Cell differentiation-inducing diterpenes from Andrographis paniculata Nees

The methanol extract of the aerial part of Andrographis paniculata Nees showed potent cell differentiation-inducing activity on mouse myeloid leukemia (M1) cells. From the ethyl acetate-soluble fraction of the methanol extract, six new diterpenoids of ent-labdane type, 14-epi-andrographolide (3), isoandrographolide (4), 14-deoxy-12-methoxyandrographolide (7), 12-epi-14-deoxy-12-methoxyandrographolide (8), 14-deoxy-12-hydroxyandrographolide (9) and 14-deoxy-11-hydroxyandrographolide (10) as well as two new diterpene glucosides, 14-deoxy-11,12-didehydroandrographi-side (12) and 6'-acetylneoandrographolide (14), and four new diterpene dimers, bis-andrograpolides A (15), B (16), C (17) and D (18), were isolated along with six known compounds. The structures of the diterpenoids were determined by means of spectral methods. Some of these compounds showed potent cell differentiation-inducing activity towards M1 cells.

Apoptosis is induced by 1-methyl-4-phenylpyridinium ion (MPP+) in ventral mesencephalic-striatal co-culture in rat

Apoptosis may be an important mechanism of cell death in some experimental cell death models as well as in human neurodegenerative disorders. We report evidence to indicate that 1-methyl-4-phenylpyridinium ion (MPP+) induces apoptotic cell death using ventral mesencephalic and striatal co-culture; Apoptosis was defined by characteristic changes in nuclear morphology as revealed by hematoxylin-staining and DNA breaks in situ, which were demonstrated histochemically by labeling 3'-OH ends with biotinylated deoxyuridine through the action of terminal deoxynucleotidyltransferase, and DNA fragmentation, which was shown by agarose-gel electrophoresis. Apoptosis may be an important mechanism of cell death in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced parkinsonism.

Leptomycin B targets a regulatory cascade of crm1, a fission yeast nuclear protein, involved in control of higher order chromosome structure and gene expression

The molecular action of leptomycin B (LMB), an agent inducing arrest of the eukaryotic cell cycle at G1 and G2 phases, was investigated by analyzing an LMB resistance gene of Schizosaccharomyces pombe. A genomic library of an LMB-resistant mutant was screened for LMB resistance, and a DNA fragment containing an open reading frame (ORF) of 1078 amino acids was cloned on a multicopy vector. The plasmid was found to confer drug resistance specifically to LMB. Nucleotide sequencing revealed that the ORF was a mutant gene for the essential nuclear protein crm1, which had been reported to complement a cold-sensitive mutation causing deformed nuclear morphology. The gene product named crm1-N1 had two amino acid replacements (Gly-503 to Asp and Met-546 to Ile). Two allelic mutants of crm1 (crm1-809 and crm1-119) were found to be hypersensitive and resistant, respectively, to LMB. Nuclear morphology of the cold-sensitive crm1-809 mutant at the restrictive temperature was almost the same as that of the wild-type cells treated with LMB. Furthermore, a low concentration of LMB induced the intracellular accumulation of a 25-kDa protein in the wild-type cells, which was immunologically identical to the protein accumulating in the crm1-809 mutant cells. These results strongly suggest that LMB primarily inhibits the function of the crm1 gene which is required for maintaining higher order chromosome structures, correct gene expression, and cell growth in the fission yeast.

[Pretectal syndrome caused by a plaque of multiple sclerosis]

We report a 20-year-old woman who presented with pretectal syndrome. She was well until September 12, 1991 when she noted an onset of difficulty in focusing her eyes. On neurologic examination, she showed convergence-retraction nystagmus and restriction of vertical eye movements more in the upward direction. A cranial CT scan revealed no abnormality. An oligoclonal band was detected in CSF. An MRI using Hitachi MRH-500 (0.5 T) revealed an abnormal high signal intensity lesion at the ventral area of the midbrain aqueduct, and another small lesion in the temporal white matter on the left. In addition, periventricular scattered small lesions were also visualized. Hydrocephalus, tumors and cerebrovascular disorders are common causes of pretectal syndrome, but multiple sclerosis is a rare one. Problems associated with the similar terminologies including Parinaud's syndrome, sylvian aqueduct syndrome or dorsal midbrain syndrome were discussed. According to Ranalli (1988), fibers mediating the upward gaze originate in the rostral interstitial MLF (riMLF), cross through the posterior commissure, and terminate in the contralateral oculomotor complex. On the other hand, downward gaze fibers take another route to the oculomotor complex. This may be a reason for the dissociation of the upward and downward gaze palsy, and the riMLF seems to be one of the most important structures responsible for the upward gaze.

