Differences in the reduced 18F-Dopa uptakes of the caudate and the putamen in Parkinson's disease: correlations with the three main symptoms

It has been reported that the F-Dopa (FD) uptake in patients with idiopathic Parkinson's disease (PD) decreased significantly in the caudate and putamen when compared to controls. The FD uptake severely decreased in the putamen, while it was relatively spared in the caudate nucleus. We also previously reported that atypical parkinsonism with no or little tremor showed a homogeneously reduced FD uptake in both the caudate and the putamen. In this study we evaluated the caudate and the putaminal FD uptakes in relation to the three main symptoms in PD. The FD uptake was measured by PET with 6-L-[18F]fluorodopa in 17 patients with PD. The caudate and the putaminal FD uptake ratios to the cerebellum at 120 min were evaluated. The caudate and the putaminal FD uptake ratios in the patients with PD decreased as their clinical stages advanced. These decreases also correlated with the degree of rigidity and bradykinesia. However, such decreases did not correlate with the degree of tremor. The caudate-putamen index (CPI)(%), which was calculated by a formula based on the difference in the uptakes of the caudate and putamen divided by the caudate uptake, indicated 11.6 +/- 3.6, 16.5 +/- 5.5 and 18.3 +/- 4.1 in the group of no, mild and moderate tremor, respectively, and increased as the degree of tremor advanced. The CPI in the group of moderate tremor significantly increased from that in the group of no tremor (P < 0.04). However, the CPI did not correlate with the clinical stage, the degree of rigidity or the degree of bradykinesia. The FD/PET study therefore effectively demonstrated the severity of the clinical symptoms of rigidity and bradykinesia in patients with PD in correlation with a decrease in the FD uptakes in the caudate and the putamen, and it also demonstrated that the severity of tremor might have a different mechanism from that of such other symptoms as rigidity and bradykinesia.

Absence of lysosomal cleavage in the cytotoxicity mechanism of an immunoconjugate composed of anti-alpha-fetoprotein monoclonal antibody and vindesine analog

The effect of lysosomal enzyme inhibition on the cytotoxic activity of an immunoconjugate composed of anti-alpha-fetoprotein monoclonal antibody and vindesine analog (VDS) was studied in vitro using human tumor clonogenic assay (HTCA). Addition of the lysosome enzyme inhibitors, leupeptin and ammonium chloride, to the HTCA system had little influence on the cytotoxicity of this immunoconjugate. In separate experiments, no released VDS was detected by HPLC after incubation with the supernatant of rat liver homogenate without inhibitor. These results show that the immunoconjugate may bypass the lysosomal process and exert its activity as an intact or similar form.

Structure and expression of two seed-specific cDNA clones encoding stearoyl-acyl carrier protein desaturase from sesame, Sesamum indicum L

We have isolated two cDNA clones (CDES01) and 04) encoding stearoyl-acyl carrier protein desaturase (SACPD; EC 1.14.99.6) from immature sesame seeds, and have analyzed accumulation levels of the corresponding mRNAs at different stages and organs in sesame. Clone CDES01 contains an open reading frame coding for a 396-amino acid protein of 45 kDa. CDES04 encodes a partial sequence of 141-amino acids. Deduced amino acid sequences of both clones exhibit a high identity to those of other plant SACPD cDNAs. Northern blots probed with CDES01 and CDES04 indicate that both messages accumulate in a seed-specific manner with a peak at 21 days after anthesis. However, expression patterns also indicate that regulation between CDES01 and CDES04 are slightly different. The CDES01 message accumulates at a low level in young leaves in addition to seeds, whereas accumulation of the RNA transcript corresponding to CDES04 is restricted to seeds. This observation implies the presence of at least two isozymes of SACPD having overlapping but slightly distinct functions in sesame.

Inflammatory pseudotumors of the spleen: CT and MRI findings

OBJECTIVE

Our goal was to elucidate the CT and MRI findings of inflammatory pseudotumors of the spleen.

METHODS

The CT and MRI findings of three patients with inflammatory pseudotumors of the spleen were reviewed and compared with the pathologic findings.

RESULTS

On the early phase of CT, the masses were hypodense to the normal spleen, and on the delayed phase, they demonstrated delayed enhancement. On T1-weighted MR images, the masses were isointense to the normal spleen, and on T2-weighted images, the masses had heterogeneous low signal intensities. After administration of Gd-DTPA, the masses showed delayed enhancement.

CONCLUSION

Inflammatory pseudotumors of the spleen were characterized by low signal intensity on T2-weighted MR images and delayed enhancement after contrast material administration on CT and MRI. The fibrous stroma may contribute to these unusual findings.

