Solution structure of omega-conotoxin MVIIC determined by NMR

The solution structure of the P- and Q-type Ca2+ channel blocker, omega-conotoxin MVIIC (a peptidic neurotoxin composed of 26 amino acid residues), has been determined by 1H-NMR and simulated annealing calculations. The resulting calculated structures converged very well to a conformation with an average value of pairwised RMSD for N, C alpha and C' of 0.62 A. Lys-25 is buried in the molecule and less flexible so that among the four Lys residues, its side chain provides the lowest reactivity on biotinylation and the mono-biotinylation in this residue less influences the biological activity.

Neurohumoral variability in left ventricular dysfunction. SOLVD Investigators. Studies of Left Ventricular Dysfunction

The immediate and longer term variability of selected vasoactive- and volume-regulating neurohormones were measured in patients entering a substudy of the Studies of Left Ventricular Dysfunction--a randomized clinical trial in patients with left ventricular ejection fraction < or = 35%. The variability of these hormones has not been determined in a large cohort of patients. Immediate (short-term) variability was assessed by systematically comparing levels after 15 and 30 minutes of supine rest at the initial visit, and longer term variability was assessed by comparing 30-minute supine rest values at the initial visit with corresponding values taken at 30 minutes after 16 to 24 days of stable therapy. Initial values obtained at the first visit after 30-minute supine rest for all 209 patients were (mean +/- SEM) 512 +/- 21 pg/ml pg/ml for plasma norepinephrine, 1.9 +/- 0.2 ng/ml/hr for plasma renin activity, 3.0 +/- 0.1 pg/ml for plasma arginine vasopressin, and 129 +/- 5.3 pg/ml for plasma atrial natriuretic peptide. All variables were moderately increased relative to established normal values. There was a small but significant decrease from 15- to 30-minute supine posture in all neurohormones, except arginine vasopressin. In the presence of stable background therapy, no significant differences were found between measurements obtained after 30 minutes supine rest at the initial visit and 16 to 24 days later. Spearman correlation coefficients corresponding to immediate and longer term variability were high (range 0.55 to 0.79) (p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

[An autopsy case of traumatic subdural hematoma from arterio-venous malformation with diffuse axonal injury]

Diffuse axonal injury (DAI) is defined as widespread damage to axons in the white matter of the brain without focal injury such as contusion and acute subdural hematoma. A case of traumatic subdural hematoma from arterio-venous malformation accompanied by DAI is reported. A 58-year-old man was assaulted, and immediately lost consciousness, and remained unconscious during about 44 hours until his death. The autopsy revealed acute subdural hematoma (about 160 g) on left temporal lobe and left cingular, uncal and cerebellar tonsillar herniation, and tear and hemorrhage of the corpus callosum. Under this subdural hematoma, gray-whitish vascular lesion with subarachnoid hemorrhage was found. Histologically, this lesion was diagnosed as the arterio-venous malformation. Neuropathological examination of the corpus callosum, dorsolateral part of midbrain and superior cerebellar peduncle revealed DAI findings, such as swelling and ballooning of the myelin fibers, swelling and waving of axons, and retraction balls. Axon degenerations were also observed immunohistochemically by anti-200 kD neurofilament antibody. From the results, his unconsciousness from the moment of impact might be occurred from not only subdural hematoma but also DAI.

Interpretation of extravascular thermal volume of the lung in patients with chronic pulmonary diseases

