Selective IgA deficiency with recurrent vasculitis of the central nervous system

We describe an unusual case of selective IgA deficiency complicated by recurrent vasculitis of the central nervous system (CNS). The patient suffered from two episodes of CNS vasculitis, one of which was located in the cerebrum and the other in the cerebellum. The vasculitic process resulted in brain tumor-like lesions shown by computed tomography. There was no evidence of associated connective tissue diseases. Vasculitis in other organs or tissues was not noted. This is the first detailed description in the English literature of pathologically proven CNS vasculitis in a patient with selective IgA deficiency. Our report demonstrates that isolated CNS angiitis can be a rare clinical feature of selective IgA deficiency.

Perfusion-weighted imaging defects during spontaneous migrainous aura

Perfusion- and diffusion-weighted magnetic resonance imaging was performed during spontaneous visual auras in four migraineurs. Alterations in relative cerebral blood flow (16-53% decrease), cerebral blood volume (6-33% decrease), and tissue mean transit time (10-54% increase) were observed in the gray matter of occipital cortex contralateral to the affected visual hemifield. No changes in the apparent diffusion coefficient were observed either while the patients were symptomatic or after resolution of the visual symptoms but before the onset of headache. Functional magnetic resonance imaging can be a useful noninvasive tool to study hemodynamic changes during spontaneous attacks of migraine with aura.

Cytotoxic strains of Pseudomonas aeruginosa can damage the intact corneal surface in vitro

PURPOSE

Although the corneal epithelial cell layer is believed to serve as a barrier against most types of bacteria, certain strains of P. aeruginosa have been shown to kill corneal epithelial cells in primary cultures. The aim of this study was to test whether these strains could damage epithelia on uninjured whole corneas.

METHODS

Five-week-old Sprague-Dawley rats were sacrificed and their eyes were placed in organ culture. The corneal surface of each eye was incubated with 8 microL of media alone or a bacterial suspension containing 8 x 10(6) cfu of one of 12 cytotoxic and noncytotoxic strains of P. aeruginosa for 3 hours at 35 degrees C. Trypan blue was then added to visualize surface epithelial cell injury. A masked observer examined each cornea under a dissecting microscope and assigned a score of between 1 and 3 to describe the extent of injury.

RESULTS

Cytotoxic P. aeruginosa injured the surface epithelium. The extent of injury induced by the various strains correlated with previously published in vitro measures of cytotoxic capacity toward cultured corneal epithelial cells. Cytotoxicity required at least 2 hours of bacterial contact and was dependent upon ExsA, a transcriptional activator of several genes in P. aeruginosa, including the gene encoding exoenzyme S.

CONCLUSIONS

Cytotoxic P. aeruginosa strains can damage epithelia on an uninjured corneal surface providing there is prolonged bacterial contact. Stagnation of cytotoxic bacteria against the corneal surface may contribute to the pathogenesis of infection associated with the use of soft contact lenses.

Blocked field effects on collimator scatter factors

In routine dosimetry we assume separability of the collimator (Sc) and phantom (Sp) scatter components that together comprise the total scatter factor (Sc,p). In practice, the addition of blocking also affects the photon fluence attributable to the treatment head and flattening filter in a complicated way. The reduced aperture blocks out some of the head scatter contribution, while the block and tray add back secondary scatter. In the following we present techniques for directly measuring the aperture effect on Sc in air or in a full-scatter phantom. The change in Sc is found to be a scaleable quantity that can be modelled as a simple linear fit to the ratio of projected open-to-blocked equivalent square fields. Measurements have been made for 6, 18 and 24 MV photon beams on one Varian 2500 and two Varian 2100c accelerators. Results indicate a progressive loss of collimator scatter contribution with increased field blocking that is amplified with increasing energy. Block and tray scatter only contribute significantly to Sc for large fields and treatment distances of 80 cm or less. Application of these corrections in monitor unit calculations is presented.

