Congenital chylothorax in a patient with 21 trisomy syndrome

A female infant with 21 trisomy syndrome associated with congenital chylothorax was reported. She was born at a gestational age of 34 weeks by Cesarean section because of fetal hydrothorax and hydrops fetus, confirmed by ultrasonography at 32 weeks. Emergent resuscitation and immediate thoracentesis were performed soon after birth. After beginning breast feeding, the serous pleural fluid became opalescent and a diagnosis of congenital chylothorax was made. Feeding was changed to medium-chain triglyceride (MCT) feeding and the production of pleural effusion disappeared after thoracentesis was performed several times. Accumulating evidence suggested that MCT feeding and intermittent thoracentesis under echo guide were effective. Some reports on patients, including this one, suggest that there may be more patients with 21 trisomy associated with congenital hydrothorax. Therefore, congenital hydrothorax might be listed as a complication of 21 trisomy.

Correlation between MIB-1 staining index and the immunoreactivity of p53 protein in recurrent and non-recurrent meningiomas

Wild type p53 protein has been shown by recent investigations to be involved in the negative regulation of cell proliferation, whereas aberrant p53 protein has lost this negative regulation of cell growth. Wild type p53 protein, which has a very short half-life, has generally been considered to be undetectable using immunohistochemical methods; however, according to a recent report, wild type p53 protein may accumulate in the nuclei because of a defective ubiquitin pathway. Aberrant p53 protein has a longer half-life, and thus is visible using immunohistochemical methods. In this study, both the proliferative potential represented by the MIB-1 staining index (SI) and the immunoreactivity of p53 protein in 51 intracranial meningiomas were studied applying immunohistochemical staining methods to archival paraffin sections. The correlation among MIB-1 SI, p53 immunoreactivity, histopathologic findings and the clinical course of the meningiomas was also analyzed retrospectively. Although it is not possible with available reagents to distinguish between aberrant p53 protein and wild type p53 protein, statistical analyses show that p53 protein was immunostained both in meningiomas with high MIB-1 SI and in recurrent meningiomas. This demonstrates the close relationship among p53 immunoreactivity, MIB-1 SI, and recurrence; therefore, the presence of p53 protein by immunohistochemical examination may suggest the proliferative activity of meningioma and is capable of serving as a predictor of future recurrence.

Up-regulation of c-myc gene expression following focal ischemia in the rat brain

Changes in gene expression including that of c-fos occur following cerebral ischemia. Proto-oncogenes c-myc and s-myc and oncosuppressor gene p53 are known to induce apoptosis in some types of cells, whereas proto-oncogene bcl-2 inhibits apoptosis. Possible induction of mRNAs for c-myc, N-myc, s-myc, c-fos, p53 and bcl-2 was examined following focal ischemia in the rat anterior cortex, hippocampus, thalamus and cerebellum by Northern blot analysis. Animals were decapitated 1, 2, 6, 12, and 24 hours following the left middle cerebral artery (MCA) occlusion. In sham-operated control rats, the mRNAs for c-myc, N-myc, c-fos and p53 were present in the anterior cortex, hippocampus, thalamus on both sides, and in the cerebellum, whereas those for s-myc and bcl-2 were not. The c-myc gene expression was rapidly and markedly induced by the MCA occlusion in the ipsilateral anterior cortex, hippocampus and thalamus in a time-dependent manner. In these regions, the c-fos gene expression was also induced as early as 1 hour after the MCA occlusion. The p-53 mRNA was induced in the ipsilateral hippocampus at 24 hours after MCA occlusion. In contrast, mRNAs for N-myc, s-myc and bcl-2 were not induced following MCA occlusion. These results indicate a possibility that high-level expression of the c-myc gene may be involved in the ischemic cellular events including apoptosis.

