Pathogenic role of glutamate in hyperthermia-induced seizures

Hyperthermia induces seizures in both humans and rodents, but the underlying mechanism remains unknown. The present study showed that hyperthermia, causing rapid increase in body temperature, increases the concentration of glutamate (Glu) released into a cortical perfusate before onset of seizures in rats and that this increase in Glu concentration correlated with a decrease in seizure threshold temperature. These results indicate that increased cortical extracellular Glu induced by hyperthermia contributes to onset of seizures. The same mechanism may be involved in clinical seizures induced by fever in patients with febrile convulsions or epilepsy.

Electrical impedance in the lower limbs of patients with Duchenne muscular dystrophy: a preliminary study

Electrical impedances were measured, at a range of frequencies from 2 to 200 kHz, in the lower limbs of nine patients with Duchenne muscular dystrophy and 12 normal subjects. The specific admittance was calculated from the impedance, based on the assumption that the shape of the part of the limb measured is a truncated cone. Curve-fitting to the admittance locus on the complex plane gave the intracellular and extracellular resistances and the membrane capacitance. The intracellular resistance was higher and the membrane capacitance was lower in the patients than in the normal subjects. The membrane capacitance in the normal subjects increased with age. In the patients, the membrane capacitance decreased, and the intracellular resistance increased with the stage of disability, which was assessed by a physician. These experimental results agree well with the theoretical explanation, which uses simplified spherical models to represent living tissue.

Lymphatic transport of eicosapentaenoic and docosahexaenoic acids as triglyceride, ethyl ester and free acid, and their effect on cholesterol transport in rats

Lymphatic transport of docosahexaenoic (DHA) and eicosapentaenoic (EPA) acids given in the forms of triglyceride, ethyl ester of free acid and their effect on cholesterol transport was compared in lymph-cannulated rats. Lymphatic recovery of DHA and EPA given by stomach tube in the form of triglyceride in which they were mainly located at the 2-position was significantly higher than that of the ethyl ester or free acid during the first 6 hr after the administration and the tendency continued until 9 hr. In contrast, the 9 to 24 hr recovery of DHA and EPA in the forms of ethyl ester and free acid was considerably higher than that of triglyceride. Consequently, cumulative 24 hr recovery of EPA was comparable among the three forms. However, the 24 hr recovery of DHA was highest in free acid, lowest in ethyl ester and intermediate in triglyceride. Recovery of the free acid between 9 and 24 hr after administration was significantly higher than that given in the forms of triglyceride or ethyl ester. Cholesterol recovery in lymph of rats given with ethyl ester or free acid was lower than that given with triglyceride at an early stage after the administration in both EPA and DHA. Cumulative 24 hr recovery of cholesterol in rats given these fatty acids as ethyl ester was significantly lower than in those given as the other two forms.

[Effects of intravenous infusion of isosorbide dinitrate on hemodynamics during anesthesia and surgery]

Ninety nine patients with ischemic changes of the heart on preoperative and intraoperative ECG tracings were studied to evaluate effects of intravenous infusion of isosorbide dinitrate on hemodynamics during anesthesia and surgery. These patients ranging in ages from 24 to 80 years were administered intravenous isosorbide dinitrate at a rate of either 0.5 or 1 microgram.kg-1 x min-1 during anesthesia and surgery. Arterial blood pressure was not influenced with intravenous isosorbide dinitrate at the speed of 0.5 microgram.kg-1 x min-1 during anesthesia and surgery. The arterial pressure of the patients decreased slightly but significantly 30 min after the start of 1 microgram.kg-1 x min-1 of isosorbide dinitrate infusion, but it recovered to the control level at the end of administration of isosorbide dinitrate. Heart rate was unchanged with intravenous isosorbide dinitrate during anesthesia and surgery in both groups, except a mild increase at the end of isosorbide dinitrate infusion of 1 microgram.kg-1 x min-1. Arterial blood oxygen tension showed no decrease during the administration of isosorbide dinitrate and no adverse reactions associated with administration of the drug was detected in this study. Significant improvement of ischemic changes on ECG tracings were observed in about 25% of the patients who received 1 micrograms.kg-1 x min-1 of intravenous isosorbide dinitrate.

