Reduction of androgen receptor mRNA concentration by testosterone in mouse submandibular gland

In this study, we examine the effect of testosterone on the steady-state concentration of androgen receptor (AR) mRNA of mouse submandibular gland. Northern blot analysis showed the expression of an AR-specific 10-kb transcript in the submandibular glands of both sexes. Quantitative analysis was done by means of reverse transcription-polymerase chain reaction (RT-PCR) with a non-radioactive label of digoxigenin. The RT-PCR demonstrated that the steady-state of AR mRNA concentration was less in males than in females. Moreover, AR mRNA increased in the castrated male mice, while the administration of testosterone reduced the AR mRNA in female mice. In conclusion, the amount of AR mRNA in mouse submandibular gland is reduced by androgen.

Evolution of Mirizzi syndrome with biliobiliary fistula

The mechanisms of fistula formation were analyzed in eight patients with Mirizzi syndrome with biliobiliary fistula. The fistula was type 1 in three patients and type 2 in five, according to the Corlette-Bismuth classification. The apparent mechanisms of fistula formation include inflammation of the gallbladder, its subsequent fusion to the bile duct, and increase in the internal pressure due to either contraction of the gallbladder or multiple stones. However, no predisposing conditions other than a longstanding history of cholelithiasis have been suggested. Differences in the type of fistula are considered to be due to the mode of fusion of the gallbladder to the bile duct, and the size of the perforation, which is apparently determined by the area in contact with the stone.

A clinical survey on the compliance of exercise therapy for diabetic outpatients

To clarify the present state of exercise therapy for diabetes mellitus, we conducted a survey of 570 diabetic outpatients by written questionnaires. The results revealed that approximately 30% of the patients did not implement the prescribed exercise regimen. The principal reasons for low compliance were 'lack of time to do' and 'lack of mind to do'. 'Lack of time to do' was particularly numerous in male patients. Other reasons were 'lack of guidance by physician', 'lack of interest', 'lack of understanding of procedure'. These findings indicated that the patients should be motivated adequately when they are diagnosed as having diabetes and subsequently encouraged to reinforce their intentions by the physician and co-medical staff. Furthermore, they showed that specific approaches suitable for each individual patient and not standardized guidelines should be devised. As regards the daily environment of patients, the cooperation of the patient's family would be effective and the exercise facilities and the exercise guidance personnel should be augmented.

Ultraviolet resonance Raman studies of quaternary structure of hemoglobin using a tryptophan beta 37 mutant

Environmental changes of tyrosine and tryptophan residues of hemoglobin (Hb) upon its T to R transition of quaternary structure were investigated with ultraviolet resonance Raman (UVRR) spectroscopy excited at 235 nm. DeoxyHb A (T-form) showed a UVRR spectrum distinctly different from those of the ligated Hbs (R-form) including oxyHb, COHb, and metHb A, whereas the ligated Hbs exhibited similar UVRR spectra irrespective of the ligand species and the oxidation state of the heme. To characterize the spectral change of Trp-beta 37 at the alpha 1 beta 2 interface due to the quaternary structure transition, the UVRR spectra of Hb A were compared with the corresponding spectra of Hb Hirose (Trp-beta 37-->Ser). A difference spectrum between deoxyHb A and deoxyHb Hirose showed only Trp resonance Raman (RR) bands, which were reasonably ascribed to Trp-beta 37 in deoxyHb A. RR bands at 873 cm-1 (W17) and at 1360 and 1343 cm-1 (W7, Fermi doublet) indicated that the indole ring of Trp-beta 37 in deoxyHb A formed a strong hydrogen bond at the N1H site in hydrophobic environments. Tyr residues in deoxyHb Hirose seemed to be in the same environments as those of deoxyHb A. In contrast, the difference spectrum between Hb A and Hb Hirose in the ligated state displayed peaks for RR bands of both Trp and Tyr. The difference spectra were unaltered by the addition of 5 mM inositol hexaphosphate. This means that the differences were not caused by the tetramer to dimer dissociation but by a conformation change within a tetramer. Comparison of the Hb A-Hb Hirose difference spectra in the oxy and deoxy states revealed that the oxygenation-induced changes of Trp RR bands arose mostly from Trp-beta 37 with the small portion of remaining changes coming from Trp-beta 15, demonstrating that Trp-beta 37 plays a pivotal role in the quaternary structural change in Hb A.

