Middle cerebral artery dissecting aneurysm with persistent patent pseudolumen. Case report

The extremely rare condition of an ischemic right middle cerebral artery dissecting aneurysm with persistent patent pseudolumen is described. In the majority of cases of dissecting aneurysms, the pseudolumen persists for a very short time, probably because reentry from the pseudolumen is minimal or nonexistent. In contrast, the present case was assumed to have sufficient reentry from the bypass flow in the pseudolumen. Endothelial formation both in the true lumen and the pseudolumen was suggested as the possible mechanism of the stabilized double lumen.

Differential expression of protein kinase C isozymes and small GTP-binding proteins during HL60 cell differentiation by retinoic acid and cyclic AMP: relation with phospholipase D (PLD) activation

The differential expression of protein kinase C (PKC) isozymes and small GTP-binding proteins, and their relation to O2 generation and phospholipase D (PLD) activation were analyzed during the differentiation of human promyelocytic HL60 cells to neutrophil-like cells induced by either retinoic acid (RA) or dibutyryl cyclic AMP (dbcAMP). In response to either one of the inducers, nitroblue tetrazolium (NBT) reduction activity time-dependently increased. Although PLD activity was upregulated by dbcAMP-treatment, only a slight increase was observed in RA-treated cells. Small GTP-binding proteins Rac1, Rap1, and RhoA, which are reported to be implicated in O2- generation or PLD activation, were already expressed in undifferentiated HL60 cells and their significant changes were not detected during differentiation. The mRNAs of the cytosolic components of NADPH oxidase system, p47phox and p67phox, were present in trace amounts in undifferentiated cells. However, they rapidly increased in response to RA or dbcAMP. In response to either RA or dbcAMP, the increases were observed in cPKC isozymes (alpha, beta I, beta II) but not in other subtypes (delta, epsilon, theta, zeta) by both RT-PCR and Western blot analyses. In dbcAMP-treated cells PKC alpha increased remarkably, whereas PKC beta I and beta II mainly elevated in RA-treated cells. These results suggest the possibility that cPKCs are closely related to cell differentiation and that PKC alpha is involved in PLD activation.

Nuclear deoxyribonucleic acid ploidy of testicular tumors: peculiar features and clinical significance

To verify the usefulness of testicular DNA ploidy measurement, we tried some approaches to tumorous and nontumorous testes. Separation of paraffin-embedded specimens into single dissociated nuclei was performed by Hedley's technique and nuclei were stained with propidium iodide. Control nontumorous testes were clearly separated into the three-peak type with a high G2M percentage and the two-peak type with a low G2M percentage. Among testicular tumors, 25% (8 of 32) had a normal DNA diploid pattern, 15.6% (5 of 32) had an increased DNA tetraploid pattern including DNA polyploidy, and 59.4% (19 of 32) were DNA aneuploid. In detail, 26.3% (5 of 19) of seminomas and 23.1% (3 of 13) of nonseminomas were DNA diploid. Interestingly, seminomas showed a variety of DNA histogram profiles. Among DNA aneuploid tumors, the DNA index of a seminoma was significantly higher than that of a nonseminoma. Among patients who received curative orchiectomy, postoperative metastases did not occur in any of the 8 DNA diploid or 5 tetraploid tumors, but did occur in 4 (21.1%) of 19 DNA aneuploid tumors during an at least 6-year follow-up. Clinicopathological findings were not as predictable as DNA ploidy. Flow cytometry appeared to be useful to characterize testicular tumors.

Collagen-encapsulated coagulation necrosis in cerebral infarcts: a pathological study

Coagulation necrosis (CN)--a type of necrosis characterized by firm, eosinophilic parenchyma with recognizable cell outlines--is thought to be a result of rapid degeneration of tissue protein to a gel state and loss of water which prevents the necrotic tissue from undergoing autolysis and cellular digestion. In this study, we observed CN in cerebral infarcts of 11 of 150 consecutive autopsy cases of large cerebral infarction. Cerebral CN in patients who had survived for about 1 month had already started to be surrounded by newly formed vessels and type I collagen-positive tissue. In patients who had survived for more than 1 year, CN was deposited with calcium and cholesterin crystals and encapsulated by thick, dense collagenous tissue. Encapsulation, however, was not always complete, a finding that suggests that other factors, such as gel transformation at an early stage of CN and calcification at a later stage, are important for the persistence of CN in the infarct. The results of our study suggest that cerebral CN occurs more frequently than is generally believed.