To understand the significance of measured extravascular thermal volume of the lung (ETVL) in chronic pulmonary diseases, we measured ETVL using the double-indicator dilution technique in 17 emphysematous patients and 15 patients with pulmonary fibrosis. The level of ETVL in emphysema is significantly correlated with parameters reflecting the severity of the disease, including FEV1.0% (r = 0.54, p < 0.05), DLCO/VA (r = 0.54, p < 0.05), PaO2 (r = 0.61, p < 0.01), and mean pulmonary artery pressure (r = -0.61, p < 0.01). In pulmonary fibrosis, a significant inverse correlation was found between ETVL and PaO2 (r = -0.64, p < 0.02), DLCO/VA (r = -0.58, p < 0.05), and %VC (r = -0.61, p < 0.02). The mean level of ETVL in both groups of patients was lower than previously reported normal values. These results suggest that ETVL may reflect the decrease in pulmonary vasculature in emphysematous patients, while it may signify a decrease of pulmonary vasculature and increased volume of pulmonary interstitial tissue surrounding the pulmonary vasculature in pulmonary fibrosis. We conclude that ETVL may represent a good estimate of the condition of the pulmonary vasculature and interstitial tissue volume in patients with chronic pulmonary diseases.

Preventive effect of ulinastatin on renal scarring in rat model of pyelonephritis induced by direct or ascending infection with Serratia marcescens or Escherichia coli

Renal scarring is considered to be a characteristic of reflux nephropathy. The effects of ulinastatin, a strong inhibitor of polymorphonuclear leukocyte elastase, on renal scarring following direct parenchymal or intravesical ascending infection by Serratia marcescens or Escherichia coli were determined. Four days of treatment with ulinastatin initiated 2 or 5 days after infection prevented renal scarring. Doses of 1,000-4,000 units/kg inhibited renal scar formation, but 8,000 units/kg did not. These results suggest that it may be possible to limit renal scar formation in pyelonephritis by the use of an appropriate pharmacologic agent.

Effect of prednisolone on ascending renal infection due to biofilm disease and lower urinary tract obstruction in rats

A model of renal infection due to lower urinary tract obstruction and biofilm disease was constructed for the study of renal scarring by inserting glass beads coated with bacterial biofilm into the bladder of rats and then clamping the urethra. We previously reported the effect of antimicrobial therapy used in combination with the anti-inflammatory agent prednisolone to prevent renal scarring. In this study we investigated the effect of prednisolone on renal scar formation using our new model. Renal scarring could not be prevented in the group in which prednisolone was administered in the period during which the urethra was regularly being clamped. In contrast, scarring was prevented in the group that began to receive prednisolone after the period of clamping had ended. Therefore, in cases of lower urinary tract obstruction prednisolone should only be administered for the prevention of renal scarring after the obstruction has been resolved.

[An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhage (hematoma)]

An autopsy case of Sjögren syndrome with organized and fresh subdural hemorrhages (hematoma) is reported. A 49-year-old woman who had been suffering from Sjögren syndrome had gradually lost her consciousness and was taken to the hospital where she died several hours later. Subsequently a doctor found the subdural hematoma of unknown origin on her Brain CT. At autopsy, her skin was dry and all of her teeth were missing. There were sporadic cutaneous purpura and subcutaneous hemorrhages in her trunk and limbs. The histopathological examination revealed that the submandibular gland had no normal acini, and was replaced by fibrous and adipose tissues with numerous lymphocytes. There were signs of fibrosis with inflammation in her liver, kidneys and lungs. The thyroid gland showed thyroiditis. Serological findings showed a significant high level of antinuclear antibody, positive RA factor and high gamma-globulinemia. The autopsy revealed that her cause of death was acute subdural hematoma and uncal herniation. There were no external injuries on her head or face. It is suggested that her acute subdural hematoma according to the hemorrhagic tendency, affected by her Sjögren syndrome.

