Cerebrospinal fluid 28-kDa calbindin-D as a possible marker for Purkinje cell damage

To examine the clinical value of 28-kDa calbindin-D (CaBP) in cerebrospinal fluid (CSF) as a marker for the damage to Purkinje cells, we measured CSF CaBP levels using an enzyme immunoassay method in 107 patients with cerebellar and other neurological diseases, and 26 controls. The mean CaBP level was markedly elevated in patients with cerebellar diseases, and the elevation of CaBP level was more frequent in the diseases involving Purkinje cells, such as multiple system atrophy (MSA) and subacute cerebellar degeneration in association with lung cancer. Further, in MSA patients, the CaBP levels decreased with duration of illness. The mean levels of CaBP were also elevated in some of the other diseases. We conclude that the elevations of CaBP levels are not specific for cerebellar diseases, but CSF CaBP may be a useful marker for examining the Purkinje cell involvement in cerebellar diseases.

Organum vasculosum laminae terminalis (OVLT) is a brain site to produce interleukin-1 beta during fever

The present study was carried out to determine whether interleukin-1 (IL-1) production occurs in the rabbit organum vasculosum laminae terminalis (OVLT) during fever induced by endotoxin. The intravenous (i.v.) injection of endotoxin (4 micrograms/kg) caused significant fever in rabbits. Through the use of in situ hybridization and immunohistochemical techniques, the synthesis of IL-1 was observed in the OVLT during the fever. The present results support the hypothesis that IL-1 is produced in the brain during fever.

Levator palpebrae superioris muscle: MR evaluation of enlargement as a cause of upper eyelid retraction in Graves disease

Sympathetic stimulation of the Müller muscle may be responsible for most of the medically reversible cases of eyelid retraction in patients with Graves disease. The authors studied 21 patients with class I Graves ophthalmopathy (GO), 32 patients with Graves disease without ophthalmopathy (GD), and 12 control subjects. T1-weighted spin-echo magnetic resonance (MR) imaging was performed with a 0.5-T superconducting system. The thickness of the levator palpebrae superioris muscle was determined from sagittal MR images. The thickness of the levator muscles in patients with GD did not differ from the thickness in control subjects, but the levator muscles in patients with GO were significantly thickened (P < .01). The thickness of the levator muscles in patients with GO was significantly greater than in those of patients with GD (P < .01). In 64 orbits of patients with GD, 3% of levator muscles were thickened. In 33 of 40 (83%) orbits of patients with GO presenting with upper eyelid retraction, the levator muscles were thickened. Sagittal MR imaging demonstrated thickening of the levator muscles in patients with persistent upper eyelid retraction. The authors conclude that a thickened levator muscle probably causes upper eyelid retraction in patients with GO.

Increase in [3H]cAMP binding sites and decrease in Gi alpha and Go alpha immunoreactivities in left temporal cortices from patients with schizophrenia

To search for possible alterations in second messenger systems in the temporal cortex (Brodmann's area 22) of patients with schizophrenia, we measured the binding activities of [3H]adenosine 3',5'-cyclic monophosphate ([3H]cAMP) and [3H]4 beta-phorbol 12,13-dibutyrate ([3H]PDBu) which can label the regulatory subunit of cAMP-dependent protein kinase (protein kinase A) and the regulatory domain of Ca2+/phospholipid-dependent protein kinase (protein kinase C), respectively. We also immunoquantified the variable subunits of guanine nucleotide binding proteins (G-proteins), using specific polyclonal antisera against Gs alpha, Gi alpha and Go alpha. Brains were obtained at autopsy on 10 patients with schizophrenia and 10 age-matched control subjects. Representative Scatchard plots for specific [3H]cAMP bindings to the soluble fraction consisted of a single component with high affinity (Kd = 2.36 nM, Bmax = 737 fmol/mg protein). Among the tested adenyl and guanyl nucleotides, or neuroleptics, cAMP alone potently inhibited the binding (Ki = 4.95 nM). The binding sites for [3H]cAMP were discretely localized, and were in the order of: cerebral cortex = hypothalamus = amygdala > hippocampus = neostriatum = thalamus = nucleus accumbens > globus pallidus = cerebellum. Specific [3H]cAMP bindings to the soluble fractions were about 30% greater in the left temporal cortices of schizophrenic patients, as compared to findings in the right side of the patients and the left side of the control subjects, no control brain showed this asymmetry. The specific [3H]PDBu binding in schizophrenic and control groups did not change.(ABSTRACT TRUNCATED AT 250 WORDS)