Characterization of DBT cell clones derived from cells persistently infected with the JHM strain of mouse hepatitis virus

Twelve clones derived from the cells persistently infected with the JHM strain (JHMV) of mouse hepatitis virus (MHV) were established from mouse astrocytoma-derived DBT cells and characterized. All the cell clones were resistant to superinfection with MHV. Only one of the persistently infected cell clone synthesized viral RNA and proteins and produced virus particles. Viral RNA was detectable in some other cell clones without production of viral protein nor the virus. No cell clones exhibited contact fusion activity. The results suggested that such variety of cell clones might have resulted from persistent infection with JHMV.

Effects of selective phosphodiesterase type IV inhibitor, rolipram, on signal transducing phospholipases in neutrophil: inhibition of phospholipases A2, D but not C

The effects of a selective phosphodiesterase (PDE) type IV inhibitor, rolipram, on activation of neutrophil phospholipases in response to the chemotactic peptide formyl-methiony-leucyl-phenylalanine (fMLP) were investigated. fMLP caused liberation of arachidonic acid, a precursor of eicosanoids and in the presence of 0.3% butanol, production of phosphatidylbutanol, an indicator of phospholipase D activation. Rolipram inhibited arachidonic acid release and phosphatidylbutanol formation. The inhibition was considered to be mediated through a cAMP-dependent mechanism, probably protein kinase A, because selective inhibitors for protein kinase A, H-8 or H-89 overcame the action of rolipram. The concentration-dependent inhibitory profile for phospholipase D activation was similar to that for lysosomal enzyme release, providing additional evidence for the functional link of these two events. In contrast, rolipram was without effect on fMLP-induced inositol trisphosphate production. These results indicate that this selective PDE IV inhibitor had no effect on phosphatidylinositol-specific phospholipase C activation but effectively prevented activation of phospholipases A2 and D coupled to arachidonic acid liberation and lysosomal enzyme release, respectively.

Selenocysteylation in eukaryotes necessitates the uniquely long aminoacyl acceptor stem of selenocysteine tRNA(Sec)

Selenocysteine synthesis is achieved on a specific tRNA, tRNA(Sec), which is first charged with serine to yield seryl-tRNA(Sec). Eukaryotic tRNA(Sec) exhibits an aminoacyl acceptor stem with a unique length of 9 base pairs. Within this stem, two base pairs, G5a.U67b and U6.U67, drew our attention, whose non-Watson-Crick status is maintained in the course of evolution either through U6.U67 base conservation or base covariation at G5a.U67b. Single or double point mutations were performed, which modified the identity of either or both of the base pairs. Serylation by seryl-tRNA synthetase was unaffected by substitutions at either G5a.U67b or U6.U67. Instead, and quite surprisingly, changing G5a.U67b and U6.U67 to G5a-C67b/U6.G67 or G5a-C67b/C6-G67 gave rise to a tRNA(Sec) mutant exhibiting a gain of function in serylation. This finding sheds light on the negative influence born by a few base pairs in the acceptor stem of tRNA(Sec) on its serylation abilities. The tRNA(Sec) capacities to support selenocysteylation were next examined with regard to a possible role played by the two non-Watson-Crick base pairs and the unique length of the acceptor stem. It first emerges from our study that tRNA(Sec) transcribed in vitro is able to support selenocysteylation. Second, none of the point mutations engineered at G5a.U67b and/or U6.U67 significantly modified the selenocysteylation level. In contrast, reduction of the acceptor stem length to 8 base pairs led tRNA(Sec) to lose its ability to efficiently support selenocysteylation. Thus, our study provides strong evidence that the length of the acceptor stem is of prime importance for the serine to selenocysteine conversion step.