Inhibition of hepatic regeneration after 70% partial hepatectomy by simultaneous resection of the bowel in rats

This study was aimed to evaluate bow simultaneous resection of the bowel influences hepatic regeneration after partial hepatectomy (HTX). Two hundred and sixty-four rats underwent 70% partial HTX, ileocecal resection (ICR), transverse colon resection (TR), colon amputation and simulatenous resection of the liver and the bowel (HTX+ICR, HTX+TR). Hepatic DNA synthesis was remarkably suppressed by simultaneous resection compared with the 70% HTX group (p < 0.01). In simultaneous resection groups, delayed enhanced hepatic protein synthesis (HPS) was observed after the operation as compared with the 70% HTX group, which showed an early postoperative peak of HPS. Postoperative anastomosis leakage occurred more frequently and survival rates were significantly lower in simultaneous resection groups. Higher plasma endotoxin levels of the portal and the peripheral veins were found in simultaneous resection groups as compared with other groups (p < 0.01-0.001). This study suggested that simultaneous resection of the bowel with partial HTX might inhibit hepatic regeneration and result in the increased risk of anastomosis leakage and high surgical mortality rate by increased plasma endotoxin levels and delayed enhanced HPS.

A follow-up study of patients with cervical cancer after resection, with special emphasis on the incidence of second primary cancers

The causes of death in long-term survivors after resection of cervical cancer were investigated in a follow-up study of 375 women, focusing especially on the postoperative development of second primary cancers. The 5- and 10-year overall survival rates were 75.0 and 66.0%, respectively, in cases that showed frank invasion, 94.7 and 92.8%, respectively, in those showing microinvasion, and 96.2 and 96.2% respectively, in those showing carcinoma in situ. Multivariate analysis identified patient age and cancer stage at the time of diagnosis as separate factors prognostic for overall survival. During the observation period, 10 patients developed a second primary cancer, but no significantly elevated risk of developing a second primary cancer was demonstrated. However, during the same period, 20 patients also died of noncancerous disease, 9 of this number succumbing to acute myocardial infarction and/or heart failure. These results suggest that patients with cervical cancer may not have an increased risk of developing second primary cancer. It is felt that continued follow-up of long-term cervical cancer survivors should be pursued in order to prevent or arrest the development of noncancerous disease and/or second primary cancer, so that increased prolongation of survival can be achieved.

Baccharane glycosides from seeds of Impatiens balsamina

From the seeds of Impatiens balsamina have been isolated four rare baccharane glycosides, hosenkosides L-O. The structures of all isolates were secured by the use of 2D NMR techniques (1H-1H COSY, HMQC, HMBC, ROESY) and chemical derivatization. Hosenkosides L and M are hosenkol A 3-O-sambubiosyl-28-O-glucoside and 3-O-sambubiosyl-26-O-glucosyl-28-O-glucoside, respectively. Hosenkoside N is hosenkol C 3-O-glucosyl-28-O-glucoside. Hosenkoside O is hosenkol D 3-O-sophorosyl-28-O-glucoside.

Low-dose continuous subcutaneous infusion of granulocyte colony-stimulating factor for chemotherapy-induced neutropenia in acute myelogenous leukemia and its pharmacokinetics

Granulocyte colony-stimulating factor (G-CSF) shortens the duration of chemotherapy-induced granulocytopenia in acute leukemia. G-CSF is administered by 30-min intravenous infusion at a dose of 200 micrograms/m2/day or 5 micrograms/kg/day in most studies. In this study, the efficacy of a reduced dose (33 micrograms/m2/day) of continuous subcutaneous infusion of G-CSF was compared with the effects achieved by 30-min intravenous infusion of the standard dose (200 micrograms/m2/day) in neutropenia after identical chemotherapy in seven patients with acute myelogenous leukemia who were in remission. The duration of granulocytopenia (< 0.5 x 10(9)/l), thrombocytopenia (< 50 x 10(9)/l); G-CSF administration and fever (> 38 degrees C) were 10.1 +/- 5.0 days, 16.5 +/- 9.3 days, 16.6 +/- 7.4 days and 3.1 +/- 5.4 days for 33 micrograms/m2/day continuous subcutaneous infusion, and 10.7 +/- 6.8 days, 16.7 +/- 9.9 days, 16.1 +/- 7.6 days and 2.0 +/- 2.5 days for 30-min intravenous infusion of the standard dose of G-CSF. In each parameter studied, there was no statistical difference between the two methods of G-CSF administration by paired t-test. The costs for G-CSF could be substantially reduced. In most patients, plasma G-CSF concentration rose to the highest level of 1.8-3.7 ng/ml 48-72 h after starting 33 micrograms/m2/day continuous subcutaneous infusion, and gradually decreased as the peripheral granulocyte count recovered, suggesting binding of G-CSF molecules to the specific receptors on the cells of granulocytic lineage.