(S)-(-)-HA-966, a gamma-hydroxybutyrate-like agent, prevents enhanced mesocorticolimbic dopamine metabolism and behavioral correlates of restraint stress, conditioned fear and cocaine sensitization

This report investigates the effect of the negative enantiomer of 1-hydroxy-3-aminopyrrolidone-2 (HA-966) on behavioral and biochemical changes elicited by pharmacological or experimental paradigms which activate mesocorticolimbic dopaminergic neurotransmission. Several paradigms were used, including cocaine sensitization and two stressors: restraint for 30 min and an aversive conditioning model. (S)-(-)-HA-966 (3 and 5 mg/kg i.p.) prevented restraint stress-induced dopamine utilization in both the medial prefrontal cortex and nucleus accumbens, in contrast to the positive enantiomer. Conditioned fear increased dopamine metabolism in both the core and shell subdivisions of the nucleus accumbens, an effect blocked by (S)-(-)-HA-966. The conditioned stress-induced increase in dopamine metabolism in the medial prefrontal cortex was also blocked by (S)-(-)-HA-966. In addition, (S)-(-)-HA-966 suppressed fear-induced behaviors: immobility and defecation. In other studies, (S)-(-)-HA-966 (3 mg/kg i.p.) prevented locomotor sensitization without altering the acute motoric response elicited by cocaine. The highest dose of (S)-(-)-HA-966 (5 mg/kg i.p.) blocked acute cocaine-induced locomotion but resulted in sedation. In addition, the highest dose of (S)-(-)-HA-966 tested suppressed weight gain in control rats, unlike its enantiomer, (R)-(+)-HA-966. Because (S)-(-)-HA-966 has been proposed to act at the gamma-aminobutyric acid (GABA)B receptor, we examined the ability of (S)-(-) and (R)-(+)-HA-966 to displace [3H]-(-)-baclofen from cortical membranes to assess GABAB receptor binding. Neither enantiomer significantly altered [3H]-(-)-baclofen binding at relevant concentrations, indicating the actions of (S)-(-)-HA-966 reported here are the results of a mechanism apparently independent of the baclofen binding site on the GABAB receptor.

Identification of differentially expressed genes in chemically induced skin tumors

Previous studies have demonstrated a role for the fos gene in promoting malignant conversion of mouse skin tumors. In the study reported here, differential display was performed to identify fos- and jun-regulated genes that are differentially expressed during premalignant progression. Total RNA isolated from variants of the papilloma cell line SP-1 transduced with retroviral vectors expressing v-jun and v-fos alone or in tandem was analyzed for the presence of differentially expressed transcripts by using 35 different primer combinations. Differentially expressed clones were rescreened by dot-blot analysis by using cDNA from chemically induced tumors with a high or low risk of malignant conversion. Three differentially displayed fragments were isolated in this analysis. Homology searches indicated that these fragments shared significant homology with the apoptosis inhibitor bcl-2, human alternative splicing factor/splicing factor 2 (ASF/SF2), and a novel gene not present in the GenBank or EMBL databases. In situ hybridization indicated that the expression levels of the bcl-2 homolog increased with malignant potential in chemically derived mouse skin tumors. A similar analysis indicated that expression of the ASF/SF2 homolog was greater in papillomas than in normal skin or in squamous cell carcinomas. Transcripts for this gene were most abundant in the granular layer. The expression pattern of the third differential display fragment was consistent with that of a tumor suppressor gene. This gene was expressed at very high levels in normal skin and benign papillomas but was essentially undetectable in squamous cell carcinomas. Through this approach, we identified known and novel genes that may contribute to malignant progression in epidermal tumors.

Effect of the aqueous extract of Aquilaria agallocha stems on the immediate hypersensitivity reactions

We investigated the effects of the aqueous extract of Aquilaria agallocha Roxb. (Thymelaeaceae) on the immediate hypersensitivity reactions. The aqueous extract of Aquilaria agallocha stems showed inhibitory effects on passive cutaneous anaphylaxis, anaphylaxis induced by compound 48/80, and histamine release from rat peritoneal mast cells (RPMC). The morphological examination also clearly showed that the extract prevented the degranulation of RPMC in rats. The level of compound 48/80-induced intracellular cAMP in RPMC, when the extract was added, significantly increased about 8-fold at 10 s compared with that of basal cells. These results suggest that the aqueous extract of Aquilaria agallocha stems inhibits the immediate hypersensitivity reaction by inhibition of histamine release from mast cells.

