Differential adhesion molecule requirements for immune surveillance and inflammatory recruitment

Activated CD4 Th1 lymphocytes can enter the brain in the absence of an inflammatory focus. However, the molecular mediators that regulate this early migration of lymphocytes into the brain have remained unclear. We hypothesized that the entry of these 'pioneer' lymphocytes into the brain is regulated by a set of molecular events that are distinct from those used once inflammation has been established. Using cells fluorescently labelled with the lipophilic dye DiI, myelin basic protein (MBP)-specific CD4 lymphocytes that expressed low or high levels of very late antigen-4 (VLA-4) and non-antigen-specific activated splenocytes homed to mouse brain in similar quantities 2 h after adoptive transfer. However, antigen specificity and VLA-4 expression were required for more robust recruitment by 24 h. Immunocytochemistry revealed endothelial and microenvironmental upregulation of vascular cell adhesion molecule (VCAM), intercellular cell adhesion molecule 1 (ICAM-1), MHC class II and interferon-gamma 48 h after transfer of MBP-specific cells. In contrast, expression of meningeal and choroid plexus-associated P selectin was upregulated 2 h after adoptive transfer, but not at 48 h. Monoclonal antibody to P selectin, but not to VLA-4, inhibited early migration of high VLA-4-expressing MBP-specific lymphocytes. These results suggest that early migration occurs independent of the lymphocyte integrin VLA-4 and endothelial VCAM, but does require increased surface expression of endothelial P selectin.

Magnetic interactions in the high-spin iron(III) oxooctaethylchlorinato derivative [Fe(oxoOEC)(Cl)] and its pi-cation radical [Fe(oxoOEC.)(Cl)]SbCl6

The preparation and characterization of the beta-oxochlorin derivative [3,3,7,8,12,13,17,18-octaethyl-(3H)-porphin-2-onato(2-)]iron(III) chloride, [Fe(oxoOEC)(Cl)], and its pi-cation radical derivative [Fe(oxoOEC.)(Cl)]SbCl6 is described. Both compounds have been characterized by single-crystal X-ray structure determinations, IR, UV/vis/near-IR, and Mössbauer spectroscopies, and temperature-dependent magnetic susceptibility measurements. The macrocycles of [Fe(oxoOEC)(Cl)] and [Fe(oxoOEC.)(Cl)]SbCl6 are both saddled, and [Fe(oxoOEC.)(Cl)]-SbCl6 is slightly ruffled as well. [Fe(oxoOEC)(Cl)] shows a laterally shifted dimeric unit in the solid state, with a mean plane separation of 3.39 A and a lateral shift of 7.39 A. Crystal data for [Fe(oxoOEC)(Cl)]: triclinic, space group P1, Z = 2, a = 9.174(2) A, b = 13.522(3) A, c = 14.838(3) A, alpha = 95.79(3) degrees, beta = 101.46(2) degrees, gamma = 104.84(3) degrees. Upon oxidation, the inter-ring geometric parameters increase; the mean plane separation and the lateral shift of the dimeric unit of [Fe(oxoOEC.)(Cl)]SbCl6 are 4.82 and 8.79 A, respectively. Crystal data for [Fe(oxoOEC.)(Cl)]SbCl6: monoclinic, space group Cc, Z = 4, a = 19.8419(13) A, b = 10.027(2) A, c = 22.417(4) A, beta = 96.13(2) degrees. A broad near-IR absorption band appears at 1415 nm for the pi-cation radical, [Fe(oxoOEC.)(Cl)]SbCl6. Zero-field Mössbauer measurements at 4.2 K for both [Fe(oxoOEC)(Cl)] and [Fe(oxoOEC.)(Cl)]SbCl6 confirmed that the oxidation state of the iron atom did not change upon chemical oxidation. Solid-state magnetic susceptibility measurements for [Fe(oxoOEC.)(Cl)]SbCl6 resulted in a large temperature dependence of the magnetic moment that can best be fit with a model that includes a zero-field splitting parameter of D = 6 cm-1, antiferromagnetic intermolecular iron-iron coupling (2JFe-Fe = -0.14 cm-1), antiferromagnetic intramolecular iron-radical coupling (2JFe-r = -76 cm-1), and antiferromagnetic radical-radical coupling (2Jr-r = -13 cm-1).

HLA-A*02 allele frequencies and haplotypic associations in Koreans

We have investigated the frequencies of HLA-A*02 alleles and their haplotypic associations with HLA-B and -DRB1 loci in 439 healthy unrelated Koreans, including 214 parents from 107 families. All of the 227 samples (51.7%) typed as A2 by serology were analyzed for A*02 alleles using polymerase chain reaction (PCR)-low ionic strength-single-strand conformation polymorphism (LIS-SSCP) method. A total of six different A*02 alleles were detected (A*02 allele frequency 29.6%): A*0201/9 (16.6%), *0203 (0.5%), *0206 (9.3%), *0207 (3.0%), and one each case of *0210 and *02 undetermined type. Two characteristic haplotypes showing the strongest linkage disequilibrium were A*0203-B38-DRB]*1502 and A*0207-B46-DRB1*0803. Besides these strong associations, significant two-locus associations (P<0.001) were observed for A*0201 with B61, DRB1*0901 and DRB1*1401, and for A*0206 with B48 and B61. HLA haplotypes carrying HLA-A2 showed a variable distribution of A*02 alleles, and all of the eight most common A2-B-DR haplotypes occurring at frequencies of > or =1% were variably associated with two different A*02 alleles. These results demonstrate that substantial heterogeneity is present in the distribution of HLA-A*02 alleles and related haplotypes in Koreans.