[The first case of infantile type neuronal ceroid-lipofuscinosis in Japan]

We reported the first case of typical infantile-type neuronal ceroid-lipofuscinosis (INCL) in Japan. The patient was a 1-year-old girl presenting with rapidly progressive psychomotor deterioration and blindness. Muscular hypotonia, microcephaly and myoclonic jerks became marked with the progression of her disease. Diminution in amplitude of EEG, VEP and ERG was prominent in the initial stage, but ABR was normal. MRI showed progressive brain atrophy. Electron microscopic examination of the biopsied skin revealed granular matrix, the specific inclusion bodies, in the epithelial cell of sweet glands. Many sea-blue histiocytes were demonstrated in her bone marrow samples. INCL is a common progressive encephalopathy in the Scandinavian countries, but a typical case had not yet been fully reported in Japan. This prompted us to report our case. Future reports are need for the study of INCL in Japan.

[Neurophysiologic and histopathologic studies in a case of congenital sensory neuropathy with anhidrosis]

A three year-old boy with congenital sensory neuropathy with anhidrosis (CSNA) was described. Sural nerve biopsy specimens revealed an almost complete absence of unmyelinated fibers and a marked decrease of the density of small myelinated fibers with preservation of the density of large myelinated fibers. No evidence of active degeneration of unmyelinated or myelinated fibers was found. Skin biopsy specimens revealed the absence of nerve terminals and fibers innervating sweat glands, although sweat glands seemed to be apparently normal in their morphological findings. Therefore, it was concluded that the absence of pain and temperature sensations with preservation of touch sensation in our patient was compatible with the morphometric findings of nerve fibers of the sural nerve described. Similarly anhidrosis was concluded to be well explained by the absence of the innervation of sweat glands and the vessels around them. On the other hand, electrophysiologic studies, such as motor and sensory nerve conduction, short latency somatosensory evoked potential and auditory brainstem response, in which the function of the large myelinated fibers is presumably tested, were all normal. Therefore, the structure and function of such large myelinated fibers were spared in this case. From clinical viewpoints, electrophysiologic studies described above are useful to differentiate CSNA from other types of congenital sensory neuropathies, in which large myelinated fibers are affected.

Tea catechins decrease micellar solubility and intestinal absorption of cholesterol in rats

A(-)-epicatechin (EC) and (-)-epigallocatechin (EGC) mixture and a mixture of their gallates (ECG and EGCG, respectively) markedly lowered lymphatic cholesterol absorption in rats with a cannulated thoracic duct. A mixture of ECG and EGCG was more effective in reducing cholesterol absorption than the EC and EGC mixture. These catechins also tended to decrease lymphatic absorption of triacylglycerols, although not so pronounced as in cholesterol absorption. An in vitro study on micellar solubility of cholesterol showed that these catechin mixtures precipitated cholesterol solubilized in mixed bile salt micelles in a dose-dependent manner. A mixture of ECG and EGCG more effectively precipitated micellar cholesterol than a mixture of EC and EGC. When purified EC, EGC, ECG and EGCG were used, EGCG was more effective in precipitating micellar cholesterol than ECG. The effect of EC and EGC was comparable and weaker than their gallate esters. The bile acid concentration in the micelles was not affected by these catechins. A positive correlation was observed between the amount of coprecipitated EGCG and cholesterol. These results clearly show that tea catechins, in particular their gallate esters, effectively reduce cholesterol absorption from the intestine by reducing solubility of cholesterol in mixed micelles. The observation accounts for the hypocholesterolemic effect of tea catechins.

A female patient with Lesch-Nyhan syndrome

The authors report the second case of a female with typical Lesch-Nyhan syndrome. She exhibited athetoid movement, self-multilation, mental retardation and spasticity. Laboratory investigations revealed hyperuricaemia, hyperuricosuria and decreased erythrocyte hypoxanthine guanine phosphoribosyl transferase activity. She has normal female external genitalia and karyotype. Her parents are non-consanguineous and there is no family member with gout, nephropathy or any psychoneurological disorder. To prevent self-stimulation, it was necessary to fix the patient's upper extremities to the backrest of her wheelchair. The authors also describe an apparatus that limits elbow flexion.