Zeaxanthin dipalmitate from Lycium chinense has hepatoprotective activity

We previously reported the isolation of zeaxanthin and zeaxanthin dipalmitate using bioactivity-guided fractionation to discover hepatoprotective components of Lycium chinense against carbon tetrachloride induced hepatotoxicity. The present study was designed to uncover the effects of zeaxanthin dipalmitate on hepatic parenchymal and nonparenchymal cells in vitro. Uptake of [3H]thymidine by cultured rat Ito cells in response to zeaxanthin dipalmitate was measured. Collagen synthesis was assessed by the collagenase digestion method. The effects of zeaxanthin dipalmitate on the formation of nitric oxide (NO) and the release of tumor necrosis factor-alpha (TNF-alpha) from Kupffer cells and peritoneal macrophages were also assayed. Zeaxanthin dipalmitate showed a significant hepatoprotective activity against carbon tetrachloride toxicity. Cellular malondialdehyde (MDA) levels declined significantly with the treatment of the compound in a concentration dependent manner. Zeaxanthin dipalmitate significantly inhibited the uptake of [3H]thymidine by Ito cells. Zeaxanthin dipalmitate also reduced collagen synthesis in Ito cells by 65.1% (p < 0.05) as compared to untreated controls. The formation of NO in either Kupffer cells or in peritoneal macrophages was significantly decreased by zeaxanthin dipalmitate in a concentration dependent manner. The release of TNF-alpha was somewhat less affected by the compound. From these results, we conclude that zeaxanthin dipalmitate exerts a potent hepatoprotective activity by inhibiting Ito cell proliferation, collagen synthesis and by inhibiting certain biochemical functions of Kupffer cells.

Recurrent pleomorphic adenoma of the parotid gland involving the osseous external auditory canal. With a note on the foramen of Huschke

A recurrence of a parotid pleomorphic adenoma presenting as an external ear canal mass is reported. The route of extension was radiographically documented as an incompletely closed foramen of Huschke. The historical and developmental features of this foramen and the mechanisms of tumor extension as they relate to it are discussed.

Impaired host defense, hematopoiesis, granulomatous inflammation and type 1-type 2 cytokine balance in mice lacking CC chemokine receptor 1

CC chemokine receptor 1 (CCR1) is expressed in neutrophils, monocytes, lymphocytes, and eosinophils, and binds the leukocyte chemoattractant and hematopoiesis regulator macrophage inflammatory protein (MIP)-1alpha, as well as several related CC chemokines. Four other CCR subtypes are known; their leukocyte and chemokine specificities overlap with, but are not identical to, CCR1, suggesting that CCR1 has both redundant and specific biologic roles. To test this, we have developed CCR1-deficient mice (-/-) by targeted gene disruption. Although the distribution of mature leukocytes was normal, steady state and induced trafficking and proliferation of myeloid progenitor cells were disordered in -/- mice. Moreover, mature neutrophils from -/- mice failed to chemotax in vitro and failed to mobilize into peripheral blood in vivo in response to MIP-1alpha. Consistent with this, -/- mice had accelerated mortality when challenged with Aspergillus fumigatus, a fungus controlled principally by neutrophils. To test the role of CCR1 in granuloma formation, we injected Schistosoma mansoni eggs intravenously, and observed a 40% reduction in the size of lung granulomas in -/- mice compared to +/+ littermates. This was associated with increased interferon-gamma and decreased interleukin-4 production in -/- versus +/+ lung lymph node cells stimulated with egg-specific antigen, suggesting that CCR1 influences the inflammatory response not only through direct effects on leukocyte chemotaxis, but also through effects on the type 1-type 2 cytokine balance. Thus CCR1 has nonredundant functions in hematopoiesis, host defense, and inflammation.