Phenolic compounds from the leaves of Cornus controversa

Two novel phenolic compounds from the leaves of Cornus controversa (Cornaceae) were characterized as (-)-2,3-digalloyl-4-(E)-caffeoyl-L-threonic acid and (-)-2-galloyl-4-(E)-caffeoyl-L-threonic acid, using spectroscopic methods.

Solitary fibrous tumor of the orbit: a poorly-recognized orbital lesion

PURPOSE

The authors report three cases with solitary fibrous tumor (SFT) of the orbit with variable clinical presentation.

METHODS

The authors identified three patients with a diagnosis of SFT, and clinical histories, radiographs and pathologic specimens were reviewed.

RESULTS

Two SFTs are reported arising in the lacrimal gland fossa of a 24-year-old male and a 26-year-old female and a retrobulbar SFT is reported occurring in a 40-year-old female. While two patients had slow growth histories, one patient had a history of rapid progression. Immunohistochemically, the tumor cells were strongly positive for CD34 in all three cases.

CONCLUSION

The clinical presentation of the orbital SFT may be varied. Immunohistochemical analysis may help in the diagnosis of solitary fibrous tumor and the treatment is en bloc excision. A careful follow-up is necessary because it may recur years after excision of the primary tumor.

Transcriptional regulation of PDGF-A and TGF-beta by +KTS WT1 deletion mutants and a mutant mimicking Denys-Drash syndrome

Denys-Drash syndrome (DDS) and Frasier syndrome (FS) are rare diseases caused by the mutations of Wilms tumor gene, WT1. The common denominator in these syndromes is a nephropathy which is manifested by early-onset proteinuria, nephrotic syndrome and end stage renal failure. Although these syndromes are genetic models of nephropathy and the mutations of WT1 gene are characterized in these patients the mechanism how mutations of WT1 gene affect the embryonic kidney adversely has not been elucidated. Recently, there was a report that FS is caused by mutations in the donor splice site of WT1. These mutations predicted loss of +KTS isoform, which is one of the four splicing variants of WT1. In this study, two +KTS deletion mutants of WT1 were made as well as a WT1 mutant mimicking a mutation found in a patient who had diffuse mesangial sclerosis, end stage renal failure and Wilms tumor. Mutant embryonic kidney cell lines were established by transfection of 293 embryonic kidney cells with WT1 mutants. We investigated the transcription regulation of mutant WT1 among these cell lines using the reporter vectors containing PDGF-A and TGF-beta promoter sequence. Our results showed that the promoter activity of PDGF-A and TGF-beta, which are related to the progression of glomerular diseases, was modestly increased in the mutant cell mimicking the patent, while those activities were markedly increased in other two deletion mutant cell lines. This study demonstrated that +KTS WT1 mutation found in DDS affected the cytokine expression adversely in vitro. From these results, we suggest that the alteration of +KTS WT1 expression be responsible for the rapid progression of renal diseases in DDS and FS.

The effects of high-dose corticosteroid therapy on optic nerve head blood flow in experimental traumatic optic neuropathy

PURPOSE

The objective of this study was to ascertain the effect of high-dose steroid therapy in traumatic optic neuropathy using the Heidelberg retina flowmeter (HRF) to detect changes in optic nerve head blood flow.

METHODS

We experimentally damaged the optic nerves of 10 white rabbits with a Hartman mosquito clamp. The first group (n = 5) was treated with intravenous dexamethasone (0.25 mg/kg) every 6 h for a 48-hour period. The second group (n = 5) served as controls. Both groups were tested prior to operation, 1 week, 1 month and 2 months after surgery.

RESULTS

Experimental optic nerve damage caused a significant decrease in optic nerve head blood flow of 50.51% (p = 0.001), with a volume decrease of 46.02% (p = 0.001) and a velocity reduction of 43.12% (p = 0.002) compared to the baseline. After 2 months, in the group treated with high-dose corticosteroid therapy, optic nerve head blood flow was increased by 76.90% (p = 0.012), volume by 77.53% (p = 0.012) and velocity by 47. 21% (p = 0.012) compared to the control group.

CONCLUSION

The high-dose corticosteroid therapy improved the optic nerve head blood flow as demonstrated in experimental traumatic optic neuropathy. The HRF may be used to assess the therapeutic responses in traumatic optic neuropathy under variable conditions.

High resolution HLA-DQB1 typing by combination of PCR-RFLP and PCR-SSCP

A reliable method for high-resolution HLA-DQB1 typing using a combination of PCR- restriction fragment length polymorphism (RFLP) and PCR-single strand conformation polymorphism (SSCP) analysis is described. The second exon of the DQB1 gene was subjected to PCR using generic primers and digested with two restriction enzymes, MspA1I and HaeIII, and the DQB1 alleles were divided into seven groups. According to the RFLP patterns, appropriate group specific primers for DQ5, 6 and DQ2, 3, 4 groups were used to selectively amplify the alleles and the SSCP technique was used to distinguish the individual alleles. A total of 88 quality control samples of various ethnic groups distributed in the International Cell Exchange and HLA DNA Exchange programs and the ASHI/CAP Proficiency Tests were investigated by the PCR-RFLP/SSCP method. The concordance between our typing results and the consensus results of the surveys were 100%, and a total of 14 DQB1 alleles in 49 homozygous and heterozygous combinations were all correctly identified by the method described. This method is accurate, economical and relatively easy to interpret and well suited for routine clinical and research uses.