Memantine induces heat shock protein HSP70 in the posterior cingulate cortex, retrosplenial cortex and dentate gyrus of rat brain

High-affinity N-methyl-D-aspartate (NMDA) receptor antagonists like MK-801 are known to induce the heat shock protein, HSP70, in the posterior cingulate cortex and retrosplenial cortex of rat brain. Memantine, which is a low affinity uncompetitive NMDA receptor antagonist, has been used in the treatment of Parkinson's disease in Europe. The faster kinetics of memantine in blocking and unblocking the NMDA receptor-operated ion channel as opposed to high-affinity NMDA antagonists like MK-801 has been thought to account for the safety of memantine. The present study evaluated the neurotoxic potential of memantine and amantadine using the induction of HSP70 immunoreactivity in rat brain. Memantine (25, 50, 75 mg/kg) induced HSP70 in the posterior cingulate, retrosplenial cortex and dentate gyrus of rat brain. In contrast, amantadine (50, 100, 200 mg/kg) did not induce HSP70 in the rat brain. These results suggest that memantine has an antagonistic effect at NMDA receptor in vivo, and raises the possibility that high doses of memantine may cause neuronal damage similar to those observed with other high-affinity NMDA receptor antagonists.

How epicardial U-wave changes are reflected in body surface precordial electrocardiograms in anterior or inferoposterior myocardial ischaemia during coronary angioplasty

OBJECTIVES

To examine the epicardial U-wave changes recorded in intracoronary electrocardiograms (ECGs) during anterior or inferoposterior myocardial ischaemia and the corresponding changes in precordial ECGs recorded from the body surface in humans.

METHODS

40 patients undergoing coronary angioplasty of the left anterior descending (LAD) coronary artery (22 patients) or left circumflex (LC) artery (18 patients). Intracoronary and surface precordial ECGs were simultaneously recorded under baseline conditions and during angioplasty.

RESULTS

Four different patterns of U-wave change were identified on the intracoronary ECG: change to positivity, no change, change to negativity, and biphasic change. The incidence of each pattern was similar in the two groups (LAD v LC groups, 23% v 39%; 23% v 17%; 41% v 44%; 13% v 0%, respectively). The intracoronary ECG was more sensitive than the surface ECG for detecting U-wave changes (intracoronary v surface ECG: LAD group, 77% v 55%; LC group, 83% v 28%). A study of the correlation between intracoronary and surface precordial ECGs showed that in patients who had U-wave changes in their intracoronary ECG (17 LAD and 15 LC patients) 65% of the LAD group but only 6% of the LC group had primary U-wave changes in the surface precordial ECG, and that 27% of the LC patients had reciprocal U-wave changes in the right to central precordial ECG.

CONCLUSIONS

These results provide fundamental information for an understanding of the correlation between U-wave changes in the epicardial and surface pre-cordial ECGs during myocardial ischaemia in humans. As well as the primary U-wave changes seen in many of those with anterior myocardial ischaemia, some of those with posterior myocardial ischaemia had reciprocal U-wave changes in their surface precordial ECGs.

Simultaneous ultrastructural identification of growth hormone and its messenger ribonucleic acid using combined immunohistochemistry and non-radioisotopic in situ hybridization: a technical note

The present electron microscopical study is concerned with the simultaneous visualization of messenger ribonucleic acid (mRNA) and its encoded protein in the same specimen. Pre-embedding electron microscopical in situ hybridization (EM-ISH) on rat pituitary gland tissue localized growth hormone mRNA in the polysomes of the rough endoplasmic reticulum, and subsequent postembedding immunolabelling using protein A-colloidal gold particles identified growth hormone mainly in the secretory granules. We believe that our report provides the first simultaneous ultrastructural identification of mRNA and its encoded protein using combined pre-embedding EM-ISH and immunohistochemistry. In this method, the signals for mRNA were localized specifically as highly electron dense products on the polysomes of the endoplasmic reticulum, and those for its encoded protein were recognized as gold particles both in the cisternae of the reticulum and in the secretory granules. Our ultrastructural double labelling method for mRNA and protein may provide a tool to find important clues for elucidating the intracellular correlation of mRNA translation and secretion of translated protein, because of its high resolution, good morphological preservation, and the specific localization of the reaction products.