[Prognosis after radical surgery in prostatic cancer patients with lymph nodes metastases]

We investigated prognosis of clinically localized prostatic adenocarcinoma patients who revealed to have had lymph nodes metastases by undergoing radical surgery. Eighty six patients were operated during the last 15 years under the clinical diagnosis of A2, 9 patients, B1, 15 B2, 13 and C, 49, respectively. Total prostatectomy was done to 51, total cystoprostatectomy to 33 and total pelvic excentration to 2 patients. Of these patients, 22.2% with stage A2, 20.2% with B1, 7.7% with B2 and 43.8% with C had positive nodes and the rate of positive nodes in stage C was significantly higher than that in other stages (p < 0.01). Regarding histological differentiation, 15.4% of well, 23.7% of moderate and 51.6% of poor by differentiated had positive nodes and the rate of positive nodes in poor by differentiated was significantly higher (p < 0.01). In 2 of 21 cases whose lymph nodes were dissected to the level of the aortic bifurcation, positive nodes were detected only in the external and common iliac areas. These two cases were missed, i.e., "false negative" if limited nodes dissection was performed. All patients with positive nodes were treated with hormonal therapy. The 5-year cancer specific survival rate of patients with positive (n = 27) and negative (n = 59) nodes were 66.4% and 92.4%, respectively. The prognosis of patients with positive nodes were significantly worse than that of patients with negative nodes (p < 0.001). Among 27 patients with positive nodes, significant prognostic factor was not number or extent of positive nodes, but histological differentiation.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of hepatitis C virus replication by antisense oligonucleotide in culture cells

Oligonucleotides complementary to the sequences containing the initiator codon, AUG, of the core region of positive-stranded hepatitis C virus (HCV) were tested for their effects on viral translation in a cell-free protein synthesis system and on viral replication in a human T-lymphotropic virus type I infected cell line, MT-2C, which was cloned by the limited dilution method from MT-2 cells and showed more efficient HCV replication than an uncloned population of MT-2 cells. Treatment of HCV-infected MT-2C cells with the antisense oligonucleotide (10 microM) had a dramatic inhibitory effect on viral replication. This result suggests that the antisense oligonucleotide complementary to the sequence close to the initiation codon of the core region might be useful as an antiviral agent against HCV replication.

Amyotrophic lateral sclerosis with marked neurological asymmetry: clinicopathological study

We attempted to correlate the marked neurological asymmetry observed in two amyotrophic lateral sclerosis patients with their histopathological lesions. Patient 1, a 52-year-old man, developed dysarthria and dysphagia, followed by muscle weakness in the left arm and then of the left leg. Patient 2, a 44-year-old man, developed muscle weakness in the left hand, left leg, tongue with left-sided predominance, right hand and right leg in that order of progression. Both patients exhibited moderate to marked left-sided predominant involvement of the lower motor neuron system, accompanied by retained or hyperactive deep tendon reflexes on the left side in the early stage of their illness. Most of the asymmetry in the lower motor neuron system involvement persisted until the death of the patients. Histopathological examinations, including semiquantitative analysis, revealed that both patients exhibited left-sided predominant degeneration of the lower motor neuron system at those spinal cord levels where the neurological asymmetry was of a moderate to marked degree. In addition left-sided predominant degeneration of the lateral corticospinal tracts was seen in both patients and right-sided predominant involvement of Betz cells in the leg area of the motor cortex of patient 1. This pattern of both the neurological and histopathological asymmetry suggested the probable existence of an intimate somatotopically related linkage between the upper motor neuron system degeneration and lower motor neuron system degeneration in both patients.

Deletion and site-directed mutagenesis of EF-hand domain of phospholipase C-delta 1: effects on its activity

In order to elucidate a role of a putative EF-hand motif (144-172) in phospholipase C-delta 1 (PLC-delta 1), deletion and point mutation of the enzyme were performed and the mutated cDNAs were expressed in CHO cells and E. coli AD202 strain. Deletion of amino acid residues of 141-236 or 173-236 resulted in abolition of PLC activity. However, the decreased PLC activity to 15-20% by deletion of the EF-hand motif (144-172) was still Ca(2+)-dependent. Furthermore, mutants, in which conserved Asp153, Asp157, Glu164 or all these acidic amino acids in the EF-hand motif were replaced with alanine residues, showed nearly the same PLC activity and Ca(2+)-dependency as those of wild-type. These results suggest that the region containing the EF-hand motif may not play a role in regulation of Ca(2+)-sensitivity of PLC-delta 1, but is important for its activity.