[Clinical evaluation of prostaglandin E1 during anesthesia in non-elderly and elderly patients]

The effects of prostaglandin E1 (PGE1) on blood pressure during anesthesia and the postoperative changes in organ functions were examined and compared in 358 cases. Two hundred and eighty patients were under 64 years of age and 128 patients were over 65 years. It was possible to control blood pressure satisfactorily with PGE1 in both non-elderly and elderly groups. However in the elderly group, it was more difficult to control blood pressure with PGE1 under NLA as compared with enflurane anesthesia. In both groups, urinary flow increased during and after the administration of PGE1, and the livers and kidneys showed neither dysfunction nor deterioration after operation. We had very few incidences of side effects with this drug. PGE1 is also considered safe and useful for elderly people during and after surgery.

Three types of hyperthermic seizures in rats

Three types of rat hyperthermic seizures were observed. The first comprised generalized clonic convulsions preceded by intermittent myoclonus. Ictal EEG showed diffuse intermittent spikes and sequential rapid spike-wave bursts (type 1 seizures). In the other types of seizures, the paroxysmal discharges originated in the occipital region without (type 2a seizures) or with (type 2b seizures) secondary generalization. Type 2a seizures involved no convulsive movement whereas type 2b seizures involved clonic convulsions. The threshold temperatures for type 1, 2a and 2b seizures were 44.1 +/- 0.60, 40.9 +/- 1.47 and 42.1 +/- 0.75 degrees C, respectively. Of these seizures, the type 2 seizures (2a and 2b) did not severely affect the general condition of rats and thus may be an appropriate model for the investigation of febrile seizures.

MRI in poliomyelitis-like syndrome

We report the MRI findings in a patient with poliomyelitis-like syndrome. MRI demonstrated a lesion extending from the dorsal region of the pons to the upper level of the thoracic spinal cord. The spinal cord was particularly affected in a region involving the bilateral anterior horns. Although its pathology is unknown, the lesion of the spinal cord seemingly reflects the pathological features of this disease.

Structure/activity relationship of eel calcitonin. A study using a newly devised method for designing analogs

A series of analogs of eel calcitonin (eCT) was synthesized according to a newly devised scheme, 'the insertion-inactivation method', to clarify the structure/activity relationship of a given peptide. This method consists of two steps: the deletion of a residue of the peptide is first chosen and then a series of analogs with the residue reinserted into serial positions is synthesized and biological activities are assessed in each step. An analog lacking Lys18 (dK), selected as a deleted analog for the first step, showed marked loss of activities determined by inhibition of 125I-eCT binding, growth inhibition, and cAMP production in a porcine kidney cell line LLC-PK1. Activities of a set of 20 analogs with the reinserted lysine residue at serial positions from 12 to 32 (K12-K32) were then evaluated. The results showed the following three patterns of the expression of activities according to the position of the reinsertion: (a) analogs K12-K16 (positions 12-16) and K25 (position 25) showed lower activities than eCT in all assays; (b) K17-K24 (positions 17-24) showed slightly lower activities than eCT in the receptor binding and the growth inhibition and similar level in cAMP production; (c) K26-K32 (positions 26-32) showed considerably lower activities in the former two assays and slightly lower activity in cAMP production. Further, analogs considerably less active than eCT showed unchanged alpha-helix contents and destroyed amphiphilicity by the insertion of a lysine residue, indicating that amphiphilicity is one of important factors for expressing the activity. The results obtained here lead to a conclusion on the significance of each region of eCT molecule as follows: (a) the presence of Lys18 is necessary for the complete expression of biological activity; (b) the length of amphiphilic alpha-helix to be required for the activity is at most 10 residues ranging from position 8 to position 17; (c) the receptor binding region is located within 9 residues ranging from position 24 to position 32.