Physics and basic parameters of brachytherapy

Brachytherapy (short-distance therapy) is the therapeutic process whereby radioactive sources are placed into very close proximity to target tissue. Radioactive materials were so used beginning shortly after the discovery of radium by Marie and Pierre Curie in 1898. For the purposes of brachytherapy, radioactive materials are those that emit "rays" that can cause ionization (and hence DNA damage and the destruction of target cells). The potentially useful rays include beta, gamma, and other possibilities such as neutrons. Beta rays, properly beta particles, are simply high energy electrons. Gamma rays are high energy photons (part of the electromagnetic spectrum like visible light, but with much higher energy). These particles are produced during the radioactive decay of certain isotopes. The physics of those events and the parameters that apply to the therapeutic use of the isotopes are the primary topics of this report.

Severe fibronectin-deposit renal glomerular disease in mice lacking uteroglobin

Despite myriads of biological activities ascribed to uteroglobin (UG), a steroid-inducible secreted protein, its physiological functions are unknown. Mice in which the uteroglobin gene was disrupted had severe renal disease that was associated with massive glomerular deposition of predominantly multimeric fibronectin (Fn). The molecular mechanism that normally prevents Fn deposition appears to involve high-affinity binding of UG with Fn to form Fn-UG heteromers that counteract Fn self-aggregation, which is required for abnormal tissue deposition. Thus, UG is essential for maintaining normal renal function in mice, which raises the possibility that an analogous pathogenic mechanism may underlie genetic Fn-deposit human glomerular disease.

Effect of obesity on total and free insulin-like growth factor (IGF)-1, and their relationship to IGF-binding protein (BP)-1, IGFBP-2, IGFBP-3, insulin, and growth hormone

OBJECTIVES

We investigated the effect of obesity on the serum levels of total and free IGF-1 and their relationship to the circulating levels of insulin and IGF binding proteins (IGFBPs) in age and sex-matched groups.

SUBJECTS

The study included 43 obese subjects (ideal body weight; IBW > 120%) and 45 controls (IBW < 100%). All of the subjects were male.

MEASUREMENT

Total IGF-1, free IGF-1, IGFBP-1, IGFBP-2, IGFBP-3, and insulin were measured in obese subjects and normal control subjects.

RESULTS

No significant differences in the circulating levels of total and IGFBP-3 were observed between the obese and control groups. In contrast to total IGF-1, free IGF-1 in obese subjects was significantly increased compared to normal controls (P < 0.05). Serum total and free IGF-1 were inversely correlated with age (r = -0.42, P = 0.001, and -0.44, P = 0.001). Fasting serum insulin concentrations were elevated in all the obese subjects (P < 0.05) and positively correlated with IBW (r = 0.57, P = 0.001). The levels of serum GH and IGFBP-1 were suppressed in all the obese subjects (P < 0.05). IGFBP-1 was inversely correlated with IBW (r = -0.51, P = 0.001) and serum insulin concentrations (r = -0.48, P = 0.001). The IGFBP-2 concentrations were also suppressed in obese subjects and inversely related to free IGF-1 (r = -0.48, P = 0.001). Using multiple linear regression analysis, total IGF-1 and insulin concentrations were positively correlated (r = 0.58, P = 0.001) and free IGF-1 and IGFBP-1 concentrations were negatively correlated (r = -0.57, P = 0.001).

CONCLUSION

We confirmed that total IGF-1 and IGFBP-3 concentrations were not significantly different between the obese and control groups, despite GH hyposecretion in obesity. We also found that free IGF-1 concentrations were higher in obese subjects than in normal controls. It seems likely that overnutrition and chronic hyperinsulinaemia in obesity may alter this regulated growth response by insulin stimulation of IGF-1 production and suppression of hepatic IGFBP-1 and IGFBP-2 production, which may inhibit IGF-1 bioactivity.

Identification of putative phosphoinositide-specific phospholipase C genes in filamentous fungi

Five putative phosphoinositide-specific phospholipases C (PLC) genes were identified in three species of filamentous fungi. Using polymerase chain reaction with degenerate oligonucleotide primers, gene fragments encoding amino acid sequences homologous to PLCs of mammals and other organisms were amplified: one sequence from Botryotinia fuckeliana, one from Aspergillus nidulans, and three from Neurospora crassa. The molecular cloning and sequencing of a putative PLC gene (BCPLC1) from B. fuckeliana showed that it encoded a polypeptide containing X and Y domains, the two conserved regions found in all known PLCs. The hypothetical gene product of BCPLC1 was of delta type in its primary structural organization. The identification of three PLC genes in N. crassa shows that multiple PLC isozymes also occur in microbial eukaryotes.