Inhibition of viral multiplication in cells chronically infected with mouse hepatitis virus by antisense RNA against the polymerase gene

Recently, we showed that the antisense RNA containing a hammerhead ribozyme sequence against the polymerase gene of mouse hepatitis virus (MHV) inhibited viral multiplication in acute infection [10]. In the present study, we examined the inhibitory effects of an antisense RNA on viral multiplication in chronic MHV infection. In cell line LR-2, in which the 926-nucleotide (nt) antisense RNA containing a ribozyme sequence against the polymerase gene was expressed constitutively at a high level, chronic MHV infection was established through the maintenance of infection over 100 days postinfection (d.p.i.). After 200 d.p.i., no infectious progeny virus was observed in the culture medium of chronically MHV infected LR-2 cells. Our present results showed that the anitsense RNA could also inhibit viral multiplication in chronic MHV infection.

Danazol concentrations in ovary, uterus, and serum and their effect on the hypothalamic-pituitary-ovarian axis during vaginal administration of a danazol suppository

OBJECTIVE

To determine danazol concentrations in the ovary, uterus, and serum during daily vaginal administration of a danazol suppository and to examine its effect on the hypothalamic-pituitary-ovarian axis.

DESIGN

Sampling of tissues after vaginal or oral administration of danazol and sampling of blood during control and danazol-administration menstrual cycles.

SETTING

Outpatient volunteers and inpatients at a public hospital.

PARTICIPANTS

Thirty patients who were to undergo hysterectomy and oophorectomy because of uterine leiomyoma and eight regularly menstruating volunteers.

INTERVENTIONS

Danazol was administered as a vaginal suppository (100 mg) or orally (400 mg).

MAIN OUTCOME MEASURE

Danazol concentrations in the ovary, uterus, and serum, and serum E2 and P levels.

RESULTS

Danazol concentrations in the ovary and uterus after daily vaginal administration of a suppository containing 100 mg danazol were comparable to those after daily oral administration of 400 mg danazol, but the serum danazol concentration was much lower. Menstrual cycle patterns of serum E2 and P levels were normal during daily vaginal administration of a danazol suppository.

CONCLUSION

Daily administration of a suppository containing 100 mg danazol produces high ovarian and uterine concentrations but low serum concentrations, and no effect was detected on the hypothalamic-pituitary-ovarian axis.

Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms

The clinical characteristics of vertebrobasilar dissecting aneurysms occurring with subarachnoid hemorrhage (SAH) were reviewed in 42 patients, with particular focus on the time, incidence, and outcome in association with subsequent rupture. Twenty-nine patients underwent 31 surgical procedures, and the remaining 13 patients were managed without surgery. Surgical details included 19 proximal vertebral artery obliterations (including 1 case of endovascular surgery using balloon occlusion), 9 trappings, 1 wrapping, 1 bleb clipping, and 1 bleb clipping combined with wrapping. Surprisingly, subsequent rupture occurred in 30 (71.4%) of the 42 patients. Excluding one patient with postoperative rupture, 29 patients suffered a subsequent rupture in the unsecured stage. Of these 29 patients, 19 were operated on after the subsequent rupture and 10 were not operated on because of deteriorated clinical condition (9 patients) or anatomic considerations (1 patient). Of the 30 patients that suffered a subsequent rupture, 14 died. Twelve of the deaths were directly related to the second episode of rupture. Of the 12 patients who did not suffer a subsequent rupture, 10 underwent operations and there were no operative deaths. Only one patient died as the result of the initial critical SAH. The mortality (46.7%) of the patients with subsequent rupture was significantly higher (P < 0.05) than that (8.3%) of the patients without subsequent rupture. Seventeen (56.7%) of the 30 subsequent ruptures occurred within 24 hours after the first SAH, and 24 (80%) occurred within the first week. Six (66.7%) of the 9 patients operated on within 24 hours after the first SAH and 11 (68.8%) of the 16 patients operated on within a week suffered preoperative subsequent ruptures.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical significance of epidermal growth factor (EGF), EGF receptor, and c-erbB-2 in human gastric cancer

