Fibropapule multiplex of the nose: a variant of Cowden's disease?

A 58-year-old male presented multiple papules on the nose for over 10 years. Excisional biopsy revealed angiofibroma with perivascular fibrosis and coarse collagen fibers. Investigation for internal malignancies revealed gastric cancer. Messenger RNA for HER-2/neu and c-ras were found both in the lesions of the skin and stomach. We propose the term, fibropapule multiplex of the nose, which may be a variant of Cowden's disease associated with occult internal malignancy.

Techniques for making spacers in interstitial brachytherapy for tongue cancer

The use of a spacer has been recommended in interstitial brachytherapy for tongue cancer to reduce the radiation dose to the mandible. This article describes the development of two types of acrylic resin spacers, a mouth guard-type spacer for dentate patients, and a replica denture-type spacer for edentulous patients. These spacers can be used without suture retention and are comfortable for patients.

Absence of restricted T cell receptor V beta repertoire in skin lesions of a patient with both psoriasis vulgaris and lichen planus

In a patient with both lichen planus and psoriasis, and suffering from hepatitis C virus infection, we examined the T cell receptor (TCR) Vb repertoire by reverse transcriptase polymerase chain reaction in skin lesions from psoriasis and lichen planus. A variety of rearranged variable TCR genes was found in the skin lesions, and the TCR Vb repertoire of the infiltrating T cells was not restricted. Although different patterns of expression were observed in the two lesions, TCR Vb 2 and 7 were commonly found.

Immunohistochemical localization of aldehyde and xanthine oxidase in rat tissues using polyclonal antibodies

Tissues from male Wistar rats, fixed with 4% paraformaldehyde and embedded in paraffin, were studied with immunoperoxidase techniques using polyclonal antibodies raised against aldehyde oxidase or xanthine oxidase purified from rat liver. Immunohistochemical studies demonstrated that aldehyde oxidase-bearing cells were strongly stained in renal tubules, esophageal, gastric, intestinal and bronchial epithelium as well as liver cytoplasm. Weak but positive immunoreactivity was observed on the pulmonary alveolar epithelial cells, gastric glands and intestinal goblet cells. In contrast, it was demonstrated that cells with xanthine oxidase were strongly stained in renal tubules, esophageal, gastric, and small and large intestinal and bronchial epithelia etc. Positive immunostaining was also found in adrenal gland, skeletal muscle, spleen and cerebral hippocampus. Immunoreactivity againt aldehyde oxidase was not found in adrenal gland, spleen, mesentery or aorta, while immunoreactivity against xanthine oxidase was not found in mesentery or aorta. Although the significance of this ubiquitous and similar localization of aldehyde and xanthine oxidase seems unclear at present, these results may provide a clue as to the full understanding of the pathophysiological role of these oxidases in tissues.

Involvement of Fyn tyrosine kinase in progression of cytokinesis of B lymphocyte progenitor

We analyzed the role of Fyn tyrosine kinase in cell cycle progression of B lymphocyte progenitor (pro B cell). Whereas there were no substantial defects in the intramarrow B cell genesis in the fyn(-) mouse, and long-term proliferation of fyn(-) pro B cells was maintained in vitro under a serum containing culture condition, the cell cycle was arrested at G2/M upon serum deprivation. Morphological analyses demonstrated that the cytokinesis of fyn(-) pro B cells was retarded in the presence of serum and that the entry of fyn(-) pro B cells into late telophase was completely blocked under the serum-free condition. In contrast, the earlier phases of mitosis of fyn(-) pro B cells proceeded normally without FCS. This failure to initiate late telophase resulted in the accumulation of elliptical binucleated cells that might be the outcome of the nuclear division without cytokinesis. Consistent with this defect in the progression of cytokinesis, Fyn was localized in the midspace of dividing pro B cells at anaphase. These results suggested that Fyn localizes at the midspace of dividing pro B cells and regulates the progression of cytokinesis.

Observation of macular lesion in Best's vitelliform macular dystrophy by scanning laser ophthalmoscope

Using a scanning laser ophthalmoscope (SLO), the ocular fundus of a patient with Best's vitelliform macular dystrophy was examined. With the argon blue laser, a dark area was seen in the fovea. Areas of weakly bright reflex were seen corresponding to the scrambled-egg lesion observed by ophthalmoscope. With the argon green laser, highly bright spots were observed at the foveola. Intense bright reflex was seen over the scrambled-egg lesion at the posterior pole. The helium-neon laser revealed highly bright patches corresponding to the orderly ring distribution of the yellowish deposits at the posterior pole. The diode laser revealed a mottled appearance with dark and bright patches in the scrambled-egg lesion. SLO provided a morphologic enhancement in the specifically affected layers of the macula in Best's vitelliform macular dystrophy.