Intracranial metastasis of renal cell carcinoma: MR imaging

The purpose of this study was to evaluate the magnetic resonance (MR) findings of intracranial metastatic tumors of renal cell carcinomas (RCCs). MR images of seven patients with intracranial metastases of RCCs were retrospectively reviewed. Each of the seven patients had a single lesion, including five supratentorial intraparenchymal lesions, one 4th ventricular lesion, and one pituitary lesion. Intra- and/or peritumoral flow voids were observed in five of the seven lesions. The signal intensities of the tumors were not specific. All lesions showed gadolinium enhancement, including solid (3), nearly solid (2), and ring enhancement (2). We concluded that intra- and/or peritumoral flow void is a relatively characteristic MR finding of intracranial metastases of RCCs.

Temporary spontaneous regression of intrahepatic cholangiocarcinoma

A 34-yr-old man with a liver mass was referred to the hospital. The mass showed temporary spontaneous regression during the follow-up, however, subsequent regrowth of the tumor prompted surgical resection. The specimen revealed intrahepatic cholangiocarcinoma with two distinct components which had been clearly demonstrated on serial CT. Spontaneous resolution of a lesion does not necessarily suggest the lesion's benign, self-limiting entity. Intrahepatic cholangiocarcinoma should be included in the tumors that could spontaneously regress.

Human middle latency auditory evoked magnetic fields

The magnetic equivalents of SN10, Po, Na, Pa, Nb and Pb (SN10m, Pom, Nam, Pam, Nbm, and Pbm) in short and middle latency auditory evoked potentials were measured with a 7-channel DC superconducting quantum interference device (SQUID). The sources of Pom, Nam, Pam, Nbm and Pbm responses were estimated to be located in the auditory cortex, while the source of SN10m was considered to be in a deeper part of the brain. In addition, the source of Pam was estimated to be in the vicinity of the moving N100m source. The source of Pbm was considered to be in a separate area, anterior to the source of Pam and N100m, which suggested that source of Pam was located in the primary auditory cortex, while the source of Pbm was located in the secondary auditory cortex. The source of N100m was considered to spread from the primary auditory cortex to the secondary auditory cortex.

Relationships between fiber composition and NMR measurements in human skeletal muscle

The purpose of this study was to examine the relationships between the relative contents of phosphocreatine (PCr), inorganic phosphate (Pi), beta-adenosine triphosphate (ATP), and transverse relaxation time (T2) with fiber composition, which determined histochemically in the human skeletal muscle. The vastus lateralis muscles of 28 volunteers were subjected to phosphorus nuclear magnetic resonance (31P NMR) spectroscopy, magnetic resonance imaging (MRI) and muscle biopsy. Muscle fibers were divided into type I and type II fibers using myosin ATPase stain. A wide range of fiber composition levels were observed in the subjects (27.3-74.6% type I fibers). The PCr/ATP, Pi/ATP and (PCr + Pi)/ATP ratios were positively related to the percentage of type II fibers (r = 0.695, p < 0.001, r = 0.429, p < 0.05 and r = 0.773, p < 0.001, respectively). There was no correlation between fiber composition and the PCr/Pi ratio (r 0.127, n.s.) or intracellular pH (r = 0.305, n.s.). Moreover, no correlation was found between T2 and fiber type (r = 0.144, n.s.). These results suggest that 31P NMR can detect the differences in relative content of phosphates between type I and type II fibers, thereby noninvasively evaluating fiber composition in human skeletal muscle.

Biological and antigenic characterization of three BApNA-hydrolyzing proteases from the culture supernatant of Porphyromonas gingivalis

Biological and antigenic distinction of 3-N-alpha-benzoyl-DL-arginine p-nitroanilide (BApNA)-hydrolyzing proteases (Pase-B, Pase-C and Pase-S) isolated from the culture supernatant of Porphyromonas gingivalis were determined. Immunoblotting analysis of these enzymes using a polyclonal antibody against Pase-S, which is a soluble, clostripain-like protease, revealed immunological distinction from Pase-C, a vesicle-associated thiol-protease. Pase-B, a vesicle-associated clostripain-like protease, reacted with the antibody and was also found to contain a considerable amount of carbohydrates in its structure, as compared with the others. Analysis of N-terminal amino acids of Pase-B provided a sequence not found in the SwissProt data bank or previously reported as N-terminal sequences of proteases from P. gingivalis. Pase-S, resembling Pase-B in its hydrolytic specificity, cleaved only arginine residues of peptides and degraded type IV and denatured type I collagen. Pase-C hydrolyzed N-alpha-benzoyl-DL-lysine p-nitroanilide and showed the strongest capacity of degrading native type I collagen. This enzyme was also the only one to possess hemagglutinating activity. Our findings suggest that Pase-S from P. gingivalis is less active than Pase-C and that the enzyme may be an isozyme of Pase-B.

