[Epigenetic mechanism of depression]

Numerous epigenetic studies have revealed that the acetylated status of histone as well as methylated status of cytosine is closely involved in gene transcription. Preclinical and clinical studies demonstrate that changes in levels of various genes in the brain including BDNF, play a role in the pathophysiology of depression. It is well known that the levels of BDNF mRNA and protein in the rat brain, such as frontal cortex and hippocampus, was decreased in response to stress, but the precise mechanism of stress-induced downregulation of BDNF has yet to be characterized. In this context, we examined the influence of a single immobilization stress (SIS) on the levels of total BDNF mRNA with each exon mRNA by real-time PCR and acetylated histone at the promoters of the BDNF gene by chromatin immunoprecipitaion assay in the rat hippocampus. SIS significantly decreased the levels of total BDNF mRNA with significant reduced levels of exon I and IV mRNA. Significant decreases in acetylated histone H3, but not H4, were found at the promoters of exons I, IV, and VI. On the other hand, antidepressant-like effects has been reported with sodium butylate (SB), a histone deacetylase (HDAC) inhibitor, promoting gene transcription. We also found antidepressant-like effect of repeated administration of SB in the forced swim test using rats. In addition, we found that upregulation in transthyretin mRNA in the rat hippocampus is, at least in part, associated with this effect using DNA microarray and real-time PCR. Based on these findings, it is postulated that epigenetic regulation of the BDNF gene by stress and antidepressants may be involved in the pathophysiology of depression.

MyD88 plays a key role in LPS-induced Stat3 activation in the hypothalamus

Infection causes the production of proinflammatory cytokines, which act on the central nervous system (CNS) and can result in fever, sleep disorders, depression-like behavior, and even anorexia, although precisely how cytokines regulate the functions of the CNS remain unclear. In the present study, we investigated the regulatory-molecular mechanisms by which cytokines affect hypothalamic function in a state of infection. The intraperitoneal administration of lipopolysaccharide (LPS), a ligand of Toll-like receptor 4 (TLR4), time-dependently (2-24 h) increased signal transducer and activator of transcription 3 (STAT3) phosphorylation in the hypothalamus and liver, which corresponded with anorexia observed within 24 h. Interestingly, the pattern of phosphorylation in response to LPS differed between the hypothalamus and liver. In the hypothalamus, LPS increased STAT3 phosphorylation from 2 h, with a peak at 4 h and a decline thereafter, whereas, in the liver, the peak activation of STAT3 persisted from 2 to 8 h. The time course of the LPS-induced expression of suppressor of cytokine signaling 3 (SOCS3), a STAT3-induced negative regulator of the Janus kinase-STAT pathway, was similar to that of STAT3 phosphorylation. Using mice deficient in myeloid differentiation primary-response protein 88 (MyD88), an adapter protein of TLR4, we found that LPS-induced STAT3 phosphorylation and SOCS3 expression in the hypothalamus and liver were predominantly mediated through MyD88. Moreover, we observed that MyD88-deficient mice were resistant to LPS-induced anorexia. Taken together, our findings reveal a novel mechanism, i.e., MyD88 plays a key role in mediating STAT3 phosphorylation and anorexia in the CNS in a state of infection and inflammation.

[Development of factor VIII inhibitor in three non-hemophiliac patients]

Infrequently, inhibitors against factor VIII can develop in non-hemophiliac patients and cause serious bleeding. In the last year, we have experienced 3 non-hemophiliac patients who developed factor VIII inhibitors. Here, we describe the clinical courses of the three patients and the characteristics of the inhibitors. Case 1: A 69-year-old man underwent a partial gastrectomy because of early gastric cancer, and one month later developed signs of a bleeding tendency such as hematemesis, tarry stools and intramuscular hemorrhage. Blood coagulation tests revealed prolongation of the activated partial thromboplastin time (aPTT), which had been normal on admission. Case 2: A 78-year-old woman with no previous disease history developed generalized subcutaneous purpura. Blood coagulation tests performed on admission revealed a prolonged aPTT. Case 3: A 30-year-old man was admitted to an emergency hospital because of left intrapleural hemorrhage and liver injury caused by a traffic accident. Two months later, a hematoma developed at the site of drainage in the left chest, and blood coagulation tests revealed prolongation of the aPTT, which had been normal on admission. Plasma factor VIII procoagulant activities in cases 1, 2 and 3 were 3%, 1% and 5%, respectively. The respective factor VIII inhibitor titers were 78, 870 and 0.5 Bethesda units/ml. The immunoglobulin class and subclass of the inhibitors examined by an ELISA method were: case 1, IgG1 and 4; case 2, IgG2 and 4 (dominant); case 3, IgG4. In cases 1 and 3, the patients recovered after glucocorticoid therapy, but in case 2 the patient died of intraperitoneal hemorrhage despite receiving two courses of methylprednisolone pulse therapy. The above clinical experience suggests that patients, who develop high titers of inhibitors may be refractory to ordinary immunosuppressive therapy, and therefore more aggressive therapy such as plasma exchange and/or bypass therapy using activated prothrombin complex concentrates or an activated factor VII preparation should be considered.