Effect of amino acids on the excretions of purine bases and oxypurinol

To investigate whether or not amino acids affect the urinary excretion of purine bases and oxypurinol, a 12% amino acid solution was infused to 6 subjects who took allopurinol (300 mg) 6 h before the study. Amino acid infusion increased the urinary excretion and the fractional clearance of uric acid and oxypurinol and decreased the plasma concentration of oxypurinol. However, it affected neither the urinary excretion, the fractional clearance, the plasma concentration of oxypurines nor the plasma concentration of uric acid. These results indicate that amino acids affect the renal transport pathways of oxypurinol and uric acid but not those of oxypurines. In addition, it was suggested that the amino acid-induced increase in the urinary excretion of oxypurinol may be considered when allopurinol is administered to hyperuricemic patients with hypoproteinemia who have taken amino acids either orally or intravenously.

Blood velocity profiles in the human renal artery by Doppler ultrasound and their relationship to atherosclerosis

Blood velocity profiles were measured in the renal branch (diameter 5.9 +/- 1.3 mm) of the aortorenal bifurcation using a 20-MHz 80-channel pulsed Doppler velocimeter during retroperitoneal surgery in 10 patients. The peak Reynolds number was 1145 +/- 140 and the frequency parameter (Wormersley parameter) was 3.0 +/- 0.8. Immediately distal to the ostium of the renal artery, reverse flow, indicating flow separation, was observed near the cranial wall mainly during the first part of the cardiac cycle. There were flows from the cranial to the caudal side of the artery at this location, indicating the presence of strong secondary flows. Two diameters downstream of the ostium, the velocity profiles were skewed to the caudal side in all patients. Four diameters downstream, the flow profile was symmetrical (3 patients) or only slightly skewed (7 patients) and virtually parabolic throughout the cardiac cycle. These observations mean that the flow on the cranial side of the renal branch of the human aortorenal bifurcation is characterized by (1) a bidirectional oscillation of the flow, (2) separation of the flow during systole, and (3) low time-averaged shear rate. These blood velocity patterns may be related to the localization and development of atheromatous plaque that occurs preferentially in this region of the renal artery. Conversely, the unidirectional, axisymmetrical flow found in more distal parts of the renal artery are associated with a very low incidence of lesions.

[Benign intracranial hypertension and continuous CSF pressure monitoring: case report]

The authors report a case of benign intracranial hypertension (BIH) treated with a ventriculoperitoneal shunt. A 62-year-old man was referred to the Kobe City General Hospital with several episodes of transient visual obscuration. Neurological examination on admission revealed bilateral papilledema and a right lower quadrantic homonymous hemianopsia. Computed tomography (CT) showed normalized ventricles and a low-density area in the left occipital lobe without mass effects. From the findings of magnetic resonance images (MRIs) the occipital lesion was diagnosed as a chronic intracerebral hematoma. Because the hematoma did not show mass effects. BIH was suspected to be responsible for the papilledema. In spite of intravenous administration of dexamethasone and glycerol for a week, a lumbar puncture showed an opening pressure of 360mm H2O. Several subsequent lumbar punctures failed to improve intracranial hypertension. The mean opening pressure of the last 6 punctures was 392mm H2O. The mean terminal pressure dropped to 32mm H2O after removal of 10m/ of cerebrospinal fluid (CSF). A spinal subarachnoid drainage was inserted at the level of L4-L5 interspace for continuous CSF pressure monitoring. The mean CSF pressure ranged from 20 to 40mmHg. The continuous recording showed typical B waves frequently and plateau waves (A waves) occasionally. Removal of only 8m/ of CSF caused significant pressure reduction immediately. Then, pressure returned to the predrainage level about 35 minutes later. These findings supported the diagnosis of BIH. A ventriculoperitoneal shunt was inserted, which resulted in rapid and complete resolution of the papilledema. Postoperative CSF monitoring returned to normal pressure and waves. This case emphasizes the usefulness of continuous CSF pressure recording for the diagnosis and subsequent therapy of BIH.

Computerization of Fujimori's method of waveform recognition. A review and methodological considerations for its application to all-night sleep EEG

This article critically reviews 8 computer implementations of Fujimori's method for EEG waveform recognition, with methodological considerations for the application of this method to the analysis of all-night sleep EEG. Fujimori's method has been considered one of the most appropriate waveform analyses for EEG. This kind of analysis is advantageous for measuring frequency and amplitude of each EEG wave separately. However, current implementations have drawbacks which must be resolved before they can be used on all-night sleep EEG. An optimal sampling rate should be determined which is appropriate to the purpose of analysis. Amplitude thresholds for wave recognition, which are now set arbitrarily, should also be improved. Measurement of waves in higher orders of superimposition is also necessary, although existing systems are limited to the second order. Additional algorithms, such as for the separate detection of sleep slow waves, may be useful. Further applications for Fujimori's method are suggested.