Spatial memory disturbance after focal cerebral ischemia in rats

We investigated the impairment of retention of spatial memory in rats with chronic focal cerebral ischemia, and examined the correlation between this impairment and pathological outcomes. A preoperative acquisition trial of the Morris water-maze task was performed twice a day for 14 successive days, and then the middle cerebral artery (MCA) was occluded. A retention trial was performed 8 weeks after MCA occlusion. Escape latency and swimming path length to the platform were significantly increased in MCA-occluded rats compared with those of sham-operated rats, and these deficits significantly correlated with massive shrinkage of the brain. Retention latency of a passive avoidance task, which was trained preoperatively, was also significantly shortened in MCA-occluded rats compared with that in sham-operated rats. These results suggest that chronic focal cerebral ischemia causes prolonged spatial memory disturbance in rats and is associated with pathological changes, and that this rat model may be useful for assessing not only anterograde but also retrograde amnesia caused by focal cerebral ischemia.

Is thrombomodulin useful as a tumor marker of a lung cancer?

To evaluate whether thrombomodulin (TM) can be considered a tumor marker of lung cancer, we examined serum TM levels in 179 lung cancer patients by an enzyme immunoassay. Further, in 91 resected cases, we also investigated the TM presence in lung cancer tissue by an immunohistochemical method. Our findings revealed that 58 (32%) of 179 lung cancer patients had higher serum TM levels than our cutoff levels. No difference was seen in the serum TM-positive ratio between histologic types, but patients with Stage IV disseminated cancer showed a higher serum TM-positive ratio than those with Stage I-IIIB localized cancer, especially cases of adenocarcinoma. Immunostaining results showed a TM presence in the cancer cells of 32 (35%) of 91 lung cancer cases. The TM presence in cancer cells was higher in cases with squamous cell carcinoma than with adenocarcinoma; no differences were seen among the disease stages. No correlation was found between the serum TM and the presence of TM in cancer cells. Further, serum TM status appears to have little clinical significance as a method to detect early lung cancer or for predicting the recurrence after the surgical excision of a lung cancer. Thus, we have concluded that, although serum TM levels are elevated in some lung cancer patients, it is doubtful that the TM status is useful as a tumor marker of lung cancer.

Demonstration of antigenic and genotypic variation in Orientia tsutsugamushi which were isolated in Japan, and their classification into type and subtype

A total of 40 strains of Orientia tsutsugamushi (34 isolates from patients and trombiculid mites in Japan, and 6 prototype strains of antigenic variants) were examined for classification based on the reactivities with type-specific monoclonal antibodies in indirect immunofluorescence tests, and on the restriction fragment length polymorphism of a polymerase chain reaction (PCR)-amplified 56-kilodalton type-specific antigenic protein gene. By these methods, several antigenic and genotypic variants were found among the strains, and these variants were classified into types and further into subtypes. These results suggest that there are many variants in O. tsutsugamushi, and the methods used here seem to be useful for the systematic classification of the numerous variants. A strain which may be a new type distinguishable from those identified previously was also found in this study. Furthermore, variety in the degree of pathogenicity in mice related to type and/or subtype classification were observed.

Regional distribution of heparin-binding epidermal growth factor-like growth factor mRNA and protein in adult rat forebrain

Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is a recently described member of the EGF family that binds to and stimulates phosphorylation of the EGF receptor (EGFR). In this study, we examined the cellular localization of HB-EGF gene transcripts and protein in adult rat forebrain. In situ hybridization studies showed that neurons in various regions, including cortex, hippocampus, and deep structures, express HB-EGF mRNA. Positively labeled cells were also present in white matter, which suggests that both neurons and glia express HB-EGF mRNA. Immunohistochemical studies with an antibody specific to proHB-EGF, a transmembrane form of HB-EGF, demonstrated ubiquitous immunoreactivity in neurons and glial cells in white matter. In view of the wide expression of its cognitive receptor, EGFR, in central nervous system neurons, our results suggest that HB-EGF is an endogenous ligand for EGFR in the central nervous system and may play an important role in physiological conditions.