[Chemical fluctuation of the constituents during the drying of Ginseng radix and Ginseng radix Rubra. Crude drug processing by far-infrared treatment]

In order to evaluate the utility of far-infrared drying method for crude drugs, the efficiency in the drying process of Ginseng Radix and Ginseng Radix Rubra was examined. Furthermore, chemical fluctuation of the constituents of Ginseng Radix and Ginseng Radix Rubra, which may occur during their drying process, has been investigated by means of HPLC quantitative analysis for ginsenosides and malonyl-ginsenosides, and TLC qualitative analysis for lipophylic constituents. It has been found that the far-infrared drying method (oven temperature 45 degrees C) dried Ginseng Radix faster without reducing both ginsenosides and malonyl-ginsenosides in comparison with the conventional drying methods such as an air drying and a hot-air drying.

Sulfoorientalols a, b, c, and d, four new biologically active sesquiterpenes from Alismatis rhizoma

Four new sesquiterpenes, sulfoorientalols a, b, c, and d, having a sulfonic acid function were isolated from Chinese Alismatis Rhizoma. Their structures were determined on the basis of chemical and physicochemical evidence. Sulfoorientalols inhibited the contraction of isolated bladder smooth muscle induced by carbachol.

[A case of recurrent colon cancer treated markedly effective with 5'-DFUR]

A 71-year-old male with recurrent colon cancer was admitted to our hospital with obstructive jaundice. Virchow's node metastasis was palpable in his neck. The enlarged intraabdominal lymphnodes due to recurrence and liver metastasis were demonstrated on computed tomography. Bile duct obstruction was treated by expandable metallic biliary endoprosthesis. 5'-DFUR (5'-deoxy-5-fluorouridine) was administered orally at 600 mg daily. Virchow's node metastasis completely disappeared by 46 days after administration of 5'-DFUR. The enlarged intraabdominal lymphnodes and liver metastasis disappeared on computed tomography. No significant side effects from 5'-DFUR were encountered for 18 months. 5'-DFUR appears to be a useful and safe treatment for recurrent colon cancer.

Febrile and metabolic tolerance to endotoxin and human recombinant interleukin-1 beta in rabbits

We investigated whether or not tolerance of the febrile and metabolic responses to human recombinant interleukin-1 beta (IL-1 beta) develops in rabbits. Febrile tolerance to bacterial endotoxin was induced by daily injections of lipopolysaccharide (LPS, 5.0 micrograms/kg iv). In LPS-tolerant rabbits, the second phase of the biphasic fever induced by intravenous injections of LPS (5.0 micrograms/kg) or IL-1 beta (2.0 micrograms/kg) was significantly reduced. However, the first phase was almost the same as that observed in normal rabbits. Five daily injections of IL-1 beta (2.0 micrograms/kg iv) resulted in the development of tolerance of the febrile response to IL-1 beta. In IL-1 beta-tolerant rabbits, the second peak of the biphasic fever was significantly reduced. In addition, decreases in leukocyte count and plasma zinc induced by intravenous injections of LPS or IL-1 beta were significantly reduced in LPS- or IL-1 beta-tolerant rabbits. However the monophasic fever induced by a smaller dose of IL-1 beta (0.5 microgram/kg iv) and the first peak of the IL-1 biphasic fever were almost the same as those observed in normal rabbits. Febrile responses induced in LPS- or IL-1 beta-tolerant rabbits by intracerebroventricular injections of LPS (5.0 ng) or IL-1 beta (2.0 ng) were similar to those observed in normal rabbits. The present results suggest that tolerance of the febrile and metabolic responses to IL-1 beta is developed after repeated injections of IL-1 beta and that reduced responsiveness to IL-1 beta is partly involved in the development of LPS tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