[A distal posterior inferior cerebellar artery aneurysm in the fourth ventricle: a case report]

The authors reported a case of a fourth ventricle aneurysm originating from the choroidal branch of the posterior inferior cerebellar artery (PICA). A 65-year-old woman became comatose following the acute onset of a severe headache and vomiting. She was moribund on admission, showing decerebrate posture. CT scan revealed a massive hematoma in the fourth ventricle up to the lateral ventricle. Extension of blood to the cisterna magna through the cerebellar vermis was also noted. Angiography demonstrated an aneurysm distally located on the right PICA across the midline. The aneurysm lodged in the choroid plexus which was exclusively fed by the right PICA was excised without difficulty through suboccipital craniectomy. Postoperative course was uneventful. She regained her full consciousness by two days after the operation, and was discharged with a minimal truncal ataxia. To our knowledge, this is the first report of a ruptured aneurysm developing in the choroid plexus of the fourth ventricle. Hemodynamic stress is speculated to be a causative factor of such a lesion.

Determination of the amounts and oxidation states of hemoglobins M Boston and M Saskatoon in single erythrocytes by infrared microspectroscopy

The reduced abnormal subunits of two M-type hemoglobins, Boston (His alpha 58-->Tyr) and Saskatoon (His beta 63-->Tyr), have been determined in the presence of normal human hemoglobin A by measurement of C-O stretch bands in infrared spectra of carbon monoxide complexes. Use of an infrared microscope coupled to a Fourier transform infrared spectrometer of high sensitivity permitted measurements to be made on as small a hemoglobin mixture as is contained in a single erythrocyte. The abnormal subunits of both Hbs M exhibit bands near 1970 cm-1 compared with bands near 1951 cm-1 for the normal subunits. The increase in 1970 cm-1 band intensity upon erythrocyte reduction with dithionite provided a measure of the extent of abnormal subunit oxidation; in cell suspensions about 60% of the abnormal subunits of Hb M Boston and 80% for Hb M Saskatoon remained reduced. The amount of Hb present as abnormal Hb averaged about 25% for Hb M Boston cells and about 50% for Hb M Saskatoon cells. However, the ratio of Hb M to Hb A in individual cells varied markedly, with the ratio expected to decrease as the cell ages. These results demonstrate the unique utility of infrared microspectroscopy for the study of differences in abnormal Hb status among individual erythrocytes.

Pulsating electromagnetic field stimulates mRNA expression of bone morphogenetic protein-2 and -4

The effects of a pulsating electromagnetic field on mRNA expression of bone morphogenetic protein-2 and -4 in chick embryonic calvaria were examined. From the onset of embryogenesis (Day 0), chick embryos were incubated in a continuously generated pulsating electromagnetic field with a peak of 3.5 milli-Tesla (mean: 2 milli-Tesla) and vibration at 15 Hz. Control chicks were incubated in a normal magnetic field. Northern-blot analysis showed that the mRNAs of bone morphogenetic protein-2 and -4 were expressed in the calvaria. Quantitative analysis of the mRNA expressions was done by means of slot-blot hybridization. The magnetic field enhanced the expressions of both mRNAs. The enhancements were more pronounced in younger chick embryos (Day 15 > Day 17), and no significant change was observed in the 19-day-old embryos. These results indicate that osteo-inductive effects of the magnetic field were mediated at least in part by bone morphogenetic protein-2 and -4.