[A case of Behçet's disease complicated with acute myocardial infarction]

A 23-year-old-man was admitted to our department complaining of chest oppression. He had had a diagnosis of intestinal-Behçet because of a 7-year history of recurrent oral and genital ulcers, arthritis, cutaneous folliculitis and ulcer in the ileocecal region. Cardiac catheterization revealed total occlusion at the proximal portion of the left anterior descending artery (LAD) without aneurysm formation at other coronary trees. During medical follow-up, this case showed vasospastic angina probably associated with active coronary vasculitis. The incidence of vascular involvement in the total number of cases of Behçet's disease reported in the literature is 3.6-7.7%. Overall, thrombophlebitis and arterial aneurysm formation is relatively common and frequently reported in cases of vasculo-Behçet. Our case demonstrated the following uncommon pattern as vasculo-Behçet; 1) initial clinicopathologic manifestation at the coronary artery without any other vascular lesion, 2) abrupt total occlusion (clear cut lesion) at LAD, 3) complication of vasospastic angina, which has not yet been reported in medical literature.

Electroencephalographic study of rat hyperthermic seizures

The behavior and EEG of rat hyperthermic convulsions was studied. We found that a long run of high-voltage slow waves without convulsions, high-voltage irregular activity consisting of spikes and waves with intermittent myoclonus, and rapid spike and wave bursts accompanied by generalized clonic convulsions occurred sequentially. This behavioral and EEG activity is analogous to human febrile convulsions and supports the usefulness of this model for studies of human febrile convulsions. Rats frequently showed arrest of locomotion concurrently with paroxysmal EEG theta bursts before development of generalized convulsions. We speculate that this paroxysmal activity is a type of seizure discharge.

The circadian rhythm of typical absence seizures--the frequency and duration of paroxysmal discharges

Twelve patients with typical absence seizures, aged five years two months to 10 years, were examined to clarify the circadian rhythm of 3 c/s spike-and-wave paroxysms (s-w paroxysms), by means of video-electroencephalography with telemetry. S-w paroxysms combined with clinical symptoms and continuing for more than four seconds were fewer during the afternoon than the morning and, moreover, during sleep. The correlation ratio between the frequency and duration of s-w paroxysms was r = -0.74, which was statistically significant (p less than 0.02). The duration of s-w paroxysms evoked by hyperventilation or photic stimulation did not differ from that of spontaneous s-w paroxysms. The s-w paroxysms were shorter and deformed in sleep. Therefore, the observation of typical absence seizures during the morning should be regarded as important. In patients with modified s-w paroxysms during sleep, it is important that electroencephalographic recording with stimulation, such as hyperventilation, is performed sufficiently.

Hyperthermia-induced seizures with a servo system: neurophysiological roles of age, temperature elevation rate and regional GABA content in the rat

A servo system including a microwave generator was applied to raise a rat's body temperature at a pre-set rate. Using this system the effects of age and the temperature elevation rate upon febrile seizures in rats were studied. The relationship between the brain GABA content and hyperthermia was also studied. From the results of the present study, the seizure occurrence rate was found to be highest at the age of 20 days, brain damage was speculated to be severe after hyperthermia-induced seizures with a slow temperature rise, and the regional GABA concentration in subcortical structures was found to increase during hyperthermia. These data indicate that a servo system with a microwave generator is useful for experimental febrile convulsions, and that GABA neurotransmission in subcortical structures might contribute to feed-back regulation against seizures during hyperthermia.