Saccadic tracking of a light grey target in the mantis, Tenodera aridifolia

I presented a horizontally moving square on a computer display to the mantis, Tenodera aridifolia, and examined the effects of target brightness and velocity, and background brightness on its tracking behavior. The mantis tracked a light grey square with more saccadic head movements than a black square, although these squares moved on a homogeneous background. The amplitude of saccades was larger when the light grey square moved at a lower velocity. The background brightness had little effect on the type (smooth or saccadic) of tracking behavior. These results suggest that the saccadic tracking of light grey objects on a homogeneous background may not be caused by low contrast, i.e., the difficulty in discriminating the object from the background. The possible biological significance of saccadic tracking on a homogenous background is discussed.

Serovar, pathogenicity and antimicrobial susceptibility of erysipelothrix rhusiopathiae isolates from farmed wild boars (Sus scrofa) affected with septicemic erysipelas in Japan

Six strains of Erysipelothrix rhusiopathiae were isolated from farmed wild boars with acute septicemic erysipelas during the period from 1983 to 1998 in Japan. All isolates belonged to serovar 1a or 2 (predominant serovars in swine). The 50 per cent lethal dose values of those isolates ranged from 10(1.3)to 10(6.2)colony forming units in mice. In swine, all isolates were virulent, capable of inducing localized or generalized urticarial lesions after intradermal inoculation. All of the isolates were resistant to oxytetracycline and/or dihydrostreptomycin. These observations suggest that E. rhusiopathiae strains isolated from wild boars may have aetiological significance in swine erysipelas.

Age-associated changes in the dopamine synthesis as determined by GTP cyclohydrolase I inhibitor in the brain of senescence-accelerated mouse-prone inbred strains (SAMP8)

Our objective in this study was to elucidate the mechanism underlying the decrease in dopamine (DA) levels in the brain with ageing We administered 2,4-diamino-6-hydroxypyrimidine (DAHP), an inhibitor of GTP cyclohydrolase I to senescence-accelerated mouse-prones (SAMP8), to inhibit DA and serotonin syntheses, and following immunohistochemical staining, analyzed the immunoreactive intensities (IR-Is) for DA in the nigrostriatal dopaminergic neurons by microphotometry. The DA-IR-Is in the substantia nigra pars compacta and neostriatum of young mice (2 months old) reached a minimal value 3 h after DAHP administration and returned to the control value 12 h after the administration. However, in aged mice (10 months old), the minimal value was reached 6 h after the administration and the value remained at approximately 70 and 80% of the control value at 24 and 72 h, respectively, after DAHP administration. The results suggest that DA turnover is lower in aged mice than in young mice.

Clinical, pathological and mineralogical features in two autopsy cases of workers exposed to agalmatolite dust

An agalmatolite miner and processor showed large shadows at the bilateral hila accompanied by surrounding emphysematous changes and irregular shadows on chest X-ray films. Chest CT scans were characterized by a mixture of tiny irregular structures and small round opacities. Histopathological examination revealed massive fibrosis, which corresponded to large shadows, but only a small number of typical silicotic nodules, indicating mixed dust pneumoconiosis. Mineralogical examination of the autopsy lungs showed quartz, pyrophyllite, mica, and kaolinite. Quartz accounted for 70% of the amount of all mineral dust in both patients, but pyrophyllite accounted for 10.8% and 14.4%. The pulmonary mineral dust composition in the two patients was well consistent with the mineral composition of the raw clays in the agalmatolite mine. In the two patients, chest X-ray findings and histopathological findings of the lungs also suggested agalmatolite pneumoconiosis, which was confirmed by mineral analysis of the lungs.