Transient global amnesia and dural arteriovenous fistula of the anterior cranial fossa

Dural arteriovenous fistula (AVF) of the anterior cranial fossa is associated usually with cerebral hemorrhage or subarachnoid hemorrhage, while an association with transient global amnesia has not been reported previously. A case presenting the latter unusual symptom is described and the surgical treatment of AVF is discussed. A 64-year-old woman was hospitalized complaining of transient memory impairment. Magnetic resonance (MR) imaging demonstrated a flow void in the left frontal lobe and temporal pole. Cerebral angiography revealed an AVF in the anterior cranial fossa, which was fed bilaterally by the ethmoidal arteries and by branches of the external carotid arteries. The AVF drained into the superior sagittal sinus and the superficial sylvian vein via large varices. Following transfemoral embolization, surgical treatment was carried out. Postoperative angiography revealed complete obliteration of the anomaly. There were no further episodes of amnesia. In our presented case, there is an association between the presenting symptoms and the AVF. The combination of ischemia and congestion in the frontal and temporal lobes may have caused transient memory impairment. From our surgical experience, the excision of the vascular connection between the dura and the frontal lobe following the coagulation of the dura mater of the anterior part of the base of the skull without extensive excision seems to be recommended.

Molecular mechanisms to form leukocyte infiltration patterns distinct between synovial tissue and fluid of rheumatoid arthritis

There is a striking difference in the leukocyte infiltration pattern between synovial tissue and fluid of rheumatoid arthritis, a monocyte/macrophage-predominant infiltration in the former and a polymorphonuclear leukocyte (PMN)-predominant one in the latter. In extracts of rheumatoid arthritis synovial tissue, there is a strong chemotactic activity to monocytes but a negligible one to PMNs. The monocyte-specific chemotactic factor in the extracts represents dimers (and oligomers) of the S19 ribosomal protein which are cross-linked by a transglutaminase-catalyzed reaction. This oligomer formation may correlate to apoptosis in the lesion. On the other hand, in the synovial fluids there is the co-presence of chemotactic factors effective on PMNs as well as on monocytes and a strong chemotaxis inhibitor specific to monocytes. This inhibitory molecule is C4a which is liberated from complement component 4 in the presence of immune complexes. C4a exhibits its inhibitory activity indirectly by stimulating monocytes to release an autocrine or paracrine inhibitory cytokine to monocyte chemotaxis. These molecular mechanisms seem at least partly to cause the two distinct patterns of leukocyte infiltration in rheumatoid arthritis.

Isolation and characterization of a cDNA encoding a new type of human transcription elongation factor S-II

We report the isolation of a cDNA encoding a new type of transcription factor S-II, termed h-SII-T1, from a human library. The mRNA corresponding to the clone is highly expressed in testis and ovary. Comparison of the deduced amino acid (aa) sequence with those of other S-II molecules shows that (i) the C-terminal zinc finger (Zf) domain is highly conserved, and (ii) the central segment is most similar to that of the rat testis-specific S-II. Further analyses of the hS-II-T1 aa sequence indicate that its N-terminal sequence exhibits similarity to eubacterial sigma 54. The significance of tissue-specific S-II molecules for the regulation of transcription elongation is discussed.

Role of cholecystokinin-B receptor in the maintenance of thermal hyperalgesia induced by unilateral constriction injury to the sciatic nerve in the rat

To gain a better understanding of the role of cholecystokinin (CCK)-B receptor in the maintenance of thermal hyperalgesia induced by unilateral constriction injury to the sciatic nerve in the rat, this study evaluated the effects of intrathecally administered YM022 (a CCK-B receptor antagonist) on thermal hyperalgesia. Drugs were administered intrathecally 1 or 5 weeks after the nerve injury (1 and 5 week study). In the 5 week study, but not the 1 week study, YM022 attenuated the level of thermal hyperalgesia in a dose-dependent manner. These data indicate that a CCK-B receptor antagonist attenuates the level of thermal hyperalgesia and this effect of a CCK-B receptor antagonist is time-dependent.

A novel GTPase-activating protein for R-Ras

R-Ras, belonging to the Ras small GTP-binding protein superfamily, has been implicated in regulation of various cell functions such as gene expression, cell proliferation, and apoptotic cell death. In the present study, we purified an R-Ras-interacting protein with molecular mass of about 98 kDa (p98) from bovine brain cytosol by glutathione S-transferase (GST)-R-Ras affinity column chromatography. This protein bound to GTP gamma S (guanosine 5'-(3-O-thio)triphosphate, a nonhydrolyzable GTP analog).R-Ras but not to GDP.R-Ras, GTP gamma S.R-Ras with a mutation in the effector domain (R-RasA64), GTP gamma S.Ha-Ras, or GTP gamma S.RalA. We obtained a cDNA encoding p98 on the basis of its partial amino acid sequences. The predicted protein consists of 834 amino acids whose calculated mass, 95,384 Da, is close to the apparent molecular mass of p98. The amino acid sequence shows a high degree of sequence similarity to the entire sequence of Gap1m, one of the GTPase-activating proteins (GAP) for Ha-Ras. A recombinant protein consisting of the GAP-related domain of p98 fused to maltose-binding protein stimulated GTPase activity of R-Ras, and showed a weak effect on that of Ha-Ras but not that of Rap1 or Rho. These results clearly indicate that p98 is a novel GAP for R-Ras. Thus, we designated this protein as R-Ras GAP.