[Studies on onset patterns in antithyroid drug-induced agranulocytosis]

We studied the patterns of the onset of antithyroid drug-induced agranulocytosis. From 1975 to 1990, 19,050 patients with Graves' disease receiving treatment with antithyroid drugs were seen at our clinic. For all patients with Graves' disease treated with an antithyroid drug, a routine white blood cell count was done every 2 weeks until euthyroid state was gained, and a count was done once every moth thereafter. Of these, 70 were found to have agranulocytosis. Agranulocytosis was defined as a granulocyte count of 500/mm3 or less. In only 19 of the 70 was agranulocytosis detected after the occurrence of infection (symptomatic: classical agranulocytosis). The remaining 51 patients were asymptomatic when agranulocytosis was detected during routine white blood cell and granulocyte count monitoring. However, 17 of the 51 patients became symptomatic several days after the withdrawal of antithyroid drug treatment (shifted from asymptomatic to symptomatic agranulocytosis). Thirty-four patients had no symptoms of infection throughout the course of the disease (asymptomatic agranulocytosis). In conclusion, 1) We found three patterns in the onset of antithyroid drug-induced agranulocytosis: classical (symptomatic), a shift from asymptomatic to symptomatic, and asymptomatic agranulocytosis, 2) Unexpectedly, classical (symptomatic) agranulocytosis was seen in only 19 of the 70 patients, 3) We were again remained of the importance of routine white blood cell and granulocyte count monitoring.

Changes in expression of nonmuscle myosin heavy chain isoforms during muscle and nonmuscle tissue development

Anti-human platelet myosin antibodies and two anti-peptide antibodies, anti-peptide IIA and anti-peptide IIB, which recognize macrophage-type (MIIA) and brain-type (MIIB) isoforms of nonmuscle myosin heavy chain, respectively, were used to study expression of nonmuscle myosin isoforms in various tissues of mice during development. Tissue-specific changes in the relative isoform concentrations were observed by performing immunoblots of crude myosin extracts from nonmuscle and muscle tissues. In fetal and neonatal mouse tissues, the anti-peptide IIB antibodies stained a single band, called MIIB2, while the anti-peptide IIA and anti-platelet myosin antibodies stained a band that migrated faster than MIIB2. In brain, a slower moving band, MIIB1, started to appear at 2 weeks after birth, and in the adult cerebellum it was at least as abundant as MIIB2. In thymus, MIIB2 decreased selectively shortly after birth, while in liver both MIIB2 and MIIA rapidly disappeared, but the isoform(s) detected by anti-platelet myosin antibodies (MIIApla) remained constant. The MIIB2 and MIIA as well as MIIApla found in striated muscles from fetal and neonatal mice decreased to levels that were below the limit of detection by 3 weeks of age. In cryosections of skeletal and cardiac muscles, MIIB2 was localized within the muscle cells, while MIIA and MIIApla were primarily in the blood vessels and capillaries.

Enhanced production of leukotriene B4 by peripheral blood mononuclear cells in patients with fulminant hepatitis

The production rate of leukotriene B4 (LTB4) was measured using peripheral blood mononuclear cells (PBMC) in patients with fulminant hepatitis (FH) or other liver diseases. LTB4 in the culture media of PBMC under stimulation with Ca-ionophore was fractionated by HPLC and measured by radioimmunoassay. The production rate of LTB4 was elevated in 16 of 17 FH patients (3.3 +/- 0.2 ng/10(6) cells for 5 min), while the production was below detectable level in patients with acute or chronic hepatitis and in healthy controls. In FH patients, the highest production rate of LTB4 was observed in the initial period of the disease. Enhanced LTB4 production may indicate the primed state of PBMC--the primed mononuclear cells are regarded as participating in the development of massive liver necrosis and of other organ failures in FH.