Molecular cloning and sequence analysis of a putative ras gene of the phytopathogenic fungus Botryotinia fuckeliana

We solated and determined the complete nucleotide sequence of a ras gene from Botryotinia fuckeliana, the causal agent of gray mold disease. Furthermore, in two other phytopathogenic fungi, Magnaporthe grisea (rice blast fungus) and Colletotrichum lagenarium (an anthracnose fungus), ras gene homologs were identified by amplifying gene fragments in polymerase chain reactions. The putative ras gene of B. fuckeliana encoded a polypeptide of 212 amino acids, and the coding sequence was interrupted by three short introns. The amino-terminal one third of the predicted Ras protein was highly homologous, and the next one third moderately homologous, to those of mammalian Ras proteins. The carboxy-terminal one third showed no homology, except in the last several amino acids that conformed to the acylation consensus.

Transcriptional activation of the matrix metalloproteinase-9 gene in an H-ras and v-myc transformed rat embryo cell line

The 92 kd type IV collagenase/gelatinase (MMP-9) is important in mediating basement membrane and extracellular matrix degradation in metastasis. Because MMP-9 is made in tumor cells, but not in quiescent normal cells, we wished to identify the transcriptional elements responsible for its synthesis in tumor cells. We chose to characterize transcriptional regulation of the MMP-9 gene in a highly metastatic H-ras and v-myc transformed rat embryo cell line which overexpresses MMP-9. Using transient transfection of reporter gene constructs containing either 5'-deleted or mutated MMP-9 promoter fragments, as well as electrophoretic mobility shift assays, we have demonstrated that multiple transcription factor consensus binding motifs in the promoter, including those for NFkappaB, SP-1, Ets, AP-1, and a retinoblastoma binding element, participate in transcriptional regulation of MMP-9 expression in this cell line. Also, deletion of an alternating purine-pyrimidine tract in the downstream promoter was found to decrease transcriptional activity, suggesting that promoter conformation may be important in MMP-9 regulation. Thus multiple pathways leading to activation of NFkappaB, SP-1, Ets, AP-1, and retinoblastoma binding factors in tumor cells all may contribute to MMP-9 transcription and hence to metastasis.

Altered hydroxylation of estrogen in patients with postmenopausal osteopenia

To study the possible contributions of the differences in estrogen metabolism to bone mass in postmenopausal osteopenia, spinal and femoral bone mineral densities (BMD) were measured, and 18 urinary metabolites of estrogen were analyzed by a gas chromatography-mass spectrometry assay system in 59 postmenopausal women (5-10 yr after menopause). The BMD of the spine and femoral neck showed positive correlations with body weight, height, and body mass index as we expected. Compared to nonosteopenic subjects, there were no significant differences in serum estrone (E1) and estradiol (E2) levels in patients with osteopenia. However, the urinary 16 alpha-hydroxyestrone [16 alpha-(OH)E1] level was significantly lower in patients with spinal osteopenia (P < 0.001). Among the 18 urinary metabolites of estrogen, the 16 alpha-(OH)E1 and 16 alpha-(OH)E1/2-hydroxyestrone [2-(OH)E1) ratio showed positive correlations with spinal BMD (P < 0.05), whereas 2-(OH)E2 showed a negative correlation with femoral neck BMD (P < 0.05). The urinary 16 alpha-(OH)E1 level also revealed a positive correlation with the age-matched z score of BMD in the spine (P < 0.05). In multiple stepwise regression analysis, weight, 16 alpha-(OH)E1, interaction between 16 alpha-(OH)E1 and 2-(OH)E2, 2-(OH)E2, and years after menopause were statistically significant for spinal BMD (r2 = 0.4968). For femoral neck BMD and weight, 16 alpha-(OH)E1 and 2-(OH)E2 were the independent determinants (r2 = 0.3369). In conclusion, the activity of estrogen 16 alpha-hydroxylase was decreased and/or the activity of estrogen 2-hydroxylase was enhanced in post-menopausal osteopenia. We speculated that these derangements may serve as contributing factors for the acceleration of bone loss in post-menopausal osteoporosis.