A case of cutaneous endometriosis developed in postmenopausal woman receiving hormonal replacement

Cutaneous endometriosis is characterized by the presence of extrauterine endometrial tissue in or under the skin. We report a case of cutaneous endometriosis in postmenopausal woman who was receiving hormonal replacement.

Congenital intraorbital optic nerve cyst. Case report

Congenital cystic lesions of the optic nerve are exceedingly rare; only one case is reported in the world literature. The authors describe a case of congenital simple glial cyst in the intraorbital portion of the optic nerve with a brief review of the literature and comment on its histogenesis. A 45-day-old male infant was admitted to the hospital because of progressive proptosis and hypotropia in the left eye, which had been present since birth. Magnetic resonance imaging of the left orbit revealed an ovoid, well-demarcated, homogeneous cystic mass in the intraconal retrobulbar area. The mass compressed the left eyeball with downward and lateral displacement. The wall of the cystic mass was very thin, and a needle puncture of the cyst released clear, colorless, watery fluid. The cystic wall was lined by loose astroglial nerve fibers with some scattered glial cells.

Study on genetic variation and DNA polymorphism for alpha-amylase gene of D. melanogaster in Korea

The restriction maps of the 20 kb Amy region of Drosophila melanogaster in Korean populations were surveyed from 27 isogenic second chromosome lines. A subset of these populations were also scored for isozyme type and adult enzyme activity of alpha-amylase. Among 34 kinds of restriction site variations that were observed in the 20 kb region surrounding the two transcriptional units of the duplicated Amy locus, nine were polymorphic (26.5%). The low frequencies at which each of the large insertions was found are consistent with earlier reports of variation in other loci. Restriction site variation in Korean populations provided an estimated heterozygosity per nucleotide pair of 0.007. Three pairwise comparisons showed relatively high levels of linkage disequilibria. The enzyme activity of the Chounan population showed no significant difference compared with that of the Pusan population, and the activity of heterozygotes was higher than that of Amy1. Lines bearing insertion/deletion exhibited relatively low enzyme activities. All lines examined showed the duplication of Amy transcriptional units that were highly conserved, and the manner of concerted evolution.

HLA-A,-B,-DRB1 allele and haplotype frequencies in 510 Koreans

The frequencies of HLA-A, -B, and -DRB1 alleles and A-B-DRB1 haplotypes were studied in 510 healthy unrelated Koreans, using serological (for A, B) and polymerase chain reaction (PCR)-single strand conformation polymorphism (for DRB1) methods. A total of 35 DRB1 alleles were detected and the most frequent alleles were DRB1*1302 (10.9%), *0901 (9.5%), *1501 (8.2%), *0803 (7.3%), *0405 (7.3%), *0101 (6.4%), *0406 (6.0%), and *0701 (6.0%). HLA-DR4 and DR14 groups were most polymorphic, each group composed of eight DRB1 alleles. Two-locus associations between HLA-DRB1 and -B loci were analyzed. There were 16 A-B-DRB1 haplotypes occurring at frequencies of > or =1%, and the five most common haplotypes were A33-B44-DRB1*1302 (5.4%), A33-B58-DRB1*1302 (3.7%), A33-B44-DRB1*0701 (2.9%), A24-B7-DRB1*0101 (2.2%), and A24-B52-DRB1*1502 (2.0%). Comparison of the distribution of A-B-DRB1 haplotypes among East Asian populations revealed that Koreans are closest to Japanese, out show a higher degree of polymorphism compared with Japanese.

Malignant granular cell tumor at the retrotracheal space

We report a case of an extremely rare neoplasm, malignant granular cell tumor (MGCT). The patient was a 21-year-old woman, who was 5 months pregnant. The tumor occurred in the retrotracheal space, extending from the level of the larynx to the thoracic inlet. In addition, there were multiple, variable-sized tumor nodules within both lung fields on chest CT scan. Histologically, tissue biopsied from the periphery of the tumor consisted of solid sheets of large ovoid cells with ample, eosinophilic cytoplasm, eccentric nuclei, and prominent nucleoli. Each cell showed slight atypism of the nuclei. There was a focal necrosis at the periphery of the lesion. These cells stained strongly for S-100 protein, neuron-specific enolase (NSE) and CD68. On electron microscopy, the tumor cells contained autophagic vacuoles. The patient refused further treatment and died 7 months later. The exact cause of death was not known. Until now, the diagnosis of MGCTs has been made only when metastasis and an aggressive clinical course are identified, although some observers advocate that some histologic features such as nuclear pleomorphism, necrosis, and the presence of any mitotic activity are indicative of malignancy. These histologic findings are not easily detectable in every case of MGCT, as in our case. So the diagnosis of a MGCT should be considered in cases with aggressive clinical findings and some histologic features, such as necrosis, nuclear atypism, and mitotic activities, which could suggest the malignant behavior of this neoplasm.