Increased safety by two-stage hepatectomy with preoperative portal vein embolization in rats

We evaluated the usefulness of preoperative portal vein embolization (PVE) in rats for increasing the safety of liver resection. During PVE, portal vein branches that perfused the central and left lobes of the liver were embolized. Liver weight, the elimination of indocyanine green, and the number of Kupffer cells were examined 7 days after PVE and in intact rats. Then we examined rats that had undergone PVE (PVE group), rats in which the embolized part of the liver was resected 7 days after PVE (PVE-Hx group), rats without PVE in which the same lobes of the liver were resected (Hx group), and rats that had undergone a sham operation (sham-operation group) for liver weight, the mitotic index of the hepatocytes, serum alanine aminotransferase activity, total bilirubin, and antithrombin III activity. Some rats in the four groups received an intravenous injection of 0.5 or 2.5 mg/kg endotoxin 48 hr after the operation (the second operation, if done), and the 24-hr survival rate was calculated. Some rats given 0.5 mg/kg endotoxin were killed 6 hr after the injection, and the extent of liver injury was examined biochemically and histologically. Seven days after PVE, the nonembolized part of the liver was about twice the weight of the corresponding lobes in the intact rats, the density of Kupffer cells was doubled, and the hepatic function per unit weight was about the same as that in these controls. Hepatic dysfunction and the endotoxin-induced liver injury were significantly slighter in the PVE and PVE-Hx groups than in the Hx group. Preoperative PVE could make hepatectomy safer.

Influence of hyperosmotic environment comparable to the renal medulla upon membrane NADPH oxidase of human polymorphonuclear leukocytes

Hyperosmotic environment in the renal medulla seems important for bacterial pyelonephritis because it exerts inhibitory influences upon the function of polymorphonuclear leukocytes (PMN). Urea and NaCl primarily contribute to high osmolarity in the renal medulla. We previously reported that PMN function was actually suppressed in phagocytosis, intracellular bacterial killing and superoxide generation in the hyperosmotic solution of urea and NaCl. In the present report, to verify the mechanism of this inhibitory effect, a kinetic study for NADPH oxidase in the cell membrane, the key enzyme complex of superoxide generation, was carried out in the cell membrane-solubilizing system under the hyperosmotic condition caused by urea or NaCl. Urea directly denaturated NADPH oxidase, and its inhibitory mechanism was reversible and uncompetitive with a decrease in Vmax and Km, while NaCl had no effect upon it, maintaining Lineweaver-Burk plots in the same position as those of the control. This result suggests that urea at least produces an inhibitory effect upon PMN through the direct inactivation of NADPH oxidase, although NaCl was unable to do so.

A neonatal case of hydranencephaly caused by atheromatous plaque obstruction of aortic arch: possible association with a congenital cytomegalovirus infection?

A neonate was seen with hydranencephaly and aortic arch obstruction possibly caused by congenital cytomegalovirus infection. At autopsy the aortic arch was occluded by atheromatous plaque between the right brachiocephalic artery and left common carotid artery. Congenital cytomegalovirus infection may have caused cardiovascular disease and hydranencephaly in this case.

Immunohistological investigations of autopsied carotid bodies and their application to diagnosing strangulation

Using immunohistochemical staining, the histological changes and the presence of neuropeptides (enkephalin and VIP) in the carotid body have been investigated in medico-legal autopsy cases, especially asphyxia cases. Only in cases of manual and/or ligature strangulation cases that sustained a force near the carotid body, were the chief cells mainly lightly stained, indicating that they had been "active" cells. Furthermore, these cells and their nuclei were enlarged in comparison to the chief carotid body cells in other autopsy groups. It was thus felt that these changes had resulted from the force that had directly affected the carotid body. Based on these findings, it was concluded that immunohistochemical investigation of the carotid body offers a useful possibility for diagnosing manual asphyxia, especially in autopsy cases involving strangulation.

The distribution of secretory immunoglobulin A in the intrahepatic biliary epithelium of patients with hepatolithiasis

In the treatment of hepatolithiasis, liver resection helps to prevent recurrence and may reduce the incidence of infection by removal of the atrophic tissue. This study was conducted to determine if the affected liver tissue in hepatolithiasis is inflamed or has lowered local immunity by examining the distribution of secretory immunoglobulin A (sIgA) and proliferating cell nuclear antigen (PCNA) in the intrahepatic biliary tracts of 27 patients with hepatolithiasis. Operative specimens were sectioned and stained with avidinbiotin complex, and the labeling index for both sIgA and PCNA was calculated as a percentage of the biliary epithelial cells stained. Cells stained for sIgA increased to a certain point as the cholangitis became more severe; however, in advanced cholangitis, with severe parenchymal atrophy or actively proliferating biliary epithelium, there were fewer cells stained for sIgA than in mild cholangitis. In hepatolithiasis, the decreased local immunity related to sIgA accompanied severe chronic proliferative cholangitis and parenchymal atrophy.