Zinc protoporphyrin IX, an inhibitor of the enzyme that produces carbon monoxide, blocks spinal nociceptive transmission evoked by formalin injection in the rat

Carbon monoxide (CO) is now thought to act as a neural messenger, but the role of CO is poorly understood. In the present study, we investigated the role of CO in both the spinal thermal nociceptive transmission and spinal nociceptive transmission during peripheral inflammation using zinc protoporphyrin-IX (Zn-P), a potent inhibitor of hemoxygenase inhibitor (HO). Peripheral inflammation was induced by the paw formalin injection (formalin test). It is thought that CO acts as a second messenger for metabotropic glutamate receptor. We also investigated the effect of metabotropic glutamate receptor antagonists, L-2-amino-3-phosphonopropionic acid (L(+)AP3) and (RS)-alpha-methyl-4-carboxyphenylglycine (MCPG), on the formalin test. Drugs were administered intrathecally 5 min before (pre-treatment) or 7 min after (post-treatment) the formalin injection. In both the pre-treatment and the post-treatment study, Zn-P inhibited the formalin induced flinching behavior in a dose-dependent manner. Both L(+)AP3 and MCPG had no effect on the formalin induced flinching behavior in the pre-treatment study. Zn-P had no effect on the thermal nociceptive test. These data suggest that CO plays an important role in spinal nociceptive transmission during the formalin test, but not during the thermal nociceptive test, and that, during the formalin test, CO may not act as a second messenger for metabotropic glutamate receptor in the spinal cord.

CD40 signaling-mediated induction of Bcl-XL, Cdk4, and Cdk6. Implication of their cooperation in selective B cell growth

Signals sent through CD40 play crucial roles in B cell differentiation, including blocking apoptosis of germinal center B cells. In this study, using a murine B cell WEHI-231 line that undergoes apoptosis by the cross-linking of surface Ag receptors (sIgM), we have demonstrated that CD40 signalings are linked to induction of the Bcl-xL, Cdk4, and Cdk6 proteins whose expression was significantly suppressed by the apoptotic signal through sIgM. Mutational analyses of CD40 revealed that the domain of human CD40 required for blocking apoptosis of WEHI-231 cells coincides with that required for Bcl-xL induction. Signals through sIgM arrest cells in the G1 phase of the cell cycle, which is followed by apoptosis. However, while constitutive expression of Bcl-XL leads to the inhibition of apoptosis. Nevertheless, Bcl-xL fails to induce S phase entry. By CD40 signalings, both Cdk4 and Cdk6 resume their normal expression levels, which are sufficient for passing the restriction point in G1 even in the presence of the apoptotic signals mediated by sIgM. These results suggest that cooperation of Bcl-xL, Cdk4, and Cdk6 induced by CD40 signaling plays a key role in CD40-mediated selective growth of B cells.

CD40 signaling-mediated induction of Bcl-XL, Cdk4, and Cdk6. Implication of their cooperation in selective B cell growth

Signals sent through CD40 play crucial roles in B cell differentiation, including blocking apoptosis of germinal center B cells. In this study, using a murine B cell WEHI-231 line that undergoes apoptosis by the cross-linking of surface Ag receptors (sIgM), we have demonstrated that CD40 signalings are linked to induction of the Bcl-xL, Cdk4, and Cdk6 proteins whose expression was significantly suppressed by the apoptotic signal through sIgM. Mutational analyses of CD40 revealed that the domain of human CD40 required for blocking apoptosis of WEHI-231 cells coincides with that required for Bcl-xL induction. Signals through sIgM arrest cells in the G1 phase of the cell cycle, which is followed by apoptosis. However, while constitutive expression of Bcl-XL leads to the inhibition of apoptosis. Nevertheless, Bcl-xL fails to induce S phase entry. By CD40 signalings, both Cdk4 and Cdk6 resume their normal expression levels, which are sufficient for passing the restriction point in G1 even in the presence of the apoptotic signals mediated by sIgM. These results suggest that cooperation of Bcl-xL, Cdk4, and Cdk6 induced by CD40 signaling plays a key role in CD40-mediated selective growth of B cells.