Eustachian tube cartilage and medial movement of lateral pharyngeal wall on phonation

Several authors have demonstrated the importance of medial movement of the lateral pharyngeal wall in velopharyngeal closure upon phonation. However, it remains controversial what muscle is responsible for lateral pharyngeal wall movement and where is the main site of this movement. The purpose of this study was to address the above two unanswered questions. In 22 subjects (12 normal volunteers, 10 patients with cleft palate), lateral pharyngeal wall movement upon phonation was evaluated by using rapid magnetic resonance imaging (MRI). Before rapid MRI, their lateral pharyngeal wall movements were classified into three groups: the poor, moderate, and good, according to the findings of nasopharyngoscopy. Inward displacement of the eustachian tube cartilages upon phonation, which was quantified as distance ratio in the transverse plane of MR images, was compared with nasopharyngoscopic findings. In addition, the level of lateral pharyngeal wall movement was observed in the plane 5 mm lateral to the mid-sagittal plane of MR images. Inward displacement of the eustachian tube cartilage in the transverse plane of MR images was coincident with medial movement of lateral pharyngeal wall observed by nasopharyngoscopy in all 22 subjects. By using one-way analysis of variance, a statistically significant correlation was found between nasopharyngoscopic classification and distance ratio. The sagittal plane of MR images revealed that the main site of movement occurred at the level of the hard palate and above. It is concluded that medial movement of the lateral pharyngeal wall consists of inward displacement of the eustachian tube cartilage, which is caused by contraction of the levator veli palatini muscle, and that the primary site of this movement is at the level of the hard palate and above, where the eustachian tube, but not the superior constrictor muscle, exists.

In vivo evaluation of a novel alginate dressing

Alginate dressings are currently used in the management of epidermal and dermal wounds, and provide a moist environment that leads to rapid granulation and reepithelialization. However, a cytotoxic effect on proliferation of fibroblasts and residual material with inflammation in healing wounds have been reported recently. We have developed a new alginate dressing (AGA-100), which does not have an inhibitory effect on proliferation of fibroblasts. The purpose of this study was to evaluate the new alginate dressing with respect to wound healing in full- and partial-thickness pig wounds and with respect to biodegradation following implantation into rabbit muscle. Kaltostat and Sorbsan, both well-established commercial dressings, were used as control. The closure rate of full-thickness wounds treated with AGA-100 was significantly higher on day 15 compared with that with Kaltostat and Sorbsan. Reepithelialization rate of partial-thickness wounds treated with Sorbsan was statistically significantly lower on day 3 than those with the other two dressings. As to dressing debris remained in the healing wound, a large amount of foreign debris was noted in all the full-thickness wounds treated with Kaltostat or Sorbsan, while only about one-third of wounds treated with AGA-100 showed a little dressing debris. AGA-100 implanted into the muscle of rabbits was bioresorbed completely within 3 months. Therefore, dressing residue in AGA-100-treated full-thickness wounds might be fully absorbed in a few months. In conclusion, it is shown that our newly developed AGA-100 possesses superior properties compared with typical alginate dressings.

Effect of acyclovir on bronchoconstriction and urinary leukotriene E4 excretion in aspirin-induced asthma

BACKGROUND

Acyclovir (9-[2-hydroxyethoxymethyl] guanine), an inhibitor of the DNA polymerase of the herpes virus, has been reported to exhibit pharmacologic activity other than antiviral activity, including antiasthmatic effects.

OBJECTIVE

This study was designed to investigate the protective effect of acyclovir on airway responsiveness to the sulpyrine provocation test and to investigate whether this protective activity is associated with a reduction in aspirin-induced excretion of urinary leukotriene E4 (u-LTE4 ), a marker of cysteinyl leukotriene (LT) overproduction that participates in the pathogenesis of aspirin-induced asthma.

METHODS

We assessed the effects of pretreatment with acyclovir on bronchoconstriction precipitated by inhalation of sulpyrine in 16 adult patients with mild or moderate aspirin-induced asthma; those who were in stable clinical condition and were hyperresponsive to the sulpyrine provocation test were allocated to this study. A double-blind, randomized, cross-over design was used. u-LTE4 was measured by a combined reverse-phase HPLC enzyme immunoassay.