Age-related occurrence of inhibitory antibodies to streptococcal pyrogenic superantigens

Several bacteria, such as staphylococci and streptococci, can produce superantigens (SA) that induce the activation of T cells in humans. Although these organisms are the major causes of infection in children, the evidence that T cells are vigorously activated by SA produced by such organisms has not been reported except for toxic shock syndrome. In a previous paper, we demonstrated that inhibitory IgG antibodies (Ab) to SA in humans may protect against SA stimulation. In the present study, we investigated the occurrence of these inhibitory Ab to SA in 94 healthy children by the enzyme linked immunosorbent assay technique and the suppressive effect on T cell stimulation by SA. The positivity of Ab to streptococcal pyrogenic exotoxin (SPE)-A, SPE-C and staphylococcal enterotoxin B (SEB) increased with age. The age at which more than 50% of children exhibited Ab to SA was 1 year for SEB, 6 years for SPE-C and 11 years for SPE-A. Sera from these children were inhibitory to T cell proliferation elicited by SA in proportion to the concentration of IgG Ab to each SA. Sera supplemented with IgG Ab to SA by gamma-globulin therapy became inhibitory to T cell proliferation by SA. We conclude that, as children grow, they can develop Ab to SA that may play a role in protecting them against vigorous T cell activation by SA.

Hepatocellular carcinoma with sarcomatous change: characteristic findings of two-phased incremental CT

BACKGROUND

Because of its poor prognosis, the diagnosis of hepatocellular carcinoma with sarcomatous change (HCCSC) is clinically important. The purpose of this study is to elucidate the characteristic CT findings of HCCSC.

METHODS

Two-phased dynamic incremental CT images of six histologically proven HCCSC were retrospectively reviewed.

RESULTS

All tumors (100%) exhibited peripheral enhancement on delayed CT images. Lymphadenopathy was observed in 100% (six of six patients); intrahepatic metastases, in 83% (five of six). Both metastatic lesions showed findings similar to those of the primary hepatic tumors, such as peripheral enhancement. Histopathological delayed and/or prolonged peripherally enhanced areas consisted of viable cancer cells with sarcomatous changes.

CONCLUSIONS

The appearance of HCCSC on CT is that of an irregularly demarcated intrahepatic mass with delayed or prolonged peripheral enhancement, frequently with intrahepatic metastases and lymphadenopathy.

Efficient production of the C-terminal domain of secretory leukoprotease inhibitor as a thrombin-cleavable fusion protein in Escherichia coli

We have developed a high-level production system for the C-terminal domain of secretory leukoprotease inhibitor (SLPI) to investigate its pharmacological activities. A gene for the C-terminal domain of SLPI, (Asn55-Ala 107)SLPI, was constructed from chemically synthesized deoxyoligonucleotides. It was fused to a gene for the N-terminal portion of human growth hormone via a DNA sequence encoding Leu-Val-Pro-Arg, which can be cleaved by thrombin. The fused gene was expressed in Escherichia coli under the control of a trp promoter, and the fusion protein was obtained as an inclusion body. After sulfonation of the cysteine residues, the sulfonated fusion protein was cleaved at the desired site by thrombin. Sulfonated (Asn55-Ala107) SLPI was refolded in Tris buffer containing reduced and oxidized glutathione. The resulting (Asn55-Ala107) SLPI was purified by cation-exchange chromatography and reverse-phase high performance liquid chromatography. The final yield was 50 mg/I culture. (Asn55-Ala107) SLPI was as active against elastase as, but had less trypsin inhibitory activity than, native SLPI. This system is suitable for the large-scale production of the C-terminal domain of SLPI, which is an elastase-specific inhibitor.

Administration of truncated secretory leukoprotease inhibitor ameliorates bleomycin-induced pulmonary fibrosis in hamsters

The purposes of this study were to investigate the effect of our recently developed truncated secretory leukoprotease inhibitor (SLPI) on bleomycin (BLM)-induced lung injury and fibrosis in hamsters, which is widely used as a model of interstitial pulmonary fibrosis, and to assess the possible involvement of neutrophil elastase in the pathogenesis of pulmonary fibrosis. The fibrosis model was prepared by administration of BLM (10 mg/kg) intratracheally to hamsters. The truncated SLPI was administered at a dose 5 or 15 mg/kg intraperitoneally twice a day only for 10 d starting from the time of BLM administration. BLM administration resulted in decreases in body weight and survival rate. Elastase activity in the supernatant of bronchoalveolar lavage (BAL) fluids was increased at 3 and 7 d after BLM administration in parallel with the increase in the number of neutrophils in the fluids. Histopathologically, at 14 and 28 d after BLM administration, diffuse thickening and fibrosis of alveolar walls with marked cell infiltration and severe distortion of alveolar structure, including honeycomb lung, were observed to have occurred. In this model, the decreases in body weight and survival rate and the increase in elastase activity were inhibited by the truncated SLPI dose-dependently, and pulmonary fibrosis was significantly ameliorated by the administration of this shortened form of SLPI. These results suggest that neutrophil elastase may be implicated in the pathogenesis of BLM-induced pulmonary fibrosis and that the truncated SLPI might be a promising therapeutic in the treatment of interstitial pulmonary fibrosis.