Organum vasculosum laminae terminalis (OVLT) in rabbit and rat: topographic studies

The microcirculation and fine structure of the rabbit and rat organum vasculosum laminae terminalis (OVLT) were examined by light microscopy and scanning and transmission electron microscopy. In both animals, the microcirculation is composed of a superficial and a deep vascular bed but the system is more complex and extensive in the rabbit. This was particularly true of the deep vascular bed. In the rabbit, the deep bed is composed of fenestrated capillaries, which are arranged in glomerular tufts surrounded by very wide perivascular spaces (PVS). In contrast, the deep vascular bed of the rat OVLT usually consists of only one or two small vessels. These are either fenestrated and surrounded by a PVS or lined by continuous endothelium with only a few fenestrae and without a dilated PVS. A corresponding difference was seen in the contours of the ventricular surface. It is much more irregular in the rabbit than in the rat and numerous bulges reflect the underlying vascular tufts and pockets of PVS in the rabbit. Supraependymal cells are present in both species and two sizes of them occur in the rabbit. The results demonstrate that the microcirculation of the OVLT is more elaborate and more highly developed in the rabbit than in the rat. We suggest that this might result in a different neurohemal microenvironment and, ultimately, in functional differences.

Cardiac glycoside-induced elevation of intracellular Na+ ion concentration in human erythrocytes studied by 23Na NMR spectroscopy: relationship between inotropy speed and elevation rate of intracellular Na+ ion concentration

Elevation of intracellular sodium ion concentration in human erythrocyte induced by the cardiac glycoside, proscillaridin, and its four derivatives was measured using 23Na NMR spectrometry. In this examination, there was a significant correlation between the time to half maximum inotropic effect and the time to maximum of Na+ concentrations in human erythrocyte, determined by 23Na NMR.

[Weber's syndrome of ischemic vascular origin--a clinical and neuroradiologic study]

A series of 4816 patients with cerebrovascular disease have undergone CT and/or MRI examinations over the last 25 years at the Higashi Nagoya National Hospital and the Nagoya National Hospital. Of these, we experienced 5 cases (4 men and 1 woman) of Weber's syndrome: two cases were resulted from cerebral embolism and three from cerebral thrombosis. All of the patients had left hemiparesis and right oculomotor palsy. On full investigation, complete unilateral external and internal oculomotor palsy was seen in two patients, while the remaining three patients showed pupillary sparing. The patients with complete oculomotor palsy presented with left hemiparesis as the initial symptom. In addition to oculomotor palsy and crossed hemiparesis, two patients had paralysis of the face and one patient had tongue muscle on the opposite side of the lesion and disorders of sensation. Positive Babinski's sign was found in four of the five patients. In one patient with unilateral glossoplegia on the side of hemiparesis, CT or MRI revealed a limited low-density or low signal intensity (T1) area in the inner part of the crus cerebri, and in the other patient who also had hemihypesthesia, the low-density or low-signal intensity (T1) area expanded into the dorsal midbrain. We would like concluded that the frequency of Weber's syndrome was very low though this syndrome was well celebrated, and the careful clinical observation of the neurological features of affected patients guided to the obvious site of lesion in the midbrain.

Ubiquitin-positive inclusion in anterior horn cells in subgroups of motor neuron diseases: a comparative study of adult-onset amyotrophic lateral sclerosis, juvenile amyotrophic lateral sclerosis and Werdnig-Hoffmann disease

