long-standing chronic ulcerative colitis.