[Two cases of pulmonary hypertrophic osteoarthropathy associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions]

Pulmonary hypertrophic osteoarthropathy (PHO) is a syndrome of unknown etiology, presenting with osteitis of the long bones, arthritis, and clubbing of digits, associated with lung cancer or other chronic pulmonary or pleural diseases. Although about 3-10 percent of cases of lung cancer were reported to be associated with PHO in USA or Europe, reports of these cases are relatively rare in Japan. We report two cases of PHO associated with primary lung cancer, in which symptoms were rapidly improved by resection of the primary lesions. Both cases were poorly differentiated adenocarcinoma of the lung (pT2N0M0, Stage I). The bone and joint pain rapidly improved soon after the resection of the primary lesions. The abnormal findings of bone scan and bone X-ray film subsequently improved. In the 2nd case, radionuclide imaging more clearly revealed the presence and extent of subperiosteal activity than radiography. Radionuclide disclosure of PHO was considerably more sensitive than radiography.

[A 64-year-old man with recurrent blurred vision and an abdominal mass]

We report a 64-year-old man with recurrent bouts of blurred vision who died after developing an abdominal mass. He was well until June of 1985 when he was 59-years-old when he had an acute onset of loss of vision in his right eye. He was treated by prednisolone with a complete remission. In August of 1986, he had another bout of blurring of vision in his left eye. Once he lost his left vision completely, from which he showed slow recovery. In January of 1987, he developed blurring of his right eye and loss of pain and touch sensation in his right leg. Since then he repeated loss of vision in his right or left eye five times, and he was admitted to our hospital in May of 1990. On admission, he was alert and oriented. General physical examination was unremarkable. Neurologic examination revealed bilateral optic nerve atrophy. He could not discriminate light or dark by either eye. Other cranial nerves were unremarkable. He could walk in a wide-base only with support; spasticity was noted in his left leg. Muscle strength was preserved. Deep reflexes were exaggerated in both legs with extensor plantar reflex bilaterally. Pain and touch sensation was decreased in the left leg by 30%, and vibration was diminished in both feet. Position sense was preserved. Routine blood counts and chemistries were unremarkable. Cranial MRI scans revealed multiple high-signal intensity lesions in both pontine bases, basal ganglia, thalami, and in the deep cerebral white matters. He was treated with oral prednisolone, plasmapheresis, lymphocytapheresis, and then immuran. His vision showed only slight recovery to discriminate light and dark. In October of 1990, slight weakness appeared in his both legs. In December of that year, he developed nausea, and a fiber colonoscopic study revealed a stenosis in the transverse colon. In March of 1991, he developed anemia and liver dysfunction. In July of that year, jaundice appeared, and his serum bilirubin was increased. In October, his leg weakness became more prominent, and his cranial CT scans at that time revealed a low density change in the right cerebellum in the right superior cerebellar artery territory; in addition, multiple low density spots were scattered to be seen in both cerebral hemispheres including the basal ganglia and thalamic areas with ventricular dilatation and cortical atrophy.(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of 5-(N,N-hexamethylene)amiloride on action potentials, intracellular Na, and pH of guinea pig ventricular muscle in vitro

We examined the effects of 5-(N,N-hexamethylene)amiloride (one of the Na(+)-H+ exchange blockers, HMA) and amiloride (AM) on action potentials (APs), intracellular Na+ activity, and pH using conventional and double-barreled ion-selective microelectrodes in guinea pig papillary muscle in vitro. Papillary muscle preparations were superfused with HEPES-buffered solution, and intracellular Na+ (aiNa+) and H+ (intracellular pH, pHi) activities were measured in quiescent preparations without stimulation. HMA at a concentration of 1 microM began to induce prolongation of action potential duration (APD) and at concentrations > 10 microM induced a decrease in action potential amplitude (APA), depolarization of resting membrane potential (RMP), prolongation of APD and depression of the maximum upstroke velocity (Vmax). HMA exerted dose-, time-, and rate-dependent reduction in Vmax. AM began to prolong APD at a concentration of 10 microM and at 1 mM induced depolarization of RMP, decreased Vmax and induced significant prolongation of APD. HMA (100 microM) induced a decrease in aiNa+ by 2-3 mM, but exerted no effects on pHi in normal Tyrode's solution. Under conditions of intracellular acidosis induced by exposure to K(+)-free solution, HMA produced a further decrease in pHi. Our results provide direct evidence that HMA has a depressant action on cardiac Na+ channels and prolongs AP at concentrations that presumably affect Na(+)-H+ exchange in cardiac muscle.