PML-RAR alpha fusion transcripts by RNA PCR in acute promyelocytic leukemia in remission and its correlation with clinical outcome

Molecularly defined specific chromosomal translocation in leukemia allows detection of minimal residual leukemia cells by the reverse transcription-polymerase chain reaction (RT-PCR). However, the positivity of the specific fusion transcripts in chronic myelogenous leukemia and acute myelogenous leukemia with t(8;21) is reportedly not directly correlated with the predictability of relapse. We analyzed seven patients with acute promyelocytic leukemia (APL) in hematological remission for PML-retinoic acid receptor alpha (PML-RAR alpha) fusion transcripts by RT-PCR with the sensitivity level of one APL cell in 10(5) bone marrow mononuclear cells. Two of the four patients with chemotherapy-induced remission had detectable PML-RAR alpha only before treatment. In the other two patients with chemotherapy-induced remission, the PML-RAR alpha was detectable when their remission was first confirmed and became negative after consolidation chemotherapy. Two patients were resistant to chemotherapy and achieved remission by all-trans-retinoic acid; PML-RAR alpha was detectable in them for a few months during consolidation chemotherapy. Two patients whose PML-RAR alpha had become continuously positive had relapse 2 and 8 months later, but the other five patients with continuously negative or only transiently positive PML-RAR alpha remained in remission during follow-up for 11 to 35 months. These findings suggest the relevance of detectable PML-RAR alpha by RT-PCR to the predictability of relapse in acute promyelocytic leukemia.

Long-term follow up in type A insulin resistant syndrome treated by insulin-like growth factor I

Insulin-like growth factor I (IGF-I) is a useful therapeutic agent in insulin resistant diabetes mellitus due to insulin receptor disease because of its hypoglycaemic effects through the IGF-I receptor. A girl with typical type A insulin resistant syndrome was treated with IGF-I for two years and the treatment was effective in ameliorating hyperglycaemia. Overproduction of testosterone in polycystic ovaries was aggravated with this treatment, however. Therefore, IGF-I treatment may be used for glycaemic control but with caution because of its possible side effect of aggravating hyperandrogenism in these patients.

[Prevalence estimates for non-insulin dependent diabetes mellitus (NIDDM) in Japan from National Survey of Circulatory Disorders 1990 data]

Prevalence of diabetes mellitus in Japan was estimated from fructosamine and hemoglobin A1c measurement data obtained from the National Survey of Circulatory Disorders 1990, using a previously reported method which used the results of a screening test for estimating true prevalence. The prevalence for males was higher than that for females. The prevalences were less than 10% for those 49 years or younger and approximately 20% for those 50 years or older. The estimated values derived from fructosamine or hemoglobin A1c did not vary considerably.

[Massive intraventricular hemorrhage from prolactinoma during bromocriptine therapy: case report]

We are reporting herein a case with massive intraventricular hemorrhage secondary to prolactinoma, which initially extended into the suprasellar cistern but reduced in size after one year of bromocriptine therapy, resulting in intrasellar herniation. This is the 6th reported case of intraventricular hemorrhage from a pituitary adenoma. Neuroradiographic features are described in detail and the pertinent literature is reviewed.

Hosenkosides F, G, H, I, J, and K, novel baccharane glycosides from the seeds of Impatiens balsamina

From the seeds of Impatiens balsamina we have isolated six novel baccharane glycosides, hosenkosides F-K. The structures of all isolates were determined by the use of two dimensional (2D) NMR techniques (1H-1H correlation spectroscopy (COSY), heteronuclear multiple quantum coherence (HMQC), heteronuclear multiple-bond correlation (HMBC), rotating frame Overhauser enhancement spectroscopy (ROESY), total correlation spectroscopy (TOCSY)) and chemical derivatization. Hosenkosides F, H and I are hosenkol B 3-O-sambubiosido-26-O-glucoside, 3-O-sambubioside and 3,26-O-diglucoside, respectively. Hosenkoside G is hosenkol C 3-O-sambubiosido-28-O-glucoside. Hosenkosides J and K are hosenkol A 3-O-sophoroside and 3-O-sophorosido-26-O-glucosyl-28-O-glucoside, respectively.

Visual abnormalities and occipital EEG discharges: risk factors for West syndrome

Seventeen infants (7 boys and 10 girls) with visual abnormalities (such as poor tracking and following and nystagmoid eye movement) and occipital slow activities with irregular polyspikes on EEG were studied. Two thirds of the children showed development of West syndrome with hypsarrhythmia on follow-up EEG. In 1 child, hypsarrhythmia was evident on the follow-up EEG, but no clinical seizures occurred. Because most of the children in our series developed West syndrome, patients with visual abnormalities associated with occipital EEG discharges in early infancy may be at high risk for West syndrome. Occipital abnormalities in early infancy may relate to the occurrence of West syndrome.