Granulocyte-colony stimulating factor (filgrastim) accelerates granulocyte recovery after intensive postremission chemotherapy for acute myeloid leukemia with aziridinyl benzoquinone and mitoxantrone: Cancer and Leukemia Group B study 9022

This study evaluated the effect of filgrastim (granulocyte colony-stimulating factor [G-CSF]) on the duration of granulocytopenia and thrombocytopenia after intensive consolidation therapy with diaziquone (AZO) and mitroxantrone for patients less than 60 years of age with acute myeloid leukemia (AML) in complete remission. Patients less than 60 years of age with AML who achieved complete remission (CR) with daunorubicin and cytarabine induction therapy, were scheduled to receive three sequential courses of high-dose cytarabine, cyclophosphamide/etoposide, AZQ, and mitroxantrone in a pilot study to determine their tolerance of these three sequential consolidation regimens. The initial patients treated with AZQ and mitroxantrone experienced prolonged bone marrow suppression and, therefore, subsequent cohorts were treated with G-CSF, 5 micrograms/kg, beginning the day after completion of the third cycle of chemotherapy. There was a marked decrease in the duration of granulocytopenia less than 500/microL in two groups of patients receiving two different dose levels of AZQ and the same dose of mitoxantrone compared with patients not receiving the G-CSF. There was also a decrease in the need for hospitalization, as well as the duration of hospitalization. There was a trend towards shortening of the duration of thromobocytopenia, as well. The duration of complete remission and overall survival was similar in patients who received or did not receive G-CSF. G-CSF markedly shortened the duration of granulocytopenia in patients with AML receiving intensive postremission consolidation with AZQ and mitoxantrone. There was no adverse effect on CR duration or survival.

Apolipoprotein E genotyping and phenotyping in type II diabetes mellitus patients with hypertriglyceridemia

OBJECTIVES

We investigated the possible effect of apolipoprotein E (apo E) polymorphism on hypertriglyceridemia in type II diabetes mellitus (DM) patients by both apo E genotyping and phenotyping methods.

DESIGN AND METHODS

Eighty Korean type II DM patients were evaluated. Restriction isotyping after DNA amplification was used for apo E genotyping. The isoelectric focusing of neuraminidase-treated sera followed by immunoblotting was used for apo E phenotyping.

RESULTS

The concordant rate between apo E genotyping and phenotyping was 96.3%. Apo E genotype frequencies for all 77 concordant cases were as follows: 72.7% for epsilon 3/3; 16.9% for epsilon 3/4; 7.8% for epsilon 2/3; 1.3% for epsilon 2/4, 1.3% for epsilon 4/4; and 0% for epsilon 2/2. There were no significant differences in apo E genotype frequencies between hypertriglyceridemic (n = 42) and normotriglyceridemic (n = 35) groups.

CONCLUSIONS

Our findings could not support the association between apo E polymorphism and hypertriglyceridemia among type II DM patients.

A comparison study of children with sickle cell disease and their non-diseased siblings on hopelessness, depression, and perceived competence

The purpose of this comparison study was to explore the extent to which hopelessness and self-perceptions of competence are associated with depression in a community population of children with sickle cell disease compared to their non-diseased siblings. Subjects were African-American children drawn randomly from the case management programme at the L.D. Barksdale Sickle Cell Anemia Foundation. Depression scores were higher for the non-diseased siblings. The children with sickle cell disease scored lower on the perceived physical competence scale. Recommendations for practice include increasing hope, improving relationships, monitoring depression in patients and their siblings, and monitoring perceptions of cognitive, social, physical, and general self-worth.