Sphingomyelin changes in rat cerebral cortex during focal ischemia

To better define the sphingolipid metabolism during focal brain ischemia, levels of ceramide, sphingomyelin, cerebroside and gangliosides were determined in rat cerebral cortex during focal ischemia produced by occlusion of the middle cerebral artery. Sphingomyelin began to decrease at 2 hours of ischemia and continued to decrease for 96 hours. In contrast, ceramide increased at 6 hours and increased to 4.2-fold at 96 hours after ischemia, and the fatty acid composition of ceramide was solely nonhydroxylated fatty acid similar to sphingomyelin. Hydroxylated fatty acid-linked cerebroside decreased at 6 hours of ischemia, whereas any significant decrease of nonhydroxylated fatty acid-linked cerebroside didn't occur for 96 hours of ischemia. There were no measurable changes in the levels of gangliosides. These results suggested that ceramide was produced in the cerebral cortex by the breakdown of sphingomyelin during early ischemia.

[Forensic application of two short tandem repeat (STR) polymorphic markers, FES and HUMTH01]

This paper reports polymorphisms of two short tandem repeats (STR) in the human c-fes/proto-oncogene (FES) and the human tyrosine hydroxylase gene (HUMTH01), and their application to paternity cases. Genomic DNA samples from 213 unrelated Japanese individuals and from 30 paternity cases were subjected to the polymerase chain reaction (PCR) and then the amplified products were electrophoresed in denaturing polyacrylamide sequencing gels. Allelic bands were detected with autoradiography. Seven alleles differing in the numbers of the repeat units were observed at both loci. Heterozygosity (%) and polymorphism information context were calculated, being 69% and 0.641 FES, and 70% and 0.647 for HUMTH01. The allele frequencies of the two STRs in this study were found to be similar to those previously reported on Asians but different from those in Caucasians and Blacks. When the STRs were applied to 30 paternity cases that had been already tested by using conventional markers, there were no discrepancies between the results of the STRs and of conventional markers. Furthermore, the two STRs could be successfully coamplified in multiplex PCR. These results suggest that the two STRs are useful in forensic work in Japan.

Glasgow Coma Scale in the prediction of outcome after early aneurysm surgery

OBJECTIVE

A prospective study was performed to analyze whether the Glasgow Coma Scale (GCS) was useful in predicting the outcome after early surgical intervention for aneurysmal subarachnoid hemorrhage (SAH).

METHODS

In a consecutive series of 765 patients who underwent surgery for aneurysms within 7 days after SAH, the level of consciousness was assessed by the GCS just before surgery and the outcome was graded by the Glasgow Outcome Scale 6 months after surgery.

RESULTS

The patient distribution in accordance with the GCS sum scores in descending order from 15 to 3 was as follows: 334, 140, 58, 27, 20, 26, 27, 19, 26, 17, 20, 27, and 24 patients, respectively. In general, the higher the preoperative GCS score was, the better the surgical outcome was. The overall surgical result was significantly correlated with the preoperative GCS score (rs = 0.615, P < 0.001). With respect to the levels that distinguish the outcome along the GCS axis, a significant difference in the outcome was observed only between the GCS scores of 15 and 14 (P < 0.001, Wilcoxon test).

CONCLUSION

The GCS proved useful in the preoperative evaluation of patients with SAH, in terms of outcome prediction. It is suggested that the SAH scale proposed by the World Federation of Neurosurgical Societies be reexamined, because differences in outcomes were not clear between the GCS scores of 13 and 12 or between those of 7 and 6, in which Grades III and IV and Grades IV and V are differentiated in the scale, respectively.