RESULTS

Acyclovir protects against aspirin-induced attacks of asthma through mechanisms unrelated to its bronchodilator property but related to the improvement of bronchial hypersensitivity to sulpyrine; protection was nearly complete in all patients (P <.0001). By contrast, after acyclovir, the maximum level of u-LTE4 in patients was significantly lower than that in control subjects (P <. 01).

CONCLUSION

Our results suggest that acyclovir is not only an antiviral drug but also an inhibitor of analgesic-induced bronchoconstriction, probably acting by inhibiting the release of cysteinyl LTs.

Bronchial hyperresponsiveness, hypersensitivity to analgesics and urinary leukotriene E4 excretion in patients with aspirin-intolerant asthma

This study was designed to investigate the protective effect of cromolyn sodium on airway sensitivity to sulpyrine, and bronchial responsiveness to methacholine, and to investigate whether this protective activity is associated with reduction in aspirin-induced excretion of urinary leukotriene E4 (u-LTE4), a marker of the cysteinyl LT overproduction that participates in the pathogenesis of aspirin-induced asthma. We assessed the effects of pretreatment with cromolyn sodium on bronchoconstriction precipitated by inhalation of methacholine and sulpyrine in 16 adult patients with mild or moderate aspirin-intolerant asthma; those who were in stable clinical condition and were hypersensitive to a sulpyrine provocation test were included in this study. A double-blind, randomized, crossover design was used. u-LTE4 was measured using combined reverse-phase high-performance liquid chromatography enzyme immunoassay. Cromolyn sodium protected against analgesic-induced bronchoconstriction through mechanisms that are not related to its bronchodilator property, but to the improvement of both bronchial hyperresponsiveness and hypersensitivity to analgesics (p<0.01 and p<0.001). Although excretion of u-LTE4 did not increase after the methacholine provocation test, it significantly increased after sulpyrine provocation (p<0.01). Furthermore, after pretreatment with cromolyn sodium, the maximum level of u-LTE4 after the sulpyrine provocation test was significantly lower than in controls (p<0.01). These results support the hypothesis that cysteinyl LT is one of the most important components in the pathogenesis of aspirin-intolerant asthma. Cromolyn sodium improves both hypersensitivity to analgesics, and bronchial hyperresponsiveness in aspirin-intolerant asthma.

Evaluation of a novel alginate gel dressing: cytotoxicity to fibroblasts in vitro and foreign-body reaction in pig skin in vivo

Calcium alginate dressings have beneficial effects on wound healing by providing a moist wound environment. However, cytotoxicity and the nonbiodegradable nature of calcium alginate dressings induce unresolved chronic foreign-body reaction. In this study, a novel freeze-dried alginate gel dressing (AGA-100) low in calcium ions was evaluated for cytotoxicity to L929 cells in vitro and in full-thickness pig wounds in vivo. Cytotoxicity testing on L929 cells showed the cytocompatibility of AGA-100 extracts, while extracts from Kaltostat, a well-established alginate dressing, induced cytopathic effects. In an in vivo study using pigskin, AGA-100, Kaltostat, and gauze were applied on 1-in-diameter circular full-thickness wounds on the back of pigs and the time course of wound closure was evaluated. Kaltostat and gauze dressings were used as controls. For histologic evaluation, wound tissue was harvested on day 18. AGA-100-treated wounds showed rapid wound closure compared to control wounds on day 15. Foreign-body reaction was marked in Kaltostat- and gauze-treated wounds, and differed significantly from AGA-100-treated wounds. Based on these data, AGA-100 could reduce the cytotoxicity to fibroblasts and foreign-body reaction that have been observed with currently available calcium alginate dressings; it was also found to be useful as an alginate dressing.

Immunohistochemical colocalization of GTP cyclohydrolase I in the nigrostriatal system with tyrosine hydroxylase

Immunohistochemical colocalization of GTP cyclohydrolase I (GCH) in the mouse nigrostriatal system with tyrosine hydroxylase or aromatic L-amino acid decarboxylase in the somata and terminals of GCH-positive catecholaminergic neurons are proved for the first time by a double-labeling immunofluorescence method with a confocal laser-scanning microscope. GCH-immunoreactive somata in the mouse substantia nigra have synaptic contacts with monoaminergic and non-monoaminergic terminals.