DNA polymorphisms at alpha-Gpdh locus of Drosophila melanogaster in Korean population

Restriction site variation in 18-kb region including the Gpdh (sn-glycerol-3-phosphate dehydrogenase) locus has been assessed in 27 isofemale lines, 12 lines from the Chounan population and 15 lines from the Pusan population in Korea. Of the 25 restriction sites that were scored, 5 sites were polymorphic (20.0%): PstI (-2.35), XbaI (-1.7), HindIII (0.0), HindIII (+0.25), and PstI (+5.7). Two insertions (I) and three deletions (D) were detected. All the restriction sites and length polymorphisms were located in introns and outside regions of the Gpdh structure gene, the area from -7.0 site to -5.5 site. The proportion of segregating nucleotides, p, for all 27 lines was 0.019 and the estimated heterozygosity per nucleotide pair, was 0.013. Sixteen kinds of restriction map haplotypes of all lines analyzed were detected. Few lines were identical at the restriction map level. The estimated haplotype diversity, h, was 0.968. The haplotype diversity (0.997) of GpdhFF bearing chromosomes was slightly higher than that (0.982) of GpdhSS chromosomes. Analysis for a linkage disequilibria between the polymorphism also showed that HindIII (+0.25) vs. I (a) and PstI (-2.35) vs. D (a) have relatively high level of the linkage disequilibria. There were no significant relationship between restriction site polymorphism and GPDH activity in 27 second-chromosome lines; however, there was an apparent difference in the effect of length variation on GDPH activity. The activity of deletion-bearing lines was lower than that of deletion-free lines, while there was no effect of insertion on activity. Duplication of Gpdh was observed in about one-third of the 27 isofemale lines. The duplication-bearing lines in both populations had higher levels of GPDH activity and GPDH CRM than duplication-free lines. In a further investigation of the duplication structure, the duplication of Korean populations was shown to have a similar structure to other populations investigated (Symonds and Gibson, 1992; Takano et al., 1989).

Cross-species reactivity of a monoclonal antibody against glutathione S-transferase fusion protein of human beta 2-adrenergic receptor

The purpose of the present study was to produce and characterize a monoclonal antibody against human beta 2-adrenergic receptor. Male BALB/c mice were immunized with glutathione S-transferase (GST) fusion protein of the C-terminal portion of the human beta 2-adrenergic receptor which was expressed in E.Coli. The immunized splenocytes were fused with myeloma SP2/0-Ag14 cells and the resulting monoclonal antibody was named as mAb beta C02. The monoclonal antibody beta C02 was determined as IgM subtype and then purified by anti-mouse IgM-agarose affinity chromatography. The results of ELISA, Western blot, and immunocytochemistry showed that mAb beta C02 recognized human beta 2-adrenergic receptor in the beta 2-adrenergic receptor-GST fusion protein and human epidermoid carcinoma cell line A431 with highly specific immunoreactivity. In addition, mAb beta C02 showed cross-species reactivity against beta-adrenergic receptor of hamster lung and rat brain as revealed by Western blot and immunohistochemistry. The monoclonal antibody beta C02 may provide useful tools for the study of the beta-adrenergic receptor of human and other species including rats.

Comparison between ELISA and gel-filtration assay for the quantitation of airway mucins

In this study, we developed immunoassay methods for the more convenient and effective detection of rat tracheal mucin and the results were compared with those of [3H]glucosamine based gel-filtration method. A monoclonal anti-rat tracheal mucin antibody, mAbRT03, which specifically recognizes rat tracheal mucins, was used throughout in this study. To induce mucin secretion, varying concentrations of ATP (0-2 mM) were applied to the primary rat tracheal surface epithelial (RTSE) cell culture which had been metabolically radiolabeled with [3H]glucosamine and the secretion of mucin was analyzed both by the immunoassay and the gel-filtration chromatography methods. For the immunoassay, the following two procedures were employed. 1) Simple ELISA; the culture spent media were directly coated onto the assay plate and the immunoreactivity with mAbRT03 was assessed from the standard curve generated with the purified rat mucin. 2) Inhibition ELISA; A known amount of the purified rat mucin was coated onto the assay plate and then ATP-stimulated culture spent media were added to inhibit the immunoreactivity with mAbRT03. The contents of mucin in the sample were calculated from the standard inhibition curve which was generated with the purified rat mucin. The assay results obtained from the immunoassays were identical with those from the gel-filtration methods. The present result indicates that ELISA can be substituted for the laborious, time-consuming gel-filtration assay in studying the regulation of airway mucin release from cultured airway epithelial cells.

Ideal size of an intraocular lens for capsular bag fixation

PURPOSE

To determine the ideal size of an intraocular lens (IOL) for proper capsular bag fixation in different sizes of evacuated capsular bags.

SETTING

Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea, and Storm Eye Institute Medical University of South Carolina, Charleston, South Carolina, USA.

METHODS

Fifteen eyes obtained post-mortem were divided by crystalline lens size into three groups. Intraocular lenses of five different sizes were implanted in each capsular bag. The arc of contact between the haptics and capsular equator and the capsular bag distortion with each IOL were measured and compared using posterior-view analysis.

RESULTS

The arc of contact was directly proportional to the IOL size and inversely related to the lens size. The smallest arc of contact was 2.0 mm with the smallest IOL implanted in the largest lens group. The maximum capsular bag distortion was 2.6 mm in the case of the largest IOL implantation in the smallest lens group.

CONCLUSION

Implanting an IOL smaller than 12.5 mm in a large capsular bag can result in unstable fixation, while implanting an IOL larger than 12.5 mm in a small capsular bag can result in excessive stretching and distortion of the capsular bag and surrounding zonules.

Analysis of zonular-free zone and lens size in relation to axial length of eye with age

PURPOSE

To evaluate the anatomical relationships of the zonular-free zone (ZFZ) of the anterior capsule and crystalline lens diameter in relation to the axial length of the eye with age.

SETTING

Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea, and Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.

METHOD

Various ocular structures in 122 eyes obtained post-mortem were measured without prior preparation. The correlation between age, anterior-posterior (A-P) length and globe size, and diameters of the cornea, crystalline lens, and ZFZ were analyzed.