[Direct percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction: comparison with PTCA immediately after thrombolysis]

We studied 73 patients with acute myocardial infarction (AMI) treated by percutaneous transluminal coronary angioplasty (PTCA) without thrombolysis (direct PTCA) and 52 patients with AMI treated by PTCA immediately after thrombolysis (PTCR + PTCA). The initial results, angiographic findings and preservation of ventricular functions of the direct PTCA group were compared with those of the PTCR + PTCA group. 1. The success rate of coronary recanalization was higher in the direct PTCA group than in the PTCR + PTCA group, but there was no statistical significance (89% vs 77%; p = NS). 2. Major complications occurred in 4.1% of the direct PTCA group and in 5.8% of the PTCR + PTCA group (p = NS). 3. The incidence of acute coronary reocclusion was higher in the PTCR + PTCA group than in the direct PTCA group (7.4% vs 22%; p less than 0.05). 4. Angiographic haziness at the dilated site following PTCA was seen more frequently in patients in the PTCR + PTCA group than in those of the direct PTCA group (43% vs 23%; p less than 0.05). 5. Patients with haziness at the dilated site had a significantly higher incidence of acute coronary reocclusion than did the patients without such haziness (28% vs 6.3%; p less than 0.05). 6. Left ventricular ejection fraction and regional wall motion were better preserved in the direct PTCA group than in the PTCR + PTCA group, but there was not statistical significance. It was suggested that direct PTCA is safe and can be performed with good success rates. It is superior to PTCR + PTCA in avoiding acute coronary reocclusion, and thus we supposed that the response of lesions to angioplasty may be altered by the administration of thrombolytic agents.

[Effects of early myocardial reperfusion on left ventricular function in patients with acute myocardial infarction]

The effect of early myocardial reperfusion (within six hours after the onset of symptoms) on left ventricular (LV) function in 106 patients with acute myocardial infarction was studied. The subjects consisting of 26 with conventional therapy, 19 with percutaneous transluminal coronary recanalization (PTCR), 16 with percutaneous transluminal coronary angioplasty (PTCA) after PTCR, 32 with direct-PTCA and 13 with coronary artery bypass graft (CABG) were randomly observed after 1981. In these patients, left ventricular ejection fraction (LVEF), regional wall motion, end-diastolic pressure and the contractility index were measured as the indices of LV function. 1. Compared to the conventional therapy group, LVEF and regional wall motion improved significantly in all groups with reperfusion therapy except in the PTCR group. This LV function in patients with subtotal obstruction or good initial collaterals significantly improved compared to patients with total obstruction and no collateral circulation. Patients with a 75 percent or more residual stenosis after reperfusion therapy had significantly decreased LV function compared to those with residual stenosis of less than 75 percent. These findings support the potential role for reperfusion therapy in patients with acute myocardial infarction.

[Effect of continuous epidural infusion of morphine for postoperative analgesia on pituitary-adrenocortical function]

Plasma levels of cortisol, ACTH and beta-endorphin like immunoreactivity (beta-ELI) were measured to evaluate postoperative pain relief with epidural morphine and systemic analgesics in conjunction with endocrine functions in 16 patients who underwent gastrectomy. Eight of these patients (epidural morphine group) obtained postoperative analgesia with continuous epidural infusion of morphine with a pump as in our previous report. A bolus of epidural morphine was administered through an indwelling thoracic (Th8,9) catheter at 3 hrs prior to the proposed end of the surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with a pump (CADD-PCA, Model 5200P, Pharmacia) during and after anesthesia and surgery with gradual decrease in dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received systemic pentazocine and buprenorphine when needed. Plasma cortisol levels increased significantly at the end of surgery and after in both groups. However plasma concentrations of cortisol in the epidural morphine group were significantly lower than those in the systemic analgesics group on the first and second postoperative days. Plasma levels of ACTH and beta-ELI increased significantly at the end of surgery but returned to levels of the previous day in both groups postoperatively. Our study suggests that continuous epidural infusion of morphine is adequate for postoperative pain relief and has suppressing effect on plasma cortisol levels as compared with systemic analgesics regimen.

Continuous vs. bolus epidural morphine

The clinical evaluation of continuous administration of epidural morphine was undertaken using an infusion pump (Act-A-Pump 1000). Eleven patients who had undergone abdominal surgical procedures were treated with this therapeutic modality for postoperative pain control, and two cancer patients for chronic pain relief. The results were satisfactory and the advantages over repeated epidural injections are discussed.