Experimental quantitative evaluation of transvascular removal of unnecessary substances in brain edema fluid

We developed a model by which the transvascular removal of unnecessary substances in brain edema fluid could be measured quantitatively and chronologically. Brain stab wounds were produced in Wistar rats by insertion of paired microdialysis probes in the unilateral caudatoputamen. Homovanillic acid (HVA) was administered by microdialysis from one probe, and the HVA clearance was measured by HPLC analysis of perfusate from the other probe. Using this model, we evaluated the site of removal and whether the removal processes were affected by anesthesia or an elevated plasma concentration of the substance. As a result, 1) Probenecid did not change HVA clearance although this inhibits HVA removal via subarachnoid vessels. Therefore, HVA removal in this model was considered mainly due to intraparenchymal transvascular efflux. 2) There was no alteration in HVA removal induced by anesthesia or intravenous HVA injection. Consequently, this efflux mechanism seems to be a rather stable protective process, and seems to play a considerable role in brain microenvironmental homeostasis.

[Pulmonary venous obstruction after repair of total anomalous pulmonary venous drainage: report of a case with reoperation]

A 8-month-old infant with Darling' type Ib of total anomalous pulmonary venous drainage underwent surgical correction. Common pulmonary vein drained into superior vena cava. Pulmonary venous channel was constructed between orifice of common pulmonary vein and atrial septal defect (ASD) with pericardial baffle drainage. Pulmonary venous obstruction occurred at the site of ASD and pericardial baffle was atrophic. ASD was enlarged and new pulmonary venous channel was reconstructed with EPTFE graft. Post-reoperative clinical course was uneventful.

[Effect of erythromycin on mucociliary transport and clinical symptoms in patients with sinobronchial syndrome]

The effect of erythromycin (EM) on mucociliary transport function assessed by saccharin test and clinical symptoms were studied in 19 patients with sinobronchial syndrome (SBS). Before treatment with EM, the mean nasal clearance time (NCT) of SBS patients was 51.9 +/- 40.5 (SD) min, which was significantly (p < 0.01) longer than that of control subjects (12.4 +/- 5.3 min). After 4-week treatment with oral EM (600 mg/day), NCT of SBS patients significantly (p < 0.01) improved (29.2 +/- 34.2 min). In 11 of 19 SBS patients, bacteria from sputum culture disappeared after EM therapy. Frequency of cough and volume of sputum were significantly (p < 0.05) decreased by EM therapy. Nasal symptoms (such as nasal obstruction and rhinorrhea) were also significantly (p < 0.05) improved by EM therapy. These findings suggested that disorder of mucociliary transport function was present in patients with SBS, and EM therapy improved this function. EM clinically improved not only the lower airway symptoms, but also the nasal symptoms.

[A 79-year-old man with rapidly progressive tetraparesis]

We report a 79-year-old man who developed progressive gait disturbance and sensory loss. He had been doing well except for hepatitis B virus hepatitis until 72 years of age when he developed angina pectoris for which aorto-coronary bypass operation was performed when he was 73-year-old (1986). In 1990, he developed pulmonary fibrosis for which prednisolone was prescribed. His liver function deteriorated, and the liver function tests suggested liver cirrhosis. He noted an onset of gait disturbance in the middle of June in 1992 when he was 79-year-old. His gait disturbance deteriorated progressively, and he developed edema and loss of sensation in his both legs. He became unable to walk unassisted in the beginning of July. He fractured his right external malleolus after falling down from a chair. He became unable to stand by himself, and he was admitted to the cardiology service of our hospital on July 18, 1992, and the neurology service was asked to see the patient on July 30 of the same month. The patient was well developed and well nourished man in no acute distress. General physical examination revealed slight jaundice, left carotid bruit, and slight pitting pretibial edema. His temperature was 37.3 degrees C. On neurologic examination, he was alert and mentally sound without dementia. He showed a slight weakness in the facial muscles bilaterally and mild dysarthria and dysphagia, however, the other cranial nerves appeared intact. He was unable to stand unassisted. The muscle tone was hypotonic, however, no focal muscle atrophy was noted, nor was observed fasciculatory twitches.(ABSTRACT TRUNCATED AT 250 WORDS)