A study on simplification of the Standard Language Test of Aphasia (SLTA)

The Standard Language Test of Aphasia (STLA) was developed for classification and evaluation of severity of aphasia of Japanese speakers in 1975. Now it has become the most reliable test for patient with aphasic condition in Japan. However, the test involves many tasks and assessment is rather complicated. A simplified display of aphasic conditions was created by means of statistical analysis of the features of types of aphasia in order to reduce time and labor involved in SLTA for bed side use. Data were collected from 198 patients, including 40 patients with Broca aphasia (17 severe and 23 moderate cases), 64 patients with Wernicke aphasia (28 severe and 36 moderate cases) and 94 patients with global aphasia (68 severe and 26 moderate cases). A test with simplfied aphasia pattern involved naming objects for daily use (represented by pictures), pronunciation of words written in Kanji (Chinese characters) and in Kana (syllabary), pronunciation of single Kana, dictation of single Kana (oral presentation), repeating simple words presented by the examiner, dictation of words to be written in Kanji (oral presentation), matching words in Kana and a picture (pointing), writing words in Kanji (represented by pictures), writing words in Kana (represented by pictures), and auditory comprehension of words.

Effects of a hydroxyl radical scavenger on delayed ischemic neurological deficits following aneurysmal subarachnoid hemorrhage: results of a multicenter, placebo-controlled double-blind trial

A water-soluble, novel synthetic compound, AVS ((+/-)-N, N'-propylenedinicotinamide; nicaraven) has no demonstrable vasoactive properties but scavenges hydroxyl radicals in aqueous environmental conditions at neutral pH. Based on the results of preceding experimental and clinical studies showing marked ameliorative effects of AVS on cerebral vasospasm and ischemic brain damage, a multicenter, placebo-controlled double-blind clinical trial was undertaken to verify its beneficial effects on delayed ischemic neurological deficits (DINDs) due to vasospasm and on the overall outcome of patients with subarachnoid hemorrhage (SAH). A total of 162 patients with SAH who had Glasgow Coma Scale scores between 7 and 15 on admission were enrolled in the trial. Drug administration (4 g AVS or 4 g glucose as placebo; infused intravenously for 6-8 hours once a day) was begun within 5 days post-SAH and continued for 10 to 14 days. Intent-to-treat analysis of these patients revealed that the overall incidence of DINDs, which was defined as an exacerbation of impaired consciousness and/or focal neurological deficits, was significantly reduced, by 34.5% (placebo 54.2%, AVS 35.5%; p < 0.05, Mann-Whitney U-test). The Glasgow Outcome Scale (GOS) score at 1 month was significantly improved by AVS (p < 0.05, U-test). At 3 months, the difference in the GOS scores between the groups became marginal on U-tests (p < 0.10), but the percentage of good outcome tended to increase, with a relative increase of 20.3% (AVS 76.3%, placebo 63.4%; p < 0.10, chi-square test), and the cumulative incidence of death was significantly reduced (p < 0.05, log-rank test). No significant adverse reaction attributable to treatment was observed. the usefulness of AVS in therapy for SAH is strongly indicated by the fact that the agent significantly ameliorated DINDs, leading to a marked improvement in the GOS scores at 1 month, as well as a reduction in the cumulative incidence of death by 3 months.

[Projection of epicardial U-wave change to surface precordial electrocardiogram in coronary artery disease]