Pharmacology and toxicology of chemical warfare agents

Toxic chemicals have been used as weapons of war and also as means of terrorist attacks on civilian populations. The main classes of chemical weapons are: a) nerve agents, b) vesicant agents and c) blood agents. If an exposure to nerve agents is anticipated, prophylactic pyridostigmine may be used. Once exposure has occurred, the management strategy is to reduce cholinergic activity through the use of atropine as well as to attempt to regenerate acetylcholinesterase with pralidoxime. Convulsions may be managed using diazepam. Exposure to vesicant agents may be reduced through the use of protective gear, but once exposure has occurred, no specific treatment is available. Treatment remains symptomatic and supportive. Lethal atmospheric concentrations of hydrogen cyanide gas, a blood agent, is seldom achieved except in enclosed spaces. Sub-lethal exposure to hydrogen cyanide may be managed using sodium nitrite, sodium thiosulphate and VitB12.

Prognostic significance of altered cerebral blood flow velocity in acute head trauma

From July 1992 to January 1993, 31 patients with acute closed head injuries underwent blood flow velocity (BFV) measurement in the middle cerebral artery by transcranial Doppler ultrasound. Eighteen patients had abnormal changes of BFV (group A) and 13 patients had normal BFV (group B). In group A, there were eight deaths (44%) and the Glasgow Outcome Scale score was 2.6 +/- 0.4 (mean +/- SEM). On admission, 14 group A patients had decreased BFV, including nine patients with evidence of early cerebral circulatory arrest (CCA). During hospitalization, eight group. A patients were diagnosed with global hyperemia, including two patients who had early CCA. Another six in group A had ultrasound recordings consistent with vasospasm, and three of these six also experienced early CCA. The renaming four patients in group A had persistently low BFV, progressing from early CCA. In group B there were two deaths (15%) and the mean Glasgow Outcome Scale score was 4.0 +/- 0.5. Group A had higher mortality (Fisher's exact test, p = 0.128) and a significantly higher rate of unfavorable functional outcome than group B. To evaluate the prognostic significance of these BFV changes, group A was subdivided into global hyperemia, vasopasm and early CCA subgroups. Both the vasospasm and early CCA subgroups had significantly lower Glasgow Coma Scale scores on admission and a higher rate of unfavorable functional outcomes than group B. All five survivors with vasospasm and/or early CCA showed ischemic morbidity on follow-up cranial computed tomography; though those with global hyperemia did not. There were no significant differences in the Glasgow Coma Scale score on admission, mortality or functional outcome between global hyperemia patients and group B patients. Global hyperemia may represent a recovery stage of impaired cerebral hemodynamics. This stage may occur transiently and has no major impact on morbidity or mortality. Vasospasm and early CCA may be closely related to ischemic complications, and may provide clinical information for selecting appropriate therapy in acute head trauma.

Stem cell factor protects bone marrow-derived cultured mast cells (BMCMC) from cytocidal effect of nitric oxide secreted by fibroblasts in murine BMCMC-fibroblast coculture

The survival of mast cells are dependent on two kinds of growth factors, one derived from T cells (IL-3) and another derived from fibroblasts (stem cell factor [SCF]). The 3T3 fibroblast cell line derived from WCB6F(1-)+/+ mouse embryos (+/+ 3T3 fibroblasts) supported the proliferation of bone marrow-derived cultured mast cells (BMCMC) in the PWM-stimulated spleen cell conditioned medium (PWM-SCM), whereas the 3T3 fibroblast cell line from WCB6F1-Sl/Sld mouse embryos (Sl/Sld 3T3 fibroblasts) did not. To study the role of nitric oxide (NO) on the growth of mast cells in BMCMC-fibroblast coculture, we used a NO synthase inhibitor, NG-monomethyl-L-arginine (NGMMA). NGMMA recovered survival and maintained proliferation of mast cells in BMCMC-Sl/Sld 3T3 fibroblasts coculture. Sl/Sld 3T3 fibroblasts as well as 3T3 fibroblasts from NIH(-)+/+, BALB(-)+/+ or Swiss(-)+/+ mouse embryos secreted NO in PWM-SCM, but not in alpha-MEM. SCF protected BMCMC from cytotoxicity of exogenous NO in IL-3-supplemented alpha-MEM. We concluded that SCF might protect BMCMC from cytocidal effect of NO in BMCMC-fibroblasts coculture.