[Toxicological findings in a death involving hydrogen sulfide]

A case of fatal hydrogen sulfide poisoning in a sewage disposal plant is described. Hydrogen sulfide levels were determined in several postmortem body tissues and fluids using gas chromatography with a flame photometric detection (GC-FPD). The concentrations of hydrogen sulfide in the blood, muscle, liver, lung, kidney, heart and brain were 0.305, 0.690, 1.089, 1.338, 1.170, 1.366 and 0.875 (micrograms/g or ml), respectively. The results are discussed in the light of the existing literature on the toxicological significance of hydrogen sulfide concentrations.

[Ion-selective microelectrodes for intracellular measurements]

Ion-selective electrodes have been used for many years to analyze ion activities in electrolyte solutions. In recent years, these electrodes have been miniaturized and applied for measurements in the cell interior. This article describes basic principles for both the fabrication and the intracellular application of ion-selective microelectrodes, particularly focusing on double barreled liquid ion-exchanger microelectrodes. The use of ion-selective microelectrodes allows continuous and real-time measurements of intracellular ion activities of a single cell in both multicellular and isolated cell preparations under various conditions, such as changes in ion composition of the extracellular bathing fluid and exposure to certain drugs. With double-barreled ion-selective microelectrodes, the transmembrane potential and intracellular ion activities can be measured simultaneously in the same cell. Although there are still some problems or limitations to the intracellular application of ion-selective electrodes, this technique is useful for determining the actual movement of intracellular ions, and thereby to elucidate cellular mechanisms of membrane transport and other physiological functions.

Aerosolized acetaldehyde induces histamine-mediated bronchoconstriction in asthmatics

It has been reported that acetaldehyde may be a main factor of alcohol-induced bronchoconstriction in Japanese patients with asthma. The purpose of this study was to investigate the direct action of acetaldehyde on the airway in asthmatic and healthy nonasthmatic subjects. We investigated the bronchial response to inhalation of ascending doses (5, 10, 20, and 40 mg/ml) of acetaldehyde in nine asthmatic subjects, who were treated with placebo or terfenadine for 4 days in a double-blind, randomized, placebo-controlled, crossover fashion, and in nine age- and sex-matched healthy subjects. The bronchial responsiveness to inhaled methacholine was also measured in the same asthmatics on a separate day. Inhaled acetaldehyde caused marked (more than 20%) significant decrease in FEV1 in asthmatics after placebo, which was larger than that in asthmatics after terfenadine and in healthy subjects. There was no significant difference in the decrease in FEV1 between asthmatics treated with terfenadine and healthy subjects. There was a significant correlation between the methacholine and acetaldehyde concentrations producing a 20% fall in FEV1 in asthmatics. We conclude that acetaldehyde causes bronchoconstriction indirectly via histamine release in asthmatics, and that nonspecific bronchial hyperresponsiveness is a necessary precondition for the expression of acetaldehyde-produced bronchoconstriction.

Functional expression of human P-glycoprotein in Schizosaccharomyces pombe

Human MDR1 cDNA was introduced into the human cultured cells KB-3-1 and Schizosaccharomyces pombe pmd1 null mutant KN3. The drug sensitivity of KB-G2 and KN3/pgp, expressing human P-glycoprotein, was examined. KB-G2 was resistant to the peptide antibiotics valinomycin and gramicidin D as well as having a typical multidrug resistance (MDR) phenotype. KN3/pgp was resistant to valinomycin and actinomycin D, but not to adriamycin. The ATP-hydrolysis-deficient mutant did not confer KN3 resistance to these antibiotics. Human P-glycoprotein expressed in S. pombe seemed to lack N-glycosylation. The N-glycosylation-deficient mutant, however, conferred a typical MDR phenotype on KB-3-1. These results suggest that human P-glycoprotein functions as an efflux pump of valinomycin and actinomycin D in the membrane of S. pombe.