The EGF stimulation system for growth regulation is implicated in normal and neoplastic cell proliferation. The role of EGF, the EGF receptor, and c-erbB-2 in human gastric cancer is reviewed on the basis of several reports, which have been mainly oriented toward their clinical significance. EGF has been shown immunohistochemically to be present in 26% of gastric cancers (n = 395). The presence of EGF in gastric cancer is correlated with the degree of gastric wall invasion and lymph node metastasis. The 5-year survival of patients with EGF-positive tumors is worse than that of patients with EGF-negative tumors. The presence of EGF in human gastric cancer may therefore represent a higher malignant potential. Fifteen percent of gastric cancers (n = 352) were also shown to be positive for both EGF and the EGF receptor immunohistochemically, and the simultaneous occurrence of EGF and the EGF receptor suggests that these tumors grow in an autocrine fashion. Tumors exhibiting EGF and the EGF receptor simultaneously show a greater degree of local invasion and lymph node metastasis. Increased expression of EGF receptor protein in gastric cancer appears to be related to biologic aggressiveness, although gene amplification has occurred only to a small extent. Twelve percent of gastric cancers (n = 486) were found to be positive for c-erbB-2. This type of tumor has a frequent metastasis, and patients with c-erbB-2-positive cancer have a poorer prognosis than those with c-erbB-2-negative tumors. Selective blockade of the EGF receptor and c-erbB-2 from their ligands with monoclonal antibodies (MoAbs) inhibits the growth of human gastric cancer xenografts. These MoAbs may therefore be effective antitumor agents against gastric cancer showing overexpression of EGF receptors or c-erbB-2.

Clinical significance of epidermal growth factor (EGF), EGF receptor, and c-erbB-2 in human gastric cancer

The EGF stimulation system for growth regulation is implicated in normal and neoplastic cell proliferation. The role of EGF, the EGF receptor, and c-erbB-2 in human gastric cancer is reviewed on the basis of several reports, which have been mainly oriented toward their clinical significance. EGF has been shown immunohistochemically to be present in 26% of gastric cancers (n = 395). The presence of EGF in gastric cancer is correlated with the degree of gastric wall invasion and lymph node metastasis. The 5-year survival of patients with EGF-positive tumors is worse than that of patients with EGF-negative tumors. The presence of EGF in human gastric cancer may therefore represent a higher malignant potential. Fifteen percent of gastric cancers (n = 352) were also shown to be positive for both EGF and the EGF receptor immunohistochemically, and the simultaneous occurrence of EGF and the EGF receptor suggests that these tumors grow in an autocrine fashion. Tumors exhibiting EGF and the EGF receptor simultaneously show a greater degree of local invasion and lymph node metastasis. Increased expression of EGF receptor protein in gastric cancer appears to be related to biologic aggressiveness, although gene amplification has occurred only to a small extent. Twelve percent of gastric cancers (n = 486) were found to be positive for c-erbB-2. This type of tumor has a frequent metastasis, and patients with c-erbB-2-positive cancer have a poorer prognosis than those with c-erbB-2-negative tumors. Selective blockade of the EGF receptor and c-erbB-2 from their ligands with monoclonal antibodies (MoAbs) inhibits the growth of human gastric cancer xenografts. These MoAbs may therefore be effective antitumor agents against gastric cancer showing overexpression of EGF receptors or c-erbB-2.

Clinical significance of epidermal growth factor (EGF), EGF receptor, and c-erbB-2 in human gastric cancer