RESULTS

The average A-P globe length, and corneal, lens, and ZFZ diameters were 24.48, 11.67, 9.65, and 6.93 mm, respectively. There was no significant relationship between A-P length and globe size and corneal diameter in different age groups. The ZFZ size varied negligibly among age groups. There was a statistically significant correlation between lens diameter and age (correlation coefficient = 0.2647; P < .01) and lens diameter and A-P globe length (correlation coefficient = 0.3183; P < .001).

CONCLUSIONS

When choosing an intraocular lens, one should consider the patient's age and the A-P globe length. Six eyes (5%) showed unusual anterior insertion of zonular attachment, which reminds us to be prudent with a large paracentral capsulorhexis.

Low-frequency response of pyroelectric sensors

Sensitivity of pyroelectric IR-detectors of slow thermal processes, especially of human body sensors, depends strongly on their response in the infra-low (~0.1 to 1 Hz) region of frequency spectrum. The main mechanisms of heat losses-heat conduction of environment, lateral heat conduction in the plane of sensitive element, and emission of radiation-are considered. Their influence on the low-frequency response of pyroelectric sensors is estimated. Exact solutions and simple expressions for quantitative description of main specific features of real systems are obtained. Criteria of validity of the adequate models are determined.

The effect of dietary threonine on Adh expression during the development of Drosophila melanogaster

The alcohol dehydrogenase (ADH) activity and ADH cross reacting material (ADH CRM) were measured and Northern blot analysis was carried to define the function and the regulation mechanism of the Adh gene. This study examined how dietary threonine affects the expression of the Adh gene during development of Drosophila melanogaster. Two wild type strains, one homozygous for Adh(F) and one for Adh(S) from Chunan, Korea were used. The ADH activity and CRMs of the Adh(F) strain were 2.1 times higher than those of Adhs strain, and ADH activity was higher with isopropanol (secondary alcohol) than with ethanol (primary alcohol) as a substrate in both Adh(F) and Adh(S) strains. When the larvae, pupae, newly emerged adults (0-1 day), and adults (5-7 days) of Drosophila melanogaster Adh(F) and Adh(S) strains were fed on a defined low yeast and threonine medium, ADH activity and ADH CRM levels were increased. Northern blot analyses indicated that the production of mRNA of the larvae, young adults (0-1 day), and adults (5-7 days) was increased by dietary threonine. ADH activity and ADH CRM increases in Drosophila melanogaster fed on threonine were as a result of threonine-stimulated alteration in the amount of ADH mRNA. The elevated level of the ADH mRNA transcribed from the proximal and distal promoters of threonine-fed larvae and adults showed that there was an induction.

Genetic alterations of p16INK4a and p53 genes in sporadic dysplastic nevus

It is still unclear whether the sporadic form of dysplastic nevi (SDN) represents a premalignant lesion of malignant melanoma and whether genetic alterations are involved in the development of SDN. To determine whether p16INK4a and p53 genetic abnormalities could be associated with development of SDN, nevus cell nests were procured selectively from H & E-stained slide sections by using a modified microdissection technique and were screened for the presence of mutations and loss of heterozygosity (LOH) of p16INK4a and p53 genes using a polymerase chain reaction-based LOH, single-strand conformation polymorphism, and direct DNA sequencing analyses. Hemizygous deletion was detected in 9 of 12 informative cases (75%) for 9p21-22 (p16INK4a) at one or more loci and 60% (6/10) for 17p13 (p53). As for mutation, we found 3 missense mutations and 1 mutation in the first intron in p16INK4a and 2 missense mutations in p53. Among these mutations in p16INK4a and p53, 5 of 6 mutations were of the C:G to T:A transitional type; this is known to be related to ultraviolet radiation as previously confirmed in other skin cancers. This indicates that p16INK4a and p53 genetic alterations may play an important role in the evolution of SDN and may represent an early event in the development of malignant melanoma. Furthermore, ultraviolet radiation might be the predominant etiologic agent in the development of SDN.

Human dura mater as a wrapping material for hydroxyapatite implantation in the anophthalmic socket

Homologous sclera and autologous fascia lata have been accepted as common wrapping materials for hydroxyapatite implantation; however, various problems have been observed, such as the risk of transmittable diseases such as AIDS or hepatitis. This report details the use of cadaver dura mater to wrap hydroxyapatite implants. For 73 eyes of 73 patients with hydroxyapatite implantation, cadaver dura mater was used to wrap the hydroxyapatite after enucleation or secondary implantation. Of the 73 patients, 20 had conjunctival erosion; however, all of the patients but 1 healed spontaneously within an average of 22 days. Only 1 of the 73 patients progressed to implant exposure requiring a dermis graft. The authors suggest that cadaver dura mater is a suitable wrapping material for hydroxyapatite implantation.

Purely epithelioid malignant peripheral nerve sheath tumor of the vulva

Primary malignant peripheral nerve sheath tumors(MPNST) of the vulva are extremely rare and most of them are composed of a spindle cell component. A few cases of MPNST containing partially or purely epithelioid cells have been reported. Purely epithelioid MPNST differ from the ordinary epithelioid MPNST due to the absence of a spindle cell component. We present the first case of purely epithelioid MPNST arising in the vulva reviewing in the world literature without definite evidence of von Recklinghausen's disease or nerve involvement. The patient was a 63-year-old woman with a palpable vulvar mass, 6 x 4 x 1.5 cm in dimension, was not encapsulated but well-demarcated, ovoid and rubbery and showed pale yellow, homogeneous, fish-flesh appearance with focal cystic changes on cut surface. The histologic features consisted of solely epithelioid cells which were arranged in tight clusters or cords with solid growing pattern and focally scattered rosette-like structures. According to the immunohistochemical results, most of tumor cells were strongly positive for neuron specific enolase, and some of them were weakly positive for S-100 protein and vimentin. We considered that purely epithelioid MPNST would represent a certain degree of differentiation toward nerve or neuronal cells rather than Schwann cells.