Source localization of middle latency auditory evoked magnetic fields

The magnetic counterparts of middle latency auditory evoked responses (MLR) were measured for seven normal subjects with a 7-channel de superconducting quantum interference device (SQUID). The source of each component (Na, Pa, Nb and Pb) was estimated and plotted onto the individual magnetic resonance images (MRI). The source of Na, as well as those of Pa, Nb and Pb, was estimated to be in the supratemporal auditory cortex. The positions of Pa, Nb and Pb sources were compared with one another. No significant difference was observed between the positions of Pa and Nb sources. On the other hand, the source of Pb was found to be anterior to the sources of both Pa and Nb. It was suggested that there are more than two separate areas activated in the human auditory cortex during MLR.

Lymph-node metastases: efficacy for detection with helical CT in patients with gastric cancer

PURPOSE

To determine the efficacy of helical computed tomography (CT) in the detection of lymphadenopathy in patients with gastric cancer.

MATERIALS AND METHODS

Helical CT (5-mm section thickness, 5-mm/sec table incrementation) was performed in 58 patients (39 men, 19 women; mean age, 63.8 years) with gastric cancer; 1,082 lymph nodes (138 positive, 944 negative for metastasis) were resected at surgery. Findings at CT and resection were compared. Sensitivity for detecting lymph nodes was evaluated according to nodal size and presence of metastasis.

RESULTS

Seven (1.1%) of 649 lymph nodes 1-4 mm, 160 (45.1%) of 355 nodes 5-9 mm, and 56 (72%) of 78 nodes larger than 9 mm were detected at CT. For nodes of at least 5 mm, sensitivity for detecting metastasis-positive nodes (79 [75.2%] of 105 nodes) was higher than that for detecting metastasis-negative nodes (137 [41.8%] of 328; P < .01). Differences between positive and negative nodes in CT attenuation (110 HU +/- 25 vs 66 HU +/- 32) and short-to-long axis ratios (0.81 +/- 0.15 vs 0.57 +/- 0.15; P < .001) were significant.

CONCLUSION

Helical CT is effective for detection of metastatic lymphadenopathy from gastric cancer. CT attenuation and lymph-node configuration aid in diagnosis of malignant adenopathy.

[Cerebral hemodynamics and metabolism in patients with Moyamoya disease not demonstrating either cerebral infarct or hemorrhage on MRI]

We evaluated the cerebral hemodynamics and metabolism in Moyamoya patients who did not demonstrate either cerebral infarct or hemorrhage on MRI. The subjects consisted of 5 patients with Moyamoya disease (4 females and one male, aged from 15 to 40 years). The CBF, OEF and CMRO2 of the Moyamoya patients did not differ from those of the normal control subjects. The CBV did increase significantly in the cerebral cortices and striatum, but not in the cerebellum. The TT was also significantly prolonged in the frontal and parietal regions. The cerebrovascular CO2 response was markedly impaired in the frontal, temporal and parietal cortices. However, it was relatively preserved in the occipital cortex, thalamus and cerebellum. Thus, the cerebral hemodynamic reserve capacity decreased even in the Moyamoya patients not demonstrating either cerebral infarct or hemorrhage on MRI, and it should be considered in the management of these patients.

[Two cases of micrognathia caused by radiation therapy during infancy: an evaluation of their profilograms]

Two patients with micrognathia of the mandible caused by radiation therapy during infancy are reported herein. The first patient was a 25-year-old man with hemangioma of the tongue. He had previously received radiation therapy totaling 51 Gy at 1 and 2 years of age. The other patient was a 54-year-old woman who had received radiation therapy for an oral tumor during infancy. These two patients demonstrated micrognathia, and the former patient showed developmental anomaly of the teeth. In addition, the latter patient suffered from thyroid cancer at 45 years of age, and this was also thought to be radiation-related. Although reports of micrognathia caused by radiation are rare, such late effects should be taken into account when radiation therapy is planned for head and neck tumors in infants.

Epidemiological investigation of insulin resistance syndrome (syndrome X) in a city in Japan

1. In order to study the prevalence of insulin resistance syndrome (syndrome X) in Japanese subjects, inhabitants aged above 40 years living in Osaka-Sayama city from September 1992 through December 1993 were investigated. The population-based study was performed on 2498 subjects (661 males and 1837 females) constituting 10.9% of the total population aged above 40 years. 2. The prevalence of glucose intolerance was 8.7% (n = 218) in 2498 subjects. The prevalence of hypertension was 36.9% (n = 923