The EGF stimulation system for growth regulation is implicated in normal and neoplastic cell proliferation. The role of EGF, the EGF receptor, and c-erbB-2 in human gastric cancer is reviewed on the basis of several reports, which have been mainly oriented toward their clinical significance. EGF has been shown immunohistochemically to be present in 26% of gastric cancers (n = 395). The presence of EGF in gastric cancer is correlated with the degree of gastric wall invasion and lymph node metastasis. The 5-year survival of patients with EGF-positive tumors is worse than that of patients with EGF-negative tumors. The presence of EGF in human gastric cancer may therefore represent a higher malignant potential. Fifteen percent of gastric cancers (n = 352) were also shown to be positive for both EGF and the EGF receptor immunohistochemically, and the simultaneous occurrence of EGF and the EGF receptor suggests that these tumors grow in an autocrine fashion. Tumors exhibiting EGF and the EGF receptor simultaneously show a greater degree of local invasion and lymph node metastasis. Increased expression of EGF receptor protein in gastric cancer appears to be related to biologic aggressiveness, although gene amplification has occurred only to a small extent. Twelve percent of gastric cancers (n = 486) were found to be positive for c-erbB-2. This type of tumor has a frequent metastasis, and patients with c-erbB-2-positive cancer have a poorer prognosis than those with c-erbB-2-negative tumors. Selective blockade of the EGF receptor and c-erbB-2 from their ligands with monoclonal antibodies (MoAbs) inhibits the growth of human gastric cancer xenografts. These MoAbs may therefore be effective antitumor agents against gastric cancer showing overexpression of EGF receptors or c-erbB-2.

Effect of gonadotropin-releasing hormone agonists, nafarelin, buserelin, and leuprolide, on experimentally induced endometriosis in the rat

OBJECTIVE -- The purpose of this study was to compare the potency of the gonadotropin-releasing hormone (GnRH) agonists nafarelin, buserelin, and leuprolide in a newly developed model of experimental endometriosis, thus further characterizing the model. METHODS -- Endometriosis was induced in female rats by autotransplantation of endometrium to a site under the renal capsule. The effect of the GnRH agonists on explant volume and fluid accumulation was evaluated. Binding affinities of the compounds for GnRH receptors in pituitary homogenates of female rats was also measured. RESULTS -- The three GnRH agonists induced significant atrophy and regression of endometriosis. The volume of endometriosis in intact control was 26.1 +/- 4.7 cu.-mm (n = 13), 1.7 +/- 0.1 cu.-mm (n = 12) after therapy with nafarelin, 4.8 +/- 1.8 cu.- mm (n = 7) with buserelin, and 3.7 +/- 1.2 cu.-mm (n = 13) with leuprolide. The effects of these compounds were comparable to that of castration (1.9 +/- 0.5 cu.-mm; n = 10). There was no significant difference in the binding affinities of leuprolide and buserelin for pituitary GnRH receptors. CONCLUSION -- The model was found to be responsive to the GnRH agonist agents evaluated and could discriminate between dosage levels. Potency of the compound seems to correlate with binding affinity to pituitary GnRH

Total recanalization of a spontaneously thrombosed arteriovenous malformation. Case report

The authors describe what they believe to be the first case of an asymptomatic, totally recanalized arteriovenous malformation (AVM) demonstrated by angiography 31 months after complete spontaneous thrombosis. The AVM, which initially became symptomatic with bleeding, had a 2-cm diameter nidus that was located within the inferior aspect of the left frontal lobe and was fed by branches from the left anterior cerebral and anterior ethmoid arteries. A single draining vessel flowed from the nidus into the anterior superior sagittal sinus. The AVM was surgically extirpated after recanalization. The authors stress the necessity for follow-up care for angiographically "cured" AVMs.

[A case of closed head injury with diffuse axonal injury, and oculomotor nerve avulsion and midbrain infarction]

We report an autopsy case of 66-year-old woman with closed head injury due to a fall from stairs. She had recovered after a half day period of coma following the fall. Severe right peripheral oculomotor nerve palsy was noted from the beginning. MRI demonstrated lesions in the corpus callosum and right midbrain. She had died of suffocation due to sputum impaction after 50 hours after the fall. Autopsy examination revealed traumatic subarachnoidal hemorrhage, partial tearing and petechial hemorrhage of the corpus callosum, and many axonal retraction balls scattered in the cerebral white matter. Avulsion of the right oculomotor nerve root and fresh midbrain infarct with hemorrhage in the territory of right paramedian artery were observed. Axonal retraction balls were densely distributed in the periphery of midbrain infarct. The distribution pattern of axonal retraction balls in the cerebrum was similar to that of damage due to shear strain in Holbourn's gelatin model of closed head injury. The midbrain infarct and oculomotor nerve avulsion may be due to both mechanical and ischemic damage during and after the fall. All of the lesions described above may be closely related to the rotatory force from the right forehead.