Digestion of the 1-O-alkyl diacylglycerol ethers of Atlantic dogfish liver oils by Atlantic salmon Salmo salar

Dogfish (Squalus acanthias) liver poses a waste disposal problem in Canada because it is not utilized for any commercial purpose. The liver of Atlantic dogfish, which is often up to 20% of the weight of the fish, contains 40-70% oil. The oil contains about 30-40% 1-O-alkyl diacylglycerol ethers (DAGE) which render it unacceptable for human use, and it has also not been considered satisfactory for animal feed use. Polyunsaturated fatty acids (20:5n-3 and 22:6n-3) are present in dogfish liver oils at levels comparable to those in herring oil. Dogfish liver oil could be a source of essential fatty acids for Atlantic salmon (Salmo salar), but their ability to hydrolyze DAGE from dogfish oil has not been examined. Experiments were designed to measure the digestibility of fatty acids of DAGE in salmon. The fatty acid moieties were liberated by the digestive enzymes of the fish and made readily available as a source of energy. The 1-O-alkylglycerol ether moiety was absorbed to a small extent but should not constitute a health problem in either the fish or the human fish consumer. The long-chain polyunsaturated fatty acids were particularly well absorbed, with an apparent digestibility in salmon of 87-95% when feeding on dogfish liver oil. The total fatty acids and other lipids were in fact both absorbed to the extent of approximately 85%.

Ciliary neurotrophic factor antagonizes gentamicin-induced alterations of electric potentials in auditory pathway in guinea pigs

AIM

To study the effects of ciliary neurotrophic factor (CNTF) on the expressions of gentamicin ototoxicity in guinea pigs.

METHODS

The auditory function of pigmented guinea pigs was examined using auditory brainstem response (ABR), cochlea microphonic potential (CM), and action potential of auditory nerve (AP).

RESULTS

In animals injected gentamicin (80 mg.kg-1.d-1, i.m.), ABR threshold began to elevate on d 20, and prolongations of ABR wave I, IV and the I-IV interpeak latencies were observed. The animals treated with gentamicin for 30 d displayed lower amplitudes of CM and AP (N1) than the controls. CNTF (0.44 mg.kg-1.d-1, s.c.) inhibited the gentamicin-induced elevation of ABR thresholds, the prolongation of ABR wave I, IV and the I-IV interpeak latencies, and the decreases in amplitudes of CM and AP (N1).

CONCLUSION

CNTF attenuated the gentamicin-elicited auditory impairment in guinea pigs.

Hemangiopericytoma of renal sinus expanding to the renal hilum: an unusual presentation causes misinterpretation as transitional cell carcinoma

We report a case of renal hemangiopericytoma occurring in renal sinus and expanding to the renal hilum. This unusual presentation caused misinterpretation of this tumor as transitional cell carcinoma of the renal pelvis clinically. The patient who was a 30-year-old woman had a relatively well demarcated solid tumor, 8 x 6 cm, in the renal sinus of the left kidney.

The effect of photorefractive keratectomy in Korea

To assess the predictability and accuracy of photorefractive keratectomy (PRK) in myopia, we reviewed the charts of 182 patients who underwent PRK and were followed up for more than 12 months. The mean visual acuity was improved from 0.11 to 0.80 at 12 months postoperatively, and the mean refraction change shows from -7.94D to -0.89D. 47% of the treated eyes achieved final visual acuity of 1.0, and 97% achieved 0.5 or better. In the case of postoperative refraction, 96% of cases who were less than -6 D myopia achieved final refraction within +/- 1D, while 66% of cases who were more than -6 D myopia did. These results suggest that PRK is a safe and predictable procedure in treating mild to moderate myopia.

Hematic cyst formation after repair of blow-out fracture

Alloplastic implants are known to be inert for many years, though complications are infrequently reported many years after their insertion. We report the case of a patient who had undergone a blow-out fracture repair five years before the discovery of a hematic cyst. He had been free of symptoms for the first five years after his orbital floor repair but then developed pain on eyeball movement and persistent vertical diplopia, which finally led to surgical intervention. At surgery, a hematic cyst was found to have formed around the implanted silastic plate. When alloplastic material is used in orbital fracture repair, we should be alert for late complications which may occur many years after surgery.

Pitfalls of nonoperative management of blunt abdominal trauma in children in Korea

During the past decade, the nonoperative management of children with blunt abdominal trauma without operation has improved dramatically by virtue of the development of medical technology. However, missed injuries or complications after nonoperative management often are associated with serious morbidity. The authors evaluated 86 patients between 1990 and 1994 who had intraabdominal solid-organ injury (excluding retroperitoneal organs) owing to blunt trauma. The liver was injured in 43 cases, the spleen in 36, and the pancreas in 14. Initially, 68 patients (79%) were managed conservatively and 18 underwent surgery because of unstable vital signs or associated injuries. Three patients had delayed surgery more than 48 hours after trauma) because of initially missed injuries (complete infarction of the spleen, duodenal injury, major pancreatic injury). Eleven patients (17%) with nonoperative management had a total of 13 complications. The most common complications were pleural effusion and atelectasis. One patient had prolonged ileus owing to delayed absorption of an intraperitoneal hematoma, and the symptom was relieved by aspiration of the hematoma. A huge hepatic subcapsular hematoma developed in another patient and required percutaneous drainage with a pigtail catheter for 5 weeks. A pancreatic pseudocyst detected on the 16th hospital day also was drained with a pigtail catheter. A splenic abscess developed in another patient 24 days after a splenic injury, which was treated with ultrasound-guided aspiration. No patients died as a result of nonoperative management. In conclusion, even though patients with blunt abdominal trauma are stabilized and nonoperative management decided on, careful follow-up for a prolonged period is still necessary to prevent missed injuries or late complications.