U-wave changes on the intracoronary electrocardiogram (ECG) during anterior or inferoposterior myocardial ischemia were correlated with the U-wave changes in the precordial leads of the body surface ECG in 28 patients who underwent coronary angioplasty of the left anterior descending (LAD group; 17 patients) or left circumflex (LC group; 11 patients) coronary artery. The intracoronary ECG was recorded simultaneously with the body surface multiple precordial leads at the baseline and during angioplasty. The amplitude of the U-wave on the intracoronary ECG was measured quantitatively, and U-wave changes from baseline to angioplasty were assessed qualitatively on the body surface ECG. Three different patterns of U-wave changes were distinguishable on the intracoronary ECG from baseline to angioplasty: change to positivity; no change; and change to negativity. The incidence of each pattern was similar in the LAD and LC groups (35 vs 36%; 30 vs 18%; 35 vs 46%, respectively). The intracoronary ECG was more sensitive for detecting U-wave changes during angioplasty than body surface precordial ECG (LAD group 71 vs 47%; LC group 82 vs 27%). When compared to the intracoronary ECG, concordant U-wave changes occurred in the surface precordial ECG in 67% (8/12) of the LAD group with accompanying epicardial U-wave changes, and discordant changes in 33% (3/9) of the LC group with epicardial U-wave changes. The present study provides fundamental information for understanding the correlation of U-wave changes between epicardial and surface precordial ECGs during myocardial ischemia in humans. As well as primary U-wave changes in anterior myocardial ischemia, reciprocal U-wave changes may also be prominent in the surface precordial ECGs in some cases of posterior myocardial ischemia.

Membranocystic changes in the panniculitis of dermatomyositis

Clinically apparent panniculitis is rare in dermatomyositis. The common histopathological findings are infiltration of lymphocytes, epithelioid cells and plasma cells in the fat lobules, along with varying degrees of fat degeneration and fibrosis. We report a 65-year-old woman with dermatomyositis who developed panniculitis with a characteristic histological change known as a membranocystic lesion. Although this change has been observed in various diseases affecting the subcutaneous fat tissue, it has rarely been reported in dermatomyositis. Dermatomyositis should be included in the diseases showing a membranocystic lesion.

Electrocardiographic diagnosis of left circumflex artery occlusion and the occlusion site

In patients with a posteroinferior acute myocardial infarction and both ST depression (in lead V1 or V2) and ST elevation in the inferior leads, it is difficult to differentiate a left circumflex artery occlusion from a right coronary artery occlusion. Furthermore, there is no useful method to identify the obstruction site in the left circumflex artery. In a study of 52 patients with single-vessel left circumflex artery disease, ST elevation in V6 was found to be a useful indicator for left circumflex artery occlusion in such patients. Furthermore, the sum of the ST changes in leads a VF and V2 is useful for identifying the occluded site in the left circumflex artery.

Nasal biopsy in the early diagnosis of Wegener's (pathergic) granulomatosis. Significance of palisading granuloma and leukocytoclastic vasculitis

The diagnostic value of the nasal biopsy in the early diagnosis of Wegener's granulomatosis and its value in prognosis were examined in 11 patients with a clinicopathological diagnosis of the disease. The vascular lesions found included microabscess in the vascular walls in 82%, leukocytoclastic capillaritis in 73%, fibrinoid necrosis of blood vessels in 45%, leukocytoclastic endovasculitis in 27%, and palisading granuloma in vascular wall in 9% of cases. The extravascular lesions included palisading granuloma in all cases, microabscess in 91%, and diffuse granulomatous tissues in 82%. Palisading microgranuloma (82%) was more frequent than palisading macrogranuloma (45%). After therapy, complete remission occurred in 8 patients, but 3 patients died of sepsis, diffuse pulmonary haemorrhage, and cerebral haemorrhage. Comparison of the frequency of each finding in the nasal biopsy specimens between patients who achieved remission and those who died showed that leukocytoclastic vasculitis was found more commonly in fatal cases, and leukocytoclastic endovasculitis was observed only in fatal cases. Palisading granuloma as a vascular or extravascular lesion is the primary and most important finding in a histopathological diagnosis of Wegener's granulomatosis, microabscess in vascular walls is a secondary but the next most important finding, and leukocytoclastic vasculitis heralds dissemination of the disease and poor prognosis. It requires aggressive therapy.