This report concerns the expression of ubiquitin in anterior horn cells of various subgroups of adult and infantile motor neuron disease (MNDs); immunohistochemical techniques were employed. Ubiquitin-positive skein-like inclusions (SLIs) were found in all cases of adult-onset amyotrophic lateral sclerosis (ALS), including 16 cases with sporadic ALS, two cases of familial ALS with posterior column degeneration and Lewy body-like hyaline inclusions (LBHIs), two sporadic ALS cases with LBHIs, and three cases of sporadic ALS with dementia. SLIs were not found in anterior horn cells of 5 cases with Werdnig-Hoffmann disease (WHD). However, granular ubiquitin-positive deposits were seen in ballooned neurons of WHD patients. No ubiquitinated materials were found in the perikarya of two sporadic juvenile ALS patients with basophilic inclusions (BIs), but granular ubiquitin-immunoreactive deposits were occasionally observed in the BIs. These results suggest that ubiquitin-positive SLIs are characteristic features of various forms of adult-onset ALS and that aggregated ubiquitinated granules are characteristic of ballooned neurons of WHD. Ubiquitinated structures and their distribution patterns may reflect degenerative processes of anterior horn cells, and may be useful for classifying subgroups of motor neuron diseases.

Pathological mineralization in a serially passaged cell line from rat pulp

The ultrastructure of crystal formation in association with dental pulp cells isolated from rat incisor was studied in vitro. A clone, RPC-K, was obtained and incubated with Na-beta-glycerophosphate (BGP). Growing pulp cells showed low alkaline phosphatase (ALP) activity, which began to increase with cell proliferation. Pulp cells formed cell multilayers after day 14 of culture. Mineralized tissues were observed within cell multilayers on day 28 of culture. Vesicular structures were found around degenerate and necrotic cells. Some of these vesicles contained needle-like crystals. Organic structures appeared at the periphery of mineralized tissues with a post-embedding demineralization and staining method. Electron diffraction patterns of the newly formed crystals revealed a pattern consistent with hydroxyapatite (HAP). These findings suggest that the RPC-K cell line might be useful for a model system to investigate pathological mineralization.

Oculomotor nuclear pathology in amyotrophic lateral sclerosis

We examined the oculomotor and/or trochlear nuclei of 27 amyotrophic lateral sclerosis (ALS) patients and 10 controls by histological and immunohistological methods. Their neurons were relatively well preserved. In 7 of 22 sporadic ALS patients (including 3/3 ALS with ophthalmoplegia) and in 4 of 5 ALS patients with dementia, some morphological changes similar to those in anterior horns (Bunina bodies, ubiquitin-positive skein-like inclusions, Lewy body-like inclusions, conglomerate inclusions and spheroids) were rarely, but clearly seen. These changes were not observed in controls. Our results suggest that the oculomotor and trochlear nuclei in ALS patients are slightly affected in a manner similar to that in the anterior horns, but the degree is less than that necessary for development of ophthalmoplegia in the majority of ALS patients.

Granulocyte colony-stimulating factor treatment of antithyroid drug-induced granulocytopenia

The primary objective of this study was to ascertain the effectiveness of granulocyte colony-stimulating factor in the treatment of antithyroid drug-induced granulocytopenia of varying degree. Sixteen patients with Graves' disease with antithyroid drug-induced granulocytopenia (granulocyte counts < 1.0 x 10(9)/L) each received a daily dose of 75 micrograms of granulocyte colony-stimulating factor administered subcutaneously. Within 24 hours of the first injection, the granulocyte count increased (0.6 to 12.3 x 10(9)/L) in all 10 patients with mild granulocytopenia (granulocyte counts between 0.5 and 1.0 x 10(9)/L) and all three with moderate granulocytopenia (granulocyte counts < 0.5 x 10(9)/L). The three remaining patients with severe granulocytopenia (agranulocytic), whose granulocyte counts were zero, did not recover from granulocytopenia until the 6th, 7th, and 14th days of treatment with granulocyte colony-stimulating factor. Examination of bone marrow taken at the onset of the disease in all three agranulocytic patients showed a prominent decrease in granulocytic series, while identical examination in six of eight patients with mild to moderate granulocytopenia showed close to normal granulocytic series. There was no elevation of serum granulocyte colony-stimulating factor concentration in four patients with mild granulocytopenia and one with moderate granulocytopenia at the onset of their disease, whereas those of the remaining three patients with severe granulocytopenia (agranulocytic) increased at onset of agranulocytosis. This information led us to conclude that: (1) granulocyte colony-stimulating factor is effective in the treatment of antithyroid drug-induced mild to moderate granulocytopenia and (2) in severe agranulocytic cases, granulocyte colony-stimulating factor is not effective. Accordingly, we were again reminded of the importance of early diagnosis and treatment of antithyroid drug-induced agranulocytosis.