Local structural features around the C-terminal segment of Streptomyces subtilisin inhibitor studied by carbonyl carbon nuclear magnetic resonances three phenylalanyl residues

The carbonyl carbon NMR signals of the Phe residues in Streptomyces subtilisin inhibitor (SSI) were selectively observed for [F]SSI, in which all phenylalanines were uniformly labeled with [1-13C]Phe. The three enhanced resonances in the spectrum of [F]SSI were unambiguously assigned to the specific sites in the amino acid sequence by means of 15N,13C double-labeling techniques. Namely, the resonances at 174.9 and 172.6 ppm (in D2O, pH 7.3, 50 degrees C) showed the satellite peaks due to 13C-15N spin coupling in the spectra of [F,GS]SSI and [F,A]SSI, in which Ser/Gly and Ala residues were labeled with [15N]Gly/Ser and [15N]Ala, respectively, together with [1-13C]Phe. The carbonyl groups of Phe-97 and Phe-111 are involved in peptide bonds with the amino nitrogens of Ser-98 and Ala-112, respectively. These results clearly indicate that the signals at 174.5 and 172.6 ppm are due to Phe-97 and Phe-111, respectively. The signal at the lowest field (177.1 ppm) was thus assigned to the carboxyl carbon of the C-terminal Phe-113. The lifetimes of the amide hydrogens of the three Phe residues and their C-terminal-side neighbors (Ser-98 and Ala-112) were investigated by using the effect of deuterium-hydrogen exchange of amide on the line shapes (DEALS) for the Phe carbonyl carbon resonances. In this method, the NMR spectra of [F]SSI dissolved in 50% D2O (pH 7.3) were measured at various temperatures, and the line shape changes caused by deuteriation isotope shifts were analyzed.(ABSTRACT TRUNCATED AT 250 WORDS)

AMP deaminase activity of skeletal muscle in neuromuscular disorders in childhood. Histochemical and biochemical studies

We studied the histochemical staining and biochemical activity of AMP deaminase in biopsied muscle in Becker-type muscular dystrophy (BMD), Fukuyama-type congenital muscular dystrophy (FCMD), Duchenne-type muscular dystrophy (DMD), Werdnig-Hoffmann disease (WH) in order to elucidate the change of AMP deaminase activity in muscle with neuromuscular disorders in childhood. The intensity of AMP deaminase staining did not decrease in BMD with mild pathologic change, but in DMD, FCMD and WH it decreased in parallel with the severity of the pathologic change. The biochemical activity of AMP deaminase did not decrease in muscle with mild pathologic change in patients with DMD and tended to decrease according to the progress of the disease. The activity of AMP deaminase in muscle of patients with FCMD and WH which showed severe pathologic change was remarkably low. It was demonstrated that the decrease in the activity of AMP deaminase was related to the intensity of pathologic change rather than diagnosis of a neuromuscular disorder.

Histological findings of the right and left ventricular myocardium and clinical follow up in idiopathic ventricular tachycardia

In order to evaluate the etiology of so-called idiopathic ventricular tachycardia, endomyocardial biopsies were performed in four patients with electrocardiographically documented recurrent and sustained ventricular tachycardia. During the episodes of ventricular tachycardia, standard ECG showed a QRS pattern of right bundle branch block with left axis deviation in two patients and left bundle branch block in two patients. The episodes were associated with palpitation, dyspnea and hypotension in all cases. No organic heart disease was detected by physical examination, chest X-ray films, echocardiograms, left ventriculograms or coronary cineangiograms. His bundle electrograms showed blocks at various sites in the atrioventricular conduction system. The biopsy specimens revealed nonspecific myocardial degeneration in the right and left ventricles. These findings suggest mild but wide-spread myocardial damage in both the working myocardium and the conduction system. The clinical course of these patients appeared benign according to follow-up data of one to nine years' duration. None developed overt clinical signs of dilated, hypertrophic or restrictive cardiomyopathy.