Nonpathological focal enhancements on spiral CT hepatic angiography

BACKGROUND

To assess the frequency and characteristics of nonpathological focal enhancements seen on spiral computed tomographic (CT) hepatic angiography (CTA).

METHODS

Spiral CTA and spiral CT arterial portography (CTAP) were performed in 31 patients with suspected liver malignancy prior to potential liver resection. The CTA images were retrospectively reviewed for focal enhancements by two radiologists. After determining nonpathological focal enhancements on CTA images based on the other radiographic tests, surgical exploration including intraoperative sonography, follow-up imagings, the frequency, size, site, and shape of nonpathological focal enhancements with CTA were assessed.

RESULTS

Thirty-six nonpathological focal enhancements with CTA from 4 to 23 (mean = 11. 4) mm were seen in 14 (45.2%) of 31 patients. Thirteen (36.1%) of 36 nonpathological focal enhancements with CTA were not depicted with CTAP. Nonpathological focal enhancements with CTA were frequent in Couinaud segments III (27.8%), V (22.2%), and VI (19.4%). Twenty-three (63.9%) of 36 nonpathological focal enhancements were located in the edge of the liver. Shapes of 36 nonpathological focal enhancements with CTA included circular (n = 16), worm (n = 7), irregular (n = 6), dot (n = 6), and wedge (n = 1).

CONCLUSION

In nearly half of patients, spiral CTA shows various shapes of small nonpathological focal enhancements more frequently in the liver edge.

Demonstration of false-negative findings on CT hepatic angiography

False-negative findings on CT angiography (CTA) in two patients with hepatocellular carcinoma (HCC) were demonstrated. CTA images of one patient with an aberrant left hepatic artery branching from the left gastric artery and another patient whose right hepatic artery was occluded owing to an unknown cause failed to demonstrate HCCs. This report suggests one of the diagnostic pitfalls of CTA for diagnosis of liver tumors.

Renal pelvic and ureteral carcinoma with huge hydronephrosis: US, CT, and MR findings

A 78-year-old man presented huge hydronephrosis with a calculus in the left kidney, and underwent left nephroureterectomy under the diagnosis of renal pelvic and ureteral tumor. Histological examination disclosed renal pelvic and ureteral tumors featuring mixed histologic types of carcinoma. Magnetic resonance (MR) imaging was superior to computed tomography (CT) in its complete, detailed demonstration of the renal pelvic lesions. The imaging characteristics of CT, MR imaging, ultrasonography, and retrograde ureterography were discussed in the report.

Velopharyngeal closure and the longus capitis muscle

The dynamic mechanism of velopharyngeal function not only in normal individuals but also in patients with velopharyngeal insufficiency, which is mainly related to cleft palate, has been the subject of considerable interest and controversy. Recently, in order to clarify velopharyngeal movement in the valvular action on phonation we examined dynamic MR images of this area taken in the transverse plane in parallel with the muscle sling of levator veli palatini. In cases in whom the closure pattern in that plane is circular, detailed observation revealed a very interesting result; that is, the longus capitis muscle, one of the group of anterior vertebral muscles, is directly involved in velopharyngeal valving function. It has not previously been reported that the longus capitis muscle acts as one of the velopharyngeal closure muscles, in addition to levator veli palatini. The present study demonstrated that contraction of the muscle contributed to velopharyngeal closure by forward movement of the pharyngeal wall.

Transient appearance of tyrosine hydroxylase-immunoreactive non-catecholaminergic neurons in the medial geniculate nucleus of postnatal mice

Tyrosine hydroxylase-immunoreactive (TH-ir) cells were found to appear transiently in the medial geniculate nuclear region of mice at postnatal day 7 (P7) by use of an avidin-biotin peroxidase complex (ABC) method for the first time. The numbers of TH-ir cells reached maximum between P14 and P21 and decreased until P29. These cells were GTP cyclohydrolase I-negative, aromatic L-amino acid decarboxylase-negative, and dopamine-negative. Thus, they do not belong to the catecholaminergic neuron system, because they lack dopamine production. The results suggest that TH in the cells in the medial geniculate nuclear region of mice has some new functions besides catecholamine biosynthesis.