[Epidemiology of sporadic pediatric enteritis patients due to verotoxin-producing Escherichia coli]

We tried to isolate verotoxin-producing Escherichia coli (VTEC) from 323 sporadic pediatric enteritis patients who came to three clinics in the Fukuoka area. We used the sorbitol-MacConkey medium for the isolation of VTEC O157:H7. For non-O157 VTEC strains we used the V1/PECS method. VT/PECS method was applied. VTEC strains were isolated from three patients (0.9%). None of the patients were seriously, ill or developed the hemolytic uremic syndrome. The three patients were all seen in the summer season, July and August. O157:H7 strains were isolated from two patients, and O145:NM from one. This study showed that sporadic enteritis cases due to VTEC exist in the Fukuoka area. In the future a rapid and easy method for the detection of VT or VTEC should be developed and commercialized to proceed with epidemiological studies of VTEC infections throughout Japan.

Serum sialic acid levels in the diagnosis and follow-up of subacute granulomatous thyroiditis

To evaluate the usefulness of monitoring serum sialic acid (SA) levels for diagnosis and follow-up of subacute granulomatous thyroiditis (SAT), 43 patients were studied at our clinic. In the acute phase of the disease their SA levels averaged 104.9 +/- 19.7 mg/dl (normal 44-69 mg/dl). In the recovery phase SA levels returned to a range of 60.5 +/- 6.9 mg/dl. However, an increase in SA (87.4 +/- 18.2 mg/dl) was detected at the time of recurrence in 14 patients. In 29 non-recurrent patients, serum SA gradually reduced during the course of therapy and normalized in all patients by the time glucocorticoid therapy was discontinued. Thyroglobulin (Tg) and the erythrocyte sedimentation rate (ESR), however, had normalized in only half the cases even at the time of cessation of therapy (Tg 5/11, ESR 4/8). C-reactive protein (CRP) returned to negative in most patients (19/24) only one week after initiation of the therapy. These results suggested that the monitoring of SA levels can be a useful tool in diagnosis and follow-up of SAT.

DNA ploidy and stromal bone formation as prognostic indicators of thyroid papillary carcinoma in aged patients: a retrospective study

The prognostic value of flow cytometry for thyroid papillary carcinoma in aged patients was studied and compared with that of tumor histology. Seventy-five surgically removed primary papillary thyroid carcinomas larger than 30 mm in diameter were obtained from patients over 60 years of age. A subtotal thyroidectomy with modified radical neck dissection was performed in all patients. Sixteen female patients died of the carcinoma (non-survivors) and 18 survived longer than 12 years without recurrence (survivors). Histologically, papillary carcinoma was subclassified into poorly and well differentiated types, and the presence of stromal bone formation was noted. Flow cytometry was performed using paraffin-embedded materials. The incidence of the poorly differentiated type was 2/18 among the tumors of survivors and 6/16 among the tumors of non-survivors (P = 0.08). Stromal bone formation was only found in the tumors of the survivors (6/18 and 0/16; P = 0.014). In flow cytometry, tumors of the survivors showed a DNA diploid pattern (14/14), whereas half of the tumors of non-survivors (6/12) showed an aneuploid pattern (P = 0.004). Moreover, in the remaining six tumors of the non-survivors, two showed a third peak at 6C and one showed a higher S fraction. Therefore, only three showed a DNA diploid pattern that was indistinguishable from that of the survivors. These results suggest that flow cytometry is useful for estimating the prognosis of thyroid papillary carcinoma.