[Clinical studies on aspoxicillin in the pediatric field]

Studies on efficacy and safety of aspoxicillin (ASPC) were carried out to 14 cases of pediatric infections, and the following results were obtained. Clinical efficacy of ASPC to 10 respiratory infections, 1 urinary tract infection and 1 otitis media was excellent in 6 cases (50%) and good in 6 cases (50%). The efficacy rate was 100%. Bacteriological effect of ASPC to 6 cases which detected the causative organisms (S. aureus, E. faecalis, H. influenzae and P. mirabilis) was eliminate in 3 cases (50%) and replace in 3 cases (50%). The bacterial eliminated rate was 100%. Side effects of ASPC to 14 administered cases were observed in 2 cases, that were urticaria in 1 case and elevation of GOT in 1 case. From the above results, it was concluded that ASPC was the useful and secure antibiotic drug for treatment of infections in pediatric field.

A new apparatus for CT-guided stereotactic surgery

Combining whole-body CT scan with a stereotactic system, the authors have developed and applied clinically an apparatus which readily provides intraoperative CT images, making it possible to confirm the location of the target point and ascertain the intraoperative environment. It takes about 9 s to obtain a CT image. Our purpose is to make stereotactic surgery, a kind of blind surgery, as safe and reliable as a visualized procedure by intraoperative CT scanning. By the method, in which there is very little invasion under local anesthesia, evacuation of deep-seated intracerebral hematomas as well as brain abscesses and also biopsy or brachytherapy of brain tumors in the brain can be done with safety and reliability.

A case of multiple sclerosis with multi-ring-like and butterfly-like enhancement on computerized tomography

We report a case of multiple sclerosis in which CT showed multiple ring-like enhancement and butterfly-like distribution of a low density area with marginal enhancement. The latter finding is found in other demyelinating disorders but is less common in tumors or abscesses. Therefore, it seems to have some diagnostic value in multiple sclerosis.

Incidence of the coexistence of left ventricular false tendons and premature ventricular contractions in apparently healthy subjects

The incidence of the coexistence of left ventricular false tendons and premature ventricular contractions (PVCs) was evaluated prospectively. Over 14 months, left ventricular false tendons were found in 71 (6.4%) of 1117 consecutive patients examined echocardiographically. Two types of false tendons were observed: longitudinal, from the ventricular septum to the posteroapical wall (n = 62), and transverse, between the septum and the lateral wall (n = 9). Among 62 patients with PVCs and no underlying heart disease, false tendons were detected in 35 (56%); 28 had unifocal and seven had bifocal PVCs. Episodes of ventricular tachycardia were documented in one of the 28 patients with unifocal PVCs and in one of the seven patients with bifocal PVCs. These PVCs were poorly controlled by antiarrhythmic drugs but easily suppressed by exercise. Left ventricular false tendons were detected in 36 patients on routine echocardiographic examinations performed in the other 1055 subjects, and 10 of these patients were judged to have no underlying heart disease. PVCs were detected in two (20%) of these 10 patients. Although a definite conclusion that left ventricular false tendons are arrhythmogenic cannot be derived from these results, the unexpectedly high incidence of the coexistence suggests that left ventricular false tendons may be an etiologic factor in the development of PVCs, especially the rate-dependent and medically uncontrollable PVCs seen in apparently healthy individuals.

Transient hyperdense cerebral areas in childhood leukemia: CT demonstration

A child with acute myeloblastic leukemia and severe central nervous system complications during remission showed diffuse cerebral high density areas in a CT examination. These areas disappeared completely over the following few months. The possible causes for this phenomenon are discussed.

Selective binding behavior of zinc(II) and copper(II) ions to their native sites of apo-bovine superoxide dismutase

The four binding constants of zinc(II) ions to apo-bovine superoxide dismutase were measured by the method of equilibrium dialysis. The binding constants (10(11.1)-10(10.9) M-1) of zinc ions to the native zinc sites were much larger than those to the native copper sites (10(7.8)-10(6.5) M-1) at pH 6.25. The competitive reaction between copper(II) and zinc(II) ions for the native copper sites of copper free bovine superoxide dismutase was also investigated. The native copper sites of bovine superoxide dismutase selectively react with copper ions, because the binding constants of copper ions for the native copper sites were much larger (10(6) times) than those of zinc ions.