[A 47-year-old woman with meningeal signs and consciousness disturbance]

We report a 47-year-old woman with SLE, who developed meningeal signs and consciousness disturbance. She noted an onset of fever, and swelling and pain in her face, hands and feet in 1990. She was seen in another hospital and the diagnosis of SLE was made. She was treated with prednisolone with marked improvement in her symptoms. She was well with 5 mg of oral prednisolone daily until January of 1991, when she developed fever, myalgia and weakness in her legs. She was admitted to the medical service of our hospital on August 5. She was receiving 15 mg of prednisolone daily. Gram positive rods were cultured from her blood on August 5. She became incoherent 2 days later, and had a convulsive episode on August 8. After the convulsion, she lost consciousness from which she did not recover. Her CSF contained 304/3 microliters cells, 29 of which were neutrophils, 6 lymphocytes, 90 others, and 179 destructed cells. The CSF protein content was 345 mg/dl, and glucose 23 mg/dl. A neurological consultation was asked on August 9. Physical examination at that time revealed a semicomatous woman. Respiration was 30/min and regular. BP 132/82 mmHg, heart rate 122/min and regular, and BT 39.6 degrees C. General physical examination was unremarkable. Pertinent neurologic findings were positive Kernig sign and spasticity in all four limbs. Brain stem reflexes were retained. Upon painful stimulation, withdrawal response was elicited both lower extremities. She was treated with pipiracillin, latamoxef and phenobarbital, however, she had frequent seizures. She was deeply comatose on December 10. She became flaccid and no more meningeal signs were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

[Metastatic lung cancer presenting with multiple thin-walled cavity-like shadows in a young adult with gallbladder cancer]

A rare case of metastatic lung cancer presenting with multiple thin-walled cavity-like shadows in a young adult with gallbladder cancer is reported. A 30-year-old man consulted our hospital with fever, cough, and general malaise. His chest X-ray film and computed tomogram showed multiple nodular shadows and thin-walled cavity-like shadows. Cytology of sputum and bronchoalveolar lavage fluid showed class V (adenocarcinoma). Although two cycles of systemic combination chemotherapy (CDDP+VDS+MMC) were performed, his lung cancer progressed. Finally, he died of obstructive jaundice from lymph node metastasis at the pancreatic head. At autopsy, the primary site of adenocarcinoma was found to be the gallbladder. Metastatic lung tumor from gallbladder cancer is common, and thin-walled cavity-like metastasis to the lung in a young adult is a rare occurrence.

Mating of the fission yeast occurs independently of pmd1+ gene product, a structural homologue of budding yeast STE6 and mammalian P-glycoproteins

The pmd1+, a multidrug resistance gene of the fission yeast Schizosaccharomyces pombe, encodes a protein similar to the budding yeast Saccharomyces cerevisiae STE6 gene product and mammalian P-glycoproteins. The STE6 protein is a membrane transporter of a-factor, a mating pheromone of a-type S. cerevisiae, which is structurally related to M-factor of the fission yeast. However, heterothallic or homothallic pmd1 null mutant cells of S. pombe, which were constructed by means of gene disruption, showed no significant decrease in the mating abilities. On the other hand, the multidrug resistance conferred by the pmd1+ was overcome by the treatment with verapamil, a typical inhibitor of mammalian P-glycoproteins. These results indicate that the pmd1+ gene product is functionally similar to mammalian P-glycoproteins, rather than to the budding yeast STE6.

Intraocular lens encapsulation by shrinkage of the capsulorhexis opening

A 57-year-old man with retinitis pigmentosa and subcapsular cataract had phacoemulsification with a continuous curvilinear capsulorhexis and implantation of a poly(methyl methacrylate) intraocular lens. Six months later, the patient presented with blurred vision and severe anterior capsule fibrosis which led to complete posterior chamber lens encapsulation.