Management of Detached Lenticule After In Situ Keratomileusis

BACKGROUND

Attachment of a keratomileusis lenticule without sutures is a commonly used technique that reduces surgery time and makes the procedure more simple. Detachment of the lenticule after surgery is a difficult complication to manage.

PATIENTS AND METHODS

Three cases of lenticular detachment occurred among 74 eyes of microkeratome in situ keratomileusis without suture. After thorough washing of the lenticule and stromal bed, the lenticules were reattached with air drying.

RESULTS

In the first eye, the lenticule was reattached successfully with air only. In the second and third eyes, epithelial growth along the interface appeared after reattachment. In spite of removing the epithelium from the interface and suturing the lenticule to the stromal bed four times, the epithelial growth recurred along the interface. Peripheral corneal neovascularization forced the surgeon to abandon more trials of resuturing. In the second eye, the lenticule was discarded because the epithelial growth along the interface could not be blocked. In the third eye, the edge of the lenticule was buried into the stroma, mimicking epikeratoplasty. All three eyes retained useful visual acuity.

CONCLUSIONS

A detached lenticule after microkeratome keratomileusis is difficult to replace without epithelial growth in the interface. This complication may be managed successfully.

Involvement of transglutaminase in myofibril assembly of chick embryonic myoblasts in culture

Involvement of transglutaminase in myofibrillogenesis of chick embryonic myoblasts has been investigated in vitro. Both the activity and protein level of transglutaminase initially decreased to a minimal level at the time of burst of myoblast fusion but gradually increased thereafter. The localization of transglutaminase underwent a dramatic change from the whole cytoplasm in a diffuse pattern to the cross-striated sarcomeric A band, being strictly colocalized with the myosin thick filaments. For a brief period prior to the appearance of cross-striation, transglutaminase was localized in nonstriated filamental structures that coincided with the stress fiber-like structures. When 12-o-tetradecanoyl phorbol acetate was added to muscle cell cultures to induce the sequential disassembly of thin and thick filaments, transglutaminase was strictly colocalized with the myosin thick filaments even in the myosacs, of which most of the thin filaments were disrupted. Moreover, monodansylcadaverine, a competitive inhibitor of transglutaminase, reversibly inhibited the myofibril maturation. In addition, myosin heavy chain behaved as one of the potential intracellular substrates for transglutaminase. The cross-linked myosin complex constituted approximately 5% of the total Triton X-100-insoluble pool of myosin molecules in developing muscle cells, and its level was reduced to below 1% upon treatment with monodansylcadaverine. These results suggest that transglutaminase plays a crucial role in myofibrillogenesis of developing chick skeletal muscle.

Sclerosis of hepatic cavernous hemangioma: CT findings and pathologic correlation

We report a case of hepatic cavernous hemangioma with computed tomographic findings of well demarcated nodular lesser attenuation foci within the main low attenuation mass on precontrast scans and non-enhancement of the foci even on the delayed contrast scans. These have been described as one of the atypical findings of cavernous hemangioma earlier in the literature. Surgery proved that sclerosis accounted for the hypodense nodular densities within the hepatic cavernous hemangioma.

How important is the role of the internal anal sphincter in fecal continence? An experimental study in dogs

It is a generalized concept that the internal anal sphincter (IAS) plays a significant role in fecal continence by generating high pressure in the anal canal at rest and relaxation during rectal distention. Agreement also exists on the importance of internal sphincter-saving anoplasty on anorectal malformations in establishing anal continence. Twelve dogs were divided into four groups. Group 1, a control group, was subjected to a perirectal dissection only. Group 2 underwent the same perirectal dissection plus a 2-cm resection of the anal canal. Group 3 underwent the perirectal dissection plus a 4-cm resection of the anal canal, and group 4 underwent perirectal dissection and transposition of the anus to the posterolateral portion of the voluntary muscle mass. Clinical continence was evaluated, and manometric results were compared with preoperative measurements. All dogs in groups 1, 2, and 3 were clinically continent without soiling except one in group 3, and also manometric results showed minimal change between preoperative and postoperative anal pressure profiles. The transposed anus of group 4 showed continuous fecal soiling. The anal resting pressure (ARP) was also decreased but still existed in this group. This experimental study showed that the IAS contributes to the anal resting tone. However, resection of the IAS did not completely interfere with fecal continence. The smooth muscle of pulled-through rectum seemed to partly take over the function of the IAS.

Molecular phylogeny of the kinesin family of microtubule motor proteins

The rapidly expanding kinesin family of microtubule motor proteins includes proteins that are involved in diverse microtubule-based functions in the cell. Phylogenetic analysis of the motor regions of the kinesin proteins reveals at least five clearly defined groups that are likely to identify kinesins with different roles in basic cellular processes. Two of the groups are consistent with overall sequence similarity, while two groups contain proteins that are related in overall structure or function but show no significant sequence similarity outside the motor domain. One of these groups consists only of kinesin proteins with predicted C-terminal motor domains; another includes only kinesins required for mitotic spindle bipolarity. Drosophila Nod, presently an ungrouped protein, may represent a class of kinesins that, like the myosin I proteins, function as monomers. The analysis indicates that many types of kinesin proteins exist in eukaryotic organisms. At least two of the five groups identified in this analysis are expected to be present in most, or all, eukaryotes.