[A case of herpes zoster meningoencephalitis followed by involvement of cranial nerves IX, X, XI]

The patient is a 64-year-old woman with herpes zoster meningo-encephalitis followed by involvement of cranial nerves IX, X, XI. On admission, she had severe neck pain on the left side and mild nuchal rigidity. Three days later, herpetic vesicles on the left side of her neck (C2, C3, area). Herpes zoster meningoencephalitis was diagnosed based on CSF pleocytosis, high serum and CSF titers of herpes zoster antibody, and EEG abnormality. During hospitalization, paralysis of the left vocal cord, rightward deviation of the uvula, and gradual paralysis of the left sternocleidomastoideus and trapezius muscles developed. On cranial magnetic resonance imaging (MRI), T2-weighted image clearly revealed a high-signal lesion in left dorsal part of the medulla oblongata. This area appeared to correspond to the nucleus ambiguous and vagal nucleus. In this case, we believe that the inflammation originated in the C2, C3 posterior ganglion cells, extended to the IX, X, XI cranial nerves and to the part of the medulla oblongata. It is likely that the number of patients in whom a lesion of the cranial nucleus is revealed by MRI will increase in the future.

[A family case of HAM and HTLV-I carrier including two sisters presenting with myositis]

We reported a family case of HAM and HTLV-I carrier including two sisters presenting with myositis. Both the 65-year-old elder sister and her 53-year-old younger sister initially noted lumbago and developed difficulty in walking several years later. Neurologic examination revealed muscle weakness of the proximal parts of the upper and lower limbs (especially the latter). Mild hyperreflexia in all extremities, urinary disturbance and constipation were detected in the elder sister, while only urinary disturbance and constipation were seen in the younger. Anti-HTLV-I antibody in both serum and CSF was positive in both sisters. Muscle biopsy specimens showed features of myositis with perivascular, perimysial and endomysial lymphocyte infiltration. Although an association between HTLV-I and polymyositis had not yet been established, we think that our cases support such an association.

Immunophenotypic analysis of primary malignant lymphoma of the brain

The immunophenotypes in three cases of primary malignant lymphomas of the brain were analyzed by flow cytometry using a panel of monoclonal antibodies. In all three cases the immunophenotypes were CD10 negative, CD19 positive, and CD20 positive, and in two cases human leukocyte antigen (HLA)-DR positive. CD20 showed high positivity (80-97%), while CD19 revealed low positivity (30-50%). These neoplastic cells apparently became malignant at the B-cell differentiation stage, when they expressed both CD19 and CD20. Differentiation continued until CD19 was no longer expressed, when further differentiation stopped between the last stage of B-cell differentiation and the early stage of plasma cell formation (Case 3 was CD38 positive). Case 1 was immunoblastic type lymphoma and the cells were both surface immunoglobulin and HLA-DR negative. At least 40% of Case 2 cells showed both B-cell and T-cell markers. Immunophenotypic study can help determine the cell lineage, clonality, and stage of differentiation of lymphoid neoplasms.

Detection of PML-retinoic acid receptor-alpha fusion transcripts in acute promyelocytic leukemia with trisomy 8 but without t(15;17)

Chromosome translocation t(15;17), the breakpoints of which are in the PML gene on chromosome 15 and retinoic acid receptor-alpha (RAR alpha) gene on chromosome 17, is specifically found in acute promyelocytic leukemia (APL). Clinically typical APL without t(15;17) and with the PML-RAR alpha fusion transcripts or rearrangements in PML and/or RAR alpha gene has been reported, suggesting submicroscopic changes at the molecular level without apparent t(15;17) or observation of normal metaphases. Trisomy 8 is common in APL as a secondary chromosomal abnormality in addition to t(15;17), as well as in acute myelogenous leukemia in general, but it is rare as a sole chromosomal anomaly in APL. PML-RAR alpha fusion transcript was detected in an APL case with trisomy 8 but without t(15;17), indicating that the leukemic cells lacked t(15;17) and still expressed the PML-RAR alpha fusion transcripts. This indicates that the same submicroscopic molecular changes as in APL with t(15;17) do occur in APL without t(15;17) and supports the use of molecular analysis for PML-RAR alpha fusion in APL.