[A case of pleural involvement followed by idiopathic retroperitoneal fibrosis]

We report a rare case of pleural involvement followed by idiopathic retroperitoneal fibrosis in a 55-year-old man. He complained of right chest pain and his chest radiogram showed pleural thickening and calcification. Chest X-ray computed tomogram (CT) also showed a mass-like pleural thickening and a soft tissue density lesion surrounding the thoracic aorta, suggesting fibrosis. By open pleural biopsy, the mass-like pleural lesion was diagnosed as chronic pleuritis. Three years later, the patient experienced difficulty in urination, and bilateral hydronephrosis which was probably due to a retroperitoneal lesion was detected. Abdominal X-ray CT revealed a retroperitoneal lesion of soft tissue density comprised of a smooth and clearly delineated mass which encased the large vessels and ureters, compatible with retroperitoneal fibrosis. Although it was not possible to biopsy the retroperitoneal lesion, the lesion was clinically and radiologically thought to be retroperitoneal fibrosis. We could not determine the etiology of these findings, but such a case of pleural involvement followed by idiopathic retroperitoneal fibrosis was considered to be very rare.

[A case of chronic lung abscess showing a cloudy shadow of the right upper lobe, diagnosed by transbronchial aspiration cytology]

A 58-year-old healthy woman was admitted to our hospital on 8th October, 1991 for detailed investigation of an abnormal shadow on chest roentgenogram, which was detected by mass survey. The chest roentgenogram showed a cloudy shadow of the right upper lobe, and retrospectively, this abnormal shadow had been present since 1986. Flexible fiberoptic bronchoscopy showed complete obstruction of right B1b bronchus by regenerated bronchial mucosa. Aseptic pus was detected in the obstructed bronchus by means of transbronchial aspiration cytology (TBAC) and chronic lung abscess was diagnosed. The chest roentgenograms of this case is very unusual, and we were unable to find a similar case of chronic lung abscess diagnosed by means of TBAC.

[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.

[A 81-year-old man with dementia, gait disturbance, hemiparesis, and sympathetic apraxia]

We present a 81-year old male who developed dementia, gait disturbance and right hemiparesis. He was well until the age of 74 when he developed a hemorrhagic infarction in the right occipital region, which left him left homonymous hemianopsia. One year later he had one TIA attack consisting of dizziness, headache, and some clouding of consciousness. At that time, atrial fibrillation was found. At age 79, he was attacked by right hemiparesis. Cranial CT scans revealed a lesion consistent with a hemorrhagic infarct in the left middle cerebral artery territory. Two months prior to his final admission, he had a gradual onset of forgetfulness, labile affect, nocturnal agitation and hallucination which were followed by gait disturbance and urinary incontinence. On admission, he was alert but moderately demented. In addition he showed difficulty in repetition, limb kinetic and ideomotor apraxia of the left hand indicative of sympathetic apraxia, and constructional apraxia bilaterally. Granial nerves appeared intact except for left homonymous hemianopsia. His gait was wide-based and small stepped. No weakness or ataxia was noted. Deep reflexes were diminished on the left side. Plantar reflex was equivocally extensor of the left. Light touch and pain was slightly diminished on the right side. Cranial CT scans revealed a large low density area in the left fronto-temporo-parietal region. Also ventricular dilatation, diffuse low density change in the subcortical white matter, and diffuse cortical atrophy were seen. His clinical course was complicated by melena, anemia, pneumonia, cardiac failure and renal failure. He expired 2 months after his admission.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of Behçet's disease presenting with Hughes-Stovin syndrome]

A 27-year-old man suffering from incomplete type of Behçet's disease presented with swelling of the left thigh. Venography showed obstruction of the left femoral vein by thrombus, and he was diagnosed as having deep vein thrombosis of the left femoral vein. The next year, he developed recurrent hemoptysis. Pulmonary angiography showed aneurysm and mural thrombosis of the left pulmonary artery. Fiberoptic bronchoscopy showed a reddish eminence of the left Behçet bronchus, suggestive of broncho-pulmonary artery fistula. After treatment with colchicine, the hemoptysis decreased. We report a very rare case of Behçet's disease presenting with Hughes-Stovin syndrome.

Detection of a point mutation in cholesteryl ester transfer protein gene by polymerase chain reaction-mediated site-directed mutagenesis

We describe a method for the rapid and non-radioactive examination of DNA samples for a mutation of cholesteryl ester transfer protein using a polymerase chain reaction-mediated site-directed mutagenesis. CETP deficiencies were studied in 554 Japanese subjects (370 men, 184 women) aged between 18 and 91 (mean 48.3 years). By this method, we detected one homozygote and 3 heterozygotes of the CETP deficiency.