Multiple endocrine neoplasia type 1 associated with spinal ependymoma

A 51-year-old man was hospitalized with a gait disturbance and hypoesthesia below the level of his chest. These symptoms were due to a spinal tumor which was surgically resected and identified as an ependymoma. Additionally, the patient had hypercalcemia and a family history of insulinoma. An endocrine evaluation revealed parathyroid hyperplasia and a pancreatic islet cell tumor. Magnetic resonance imaging disclosed a pituitary microadenoma. He was diagnosed with spinal ependymoma and multiple endocrine neoplasia type 1 (MEN 1). A review of the literature revealed that chromosome 11q13 abnormalities have been reported in both ependymoma and MEN 1. We discuss the pathogenesis of these diseases.

Inhibition of apoptosis and augmentation of lymphoproliferation in bcl-2 transgenic Fas/Fas ligand-defective mice

Mice defective in Fas (CD95 or APO-1) or its ligand (lpr or gld mice) develop age-dependent lymphadenopathy and systemic autoimmune disease. T cells accumulating in the lymph nodes of these mice express reduced levels of Bcl-2 protein and are susceptible to spontaneous and glucocorticoid-induced apoptosis. We backcrossed bcl-2 transgenic mice to lpr and gld mice to homozygosity to determine the effects of Bcl-2 overexpression. T cells in these mice were resistant to spontaneous and glucocorticoid-induced apoptosis in vitro. Moreover, the accumulation of CD4(-)CD8(-) T cells in the lymph nodes and the spleens was augmented, suggesting that a Bcl-2-dependent mechanism regulating the number of T cells residing in the peripheral lymphoid organs in addition to the Fas-mediated pathway exists.

[Proton magnetic resonance spectroscopy of excised pig liver]

After evaluating ex vivo pig liver by 1H magnetic resonance spectroscopy (1H-MRS) using a 1.5 Tesla super-conducting unit, the assignment of peaks was reevaluated in vitro using a 9.4 Tesla superconducting unit. The portal vein was cannulated and perfused by cooled Euro-Collins solution, and pig liver was removed and preserved in the solution. Five to 8 g of the liver was excised before and after preservation, then extracted by perchloric acid (PCA). In 1H-MRS of PCA extracted pig liver, large peaks of fatty acid disappeared, while peaks of the choline group from 3.2-3.3 ppm were clearly observed. Using high performance liquid chromatography (HPLC) and 31P (phosphorus)-MRS, the 3.23 ppm peak was determined as glycerophosphorylcholine (GPC), which diminished after preservation. The chronological change of GPC in PCA extracted pig liver was able to be observed by 1H-MRS. GPC peak may play a role as an indicator in evaluating preserved liver by 1H-MRS.

Tenascin expression in endomyocardial biopsy specimens in patients with dilated cardiomyopathy: distribution along margin of fibrotic lesions

OBJECTIVE

To examine the hypothesis that tenascin, an extracellular matrix glycoprotein, contributes to fibrotic changes in dilated cardiomyopathy.

METHODS

The localisation of tenascin in biopsy specimens of the hearts obtained from eight patients with dilated cardiomyopathy was examined using staining by the avidin-biotin-peroxidase complex method.

RESULTS

(1) Perimysium and endomysium. Although positive staining for tenascin was observed in the enlarged perimysium and endomysium in all patients, moderately intense staining was characteristically observed near the replacement fibrotic lesions. In the narrow perimysium and endomysium of the myocardium not containing replacement fibrotic lesions, tenascin was not present, as in the control specimens. (2) Replacement fibrotic lesions. Non-homogeneous positive staining for tenascin was detected in all replacement fibrotic lesions examined. Intense tenascin deposition was observed in the peripheral portion of the replacement fibrotic lesions. The tenascin staining observed in the small replacement fibrotic lesions was more intense than that in the large lesions.

CONCLUSIONS

Tenascin contributes to the development of the fibrotic changes seen in the dilated cardiomyopathic heart. Its characteristic location, specifically the distribution along the margin of the fibrosis, suggests that fibrotic change is a continuous process in hearts with dilated cardiomyopathy.