Value of three-dimensional spiral CT hepatic angiography

OBJECTIVE

The aim of this study was to compare with conventional angiography images the diagnostic utility of three-dimensional CT hepatic angiography (CTHA) images reconstructed from spiral CT images obtained during direct injection of contrast material into hepatic arteries.

MATERIALS AND METHODS

Three-dimensional CTHA images were reconstructed from spiral CTHA images obtained during direct hepatic arterial contrast material injection in 22 patients. We used maximum-intensity-projection (MIP) and shaded-surface-display (SSD) techniques. We compared matched pairs of MIP CTHA images and SSD CTHA images with conventional angiograms for depiction of peripheral (segmental to subsegmental order branches) and proximal (common to proper) hepatic arteries as well as for conspicuity of the entire hepatic arterial tree in 22 patients and for conspicuity of tumors, recognition of tumor sites, and depiction of tumor-feeding arteries in 21 patients with malignant liver tumors. Our evaluations were performed in a blinded fashion by two experienced radiologists, who reached a consensus. (These radiologists also counted the number of tumors depicted by each method in the 21 patients with malignant liver tumors.)

RESULTS

Depiction of peripheral and proximal hepatic arteries and conspicuity of the entire hepatic arterial tree were significantly better on conventional angiograms than on MIP CTHA images and SSD CTHA images. Conspicuity of tumors and recognition of tumor sites were significantly better on MIP CTHA images and SSD CTHA images than on conventional angiograms. Depiction of tumor-feeding arteries was significantly better on MIP CTHA images than on SSD CTHA images and conventional angiograms. For 47 malignant liver tumors, MIP CTHA images showed 40 (85%), SSD CTHA images showed 34 (72%), and conventional angiograms showed 20 (43%).

CONCLUSION

MIP CTHA images showed liver tumors, tumor sites, and tumor-feeding arteries better than conventional angiograms. MIP was the preferred method for three-dimensional CTHA analysis.

Hemodynamics of small hepatocellular carcinomas (5 cm or less in diameter): cases with discrepant findings between dynamic MR images and hepatic arteriograms

BACKGROUND

The degrees and patterns of contrast enhancement of small hepatocellular carcinomas (HCCs) on dynamic magnetic resonance (MR) images were compared with those on hepatic arteriograms in 61 patients.

METHODS

Dynamic MR imaging was performed within 1 week before hepatic angiography prior to treatment, 3-4 weeks after treatment, and then once every 1-3 months if necessary. Hepatic arteriography was carried out with a coaxial microcatheter inserted into the proper hepatic artery or its distal branches.

RESULTS

In 58 of 61 cases, the degrees of contrast enhancement of the tumor in dynamic MR imaging were roughly consistent with those in hepatic arteriography before treatment. In the remaining three cases, however, the tumors were depicted as hyperintense in the arterial dominant phase of the dynamic MR imaging, whereas the tumors were not detected by hepatic arteriography. The tumor detectability is 97% by dynamic MR imaging and 92% by hepatic arteriography. Furthermore, when an HCC nodule was not clearly enhanced by hepatic arteriography after treatment, it was possible by dynamic MR imaging to obtain accurate information on whether the HCC nodule had parasitic arteries.

CONCLUSIONS

Dynamic MR imaging was superior to hepatic angiography in contrast resolution. It was therefore considered to be useful in assessing the degrees and patterns of contrast enhancement of small HCCs before and after treatment.

Dynamic MRI of the diaphragm

OBJECTIVE

To demonstrate the appearance of the diaphragm on single-slice dynamic MRI.

MATERIALS AND METHODS

We evaluated the diaphragm using gadolinium-enhanced single-slice dynamic MR in 53 patients.

RESULTS

The diaphragm was partially depicted in 49 cases (92.5%). Its thickest part measured 4.4 +/- 2.2 mm, range 3 to 15 mm. Enhanced high-intensity thin layer structures were partially identified between the diaphragm and liver parenchyma in 46 cases (86.8%) at 16 to 144 s (mean +/- SD, 65.7 +/- 32.6 s) after intravenous injection of Gd-DTPA.

CONCLUSION

Dynamic MR has value and limitations in demonstrating the diaphragm.