Effects of alpha- and beta-adrenergic antagonists on rise in body temperature induced by psychological stress in rats

We investigated the effects of intraperitoneal injection of alpha- and beta-adrenergic antagonists on psychological stress-induced responses in free-moving rats. Psychological stress was induced by immersion in 2-cm-deep water. The intraperitoneal injection of the alpha-adrenergic blocker, phentolamine (10 mg/kg), attenuated the stress-induced rise in body temperature and hypertension but enhanced tachycardia. In contrast, intraperitoneal injection of the beta-adrenergic blocker, propranolol (1 mg/kg), suppressed tachycardia but had no effect on rise in body temperature and hypertension during stress. The intraperitoneal injection of both blockers had no effect on the increase in metabolic rate (O2 consumption) induced by stress. The intravenous injection of propranolol (1 mg/kg) suppressed the stress-induced rise in body temperature. We then examined the effect of intracerebroventricular injection of propranolol on the stress-induced rise in body temperature and found that intracerebroventricular injection of propranolol (50 micrograms) suppressed the stress-induced rise in body temperature. These results support the following hypotheses: 1) Systemic injection of phentolamine suppresses the psychological stress-induced rise in body temperature by facilitating heat-loss; 2) Peripheral beta-adrenergic stimulation probably does not contribute to psychological stress-induced rises in body temperature; and 3) central beta-adrenergic receptors are important in stress-induced increases in body temperature.

Detection of recurrent thyroid cancer: MR versus thallium-201 scintigraphy

PURPOSE

To compare MR with thallium-201 scintigraphy in the follow-up of patients who have undergone thyroidectomy and modified radical neck dissection for differentiated thyroid cancer.

METHODS

Both MR imaging and 201Tl scintigraphy were performed in 39 patients after surgery for differentiated thyroid cancer. Ten patients did not have recurrence; 29 patients had 51 recurrent tumors in the neck and mediastinum.

RESULTS

Among 51 tumor sites, 39 sites of recurrence were detected by MR and 24 were detected by 201Tl scintigraphy. The true-positive rate, false-negative rate, true-negative rate, and false-positive rate in detecting recurrent thyroid cancer were 76.5, 23.5, 100, and 0%, respectively, for MR and 47.1, 52.9, 100, and 0%, respectively, for 201Tl scintigraphy. MR was more sensitive than 201Tl scintigraphy in detecting recurrent tumors (especially small metastatic nodes). On T2-weighted MR images, recurrent tumor was characterized by high signal intensity. Scarring in the postoperative thyroid bed was characterized by low signal intensity on both T1- and T2-weighted images. Abnormal accumulation of 201Tl in the postoperative thyroid bed was not observed.

CONCLUSIONS

Although both MR images and 201Tl scintigraphy were effective in distinguishing recurrent tumor from postoperative fibrous tissue, MR images were more sensitive than 201Tl scintigraphy in detecting recurrent tumors. These results suggest that MR imaging is more useful than 201Tl scintigraphy in the follow-up evaluation of patients after neck surgery for differentiated thyroid cancer.

Effects of electrical stimulation or local anesthesia of the rabbit's hypothalamus on the acute phase response

The effects of electrical stimulation of the rostral hypothalamic region on the acute phase response (APR) were examined in rabbits. As indicators of APR, we measured changes in the plasma concentrations of iron, zinc, copper, and fibrinogen and changes in the red and white blood cell counts. Electrical stimulation of the rostral hypothalamic region near the preoptic and anterior hypothalamic region did not induce any aspect of the APR. However, stimulation near the anteroventral portion of the third ventricle (AV3V) induced responses that were, in part, opposite to those observed in the APR: an increase in the plasma concentration of zinc and a decrease in the circulating leukocyte count. Microinjections of procaine into the brain regions near the AV3V did not induce any changes in the plasma levels of trace metals and fibrinogen but increased the circulating leukocyte count. These results suggest that nonspecific stimulation or inhibition of the rostral hypothalamic region does not induce APR.