Yeast Kar3 is a minus-end microtubule motor protein that destabilizes microtubules preferentially at the minus ends

Mutants of the yeast Kar3 protein are defective in nuclear fusion, or karyogamy, during mating and show slow mitotic growth, indicating a requirement for the protein both during mating and in mitosis. DNA sequence analysis predicts that Kar3 is a microtubule motor protein related to kinesin, but with the motor domain at the C-terminus of the protein rather than the N-terminus as in kinesin heavy chain. We have expressed Kar3 as a fusion protein with glutathione S-transferase (GST) and determined the in vitro motility properties of the bacterially expressed protein. The GST-Kar3 fusion protein bound to a coverslip translocates microtubules in gliding assays with a velocity of 1-2 microns/min and moves towards microtubule minus ends, unlike kinesin but like kinesin-related Drosophila ncd. Taxol-stabilized microtubules bound to GST-Kar3 on a coverslip shorten as they glide, resulting in faster lagging end, than leading end, velocities. Comparison of lagging and leading end velocities with velocities of asymmetrical axoneme-microtubule complexes indicates that microtubules shorten preferentially from the lagging or minus ends. The minus end-directed translocation and microtubule bundling of GST-Kar3 is consistent with models in which the Kar3 protein crosslinks internuclear microtubules and mediates nuclear fusion by moving towards microtubule minus ends, pulling the two nuclei together. In mitotic cells, the minus end motility of Kar3 could move chromosomes polewards, either by attaching to kinetochores and moving them polewards along microtubules, or by attaching to kinetochore microtubules and pulling them polewards along other polar microtubules.(ABSTRACT TRUNCATED AT 250 WORDS)

Ethnic differences in forefoot shape and the determination of shoe comfort

The kinanthropometric aspects of comfort of fit of sport shoes has not been subjected to any great scrutiny. It is suggested that comfort of fit is largely determined by the match of foot shape to shoe shape and consequently there is a need for normative data that describe foot shape, dimension and proportion for discrete populations. A study of 708 second generation Caucasian N. American (NA) and 513 Japanese and Korean (JK) male subjects was conducted to determine normative data with respect to forefoot shape and dimension. A series of 2 height, 7 length, 1 breadth and 1 girth measures of the right foot bearing full body weight was recorded using a modified Mitutoyo digital caliper interfaced with a micro-processor. Substantial differences were noted in the incidence of digital patterning. The relative proportion of digital patterns I (1 > 2 > 3 > 4 > 5) and II (2 > 1 > 3 > 4 > 5) were NA 76.09%, 23.91%; JK 50.80% and 49.20% respectively. The distance between the pternion and the distal extremity of the second digit expressed as a percentage of the maximum foot length (MFL) was found to be 98.60% (NA) and 99.60% (JK). In addition, the distance between the pternion and the distal extremity of the fifth digit relative to MFL was 82.60% (NA) and 85.00% (JK). The implication of these data is that the anterior margin of the JK foot makes a less acute angle with the long axis of the foot than the NA population. Additional information with respect to foot breadth leads to the conclusion that the shape of the JK forefoot differs from that of the NA, with the implication that unique shoe lasts for both populations are required for optimal shoe comfort.

[Tuberculous infection and autoimmune diseases]

This paper presented four cases to demonstrate the close relationship between tuberculosis and autoimmune diseases. The patients had clinical manifestation of autoimmune diseases with presence of anti-PPD IgG, specific circulating immune complexes in sera. After being treated with antituberculous chemotherapy, all patients got distinct improvement clinically. Also, the possible mechanisms of their correlationship were reviewed and discussed.

Diagnosis and treatment of hypoglycemic disorders

Many other hypoglycemic states can be confused with an insulinoma. This article presents the diagnosis, localization, and therapy of these islet cell tumors. Also presented is a discussion of the role of nesidioblastosis in persistent hyperinsulinemic hypoglycemia in the neonate.

Leukocyte adherence initiation in skeletal muscle capillaries and venules

In vivo leukocyte adherence has many physiological implications but the effect of vessel size and hemodynamic parameters on adherence initiation remains unclarified. The early phases of adherence, defined to include attachment of previously freely moving leukocytes to endothelium or leukocytes which roll along the vessel wall, are the focus of this report. Blood velocity and diameter in 121 capillaries and venules in the cremaster of 13 rats were measured. The hemodynamic and vessel size difference characterizing vessels in which either initial leukocyte wall attachment or leukocyte rolling occurred (termed "adherent vessels"), as distinguished from vessels in which neither transient stoppage nor cell rolling was observed (termed "nonadherent vessels"), was then determined. Fifty-seven percent of the vessels observed were adherent vessels. These vessels were characterized by a larger diameter, a smaller blood velocity, and a smaller calculated wall shear rate than the nonadherent vessels. The results show that leukocyte adherence can be initiated in capillaries and postcapillary vessels with diameters that are equal to and less than the leukocyte size. Within vessels less than 11 micron, adherence or nonadherence appears dependent on local hemodynamics with the possibility of a critical shear rate threshold of about 400 sec-1. In vessels with shear rates greater than this value only 7% were observed to have adherence. In vessels greater than 11 micron the absence of hemodynamic differences between adherent and nonadherent vessels suggests the presence of other adherence-initiating mechanisms. It is thought that in these larger size vessels both local erythrocyte effects and adherence initiation within upstream capillaries affect observed adherence.