Enhanced chemiluminescence response of polymorphonuclear leukocytes by new quinolone antimicrobials

Some of the many antimicrobial agents (beta-lactams, macrolides, aminoglycosides, tetracyclines, new quinolones; NQs) were reported to have a bactericidal or bacteriostatic effect cooperating with host defense mechanisms including polymorphonuclear neutrophils (PMNs). We investigated the effect of new quinolone antimicrobials on chemiluminescence (CL) response of human PMNs. Among many NQs, we chose ofloxacin, lomefloxacin, fleroxacin, sparfloxacin, AM-1155, NM-394, Q-35, Y-26611 and T-3761. Twenty-five or 100 micrograms/ml of fleroxacin and ofloxacin enhanced luminol-dependent CL response of PMNs up to 1.5-2.0 times compared to the drug free condition. Other antimicrobial agents, however, inhibited CL response. This suggested that fleroxacin and ofloxacin were more efficient in the treatment of bacterial infections with respect to the interaction between antimicrobials and PMNs.

Florid cemento-osseous dysplasia. Radiographic study with special emphasis on computed tomography

This article describes the computed tomographic and conventional radiographic findings for florid cemento-osseous dysplasia. A low-density thin layer or cystlike area was observed around the high-density masses in the tooth-bearing area in the seven cases studied. Expansion of the buccal and lingual cortical plates was observed in association with cystlike areas, but was infrequently observed in florid cemento-osseous dysplasia not having such areas. The computed tomographic number of the high-density masses ranged from 772 to 1587 Hounsfield Units and was equivalent to that of cementum or cortical bone.

Surgical treatment of brain metastases of lung cancer: retrospective analysis of 89 cases

The records of 89 patients who underwent surgery for solitary or multiple parenchymal brain metastases of lung cancer at the Osaka Center for Adult Diseases between 1978 and 1990 were reviewed with follow up until March 1992. The aim of this retrospective analysis was to identify prognostic features that were associated with a favourable outcome. The benefits of brain tumour surgery were evaluated in terms of the cause of death (brain metastasis, tumour in another organ, or treatment related) as well as the postoperative changes in functional state indicated by the Karnofsky scale. The overall mean survival time was 11.6 months, and the one and two year survival rates were 24% and 8%. The brain lesion itself was the cause of death in only 19% of the patients; the other 81% died of systemic disease. Functional state improved after surgical excision of the brain tumour in 36%, remained unchanged in 53%, and worsened in 11%. These data suggest that surgical intervention is beneficial for patients with parenchymal brain metastases. Variables significantly associated with a favourable prognosis included surgical excision of the primary lesion, adenocarcinoma as the histological diagnosis, the use of adjuvant treatment, especially chemotherapy, a preoperative score of over 80% on the Karnofsky scale, and metastasis confined to the brain with no extracranial metastatic foci or residual primary tumour. Additional but non-significant contributors to a good prognosis included age under 65 or 70 years, early tumour stage (stage 1), curative lung cancer surgery, a single metastatic brain tumour (v multiple lesions), a solid tumour (v cystic), and a supratentorial location of the brain metastasis. The disease free interval and the cerebrospinal fluid cytology were not significant prognostic factors. On the basis of these findings, it is concluded that the surgical removal of brain metastases of lung cancer should be undertaken if the primary tumour has already been removed whether or not there are extracranial metastases, and that postoperative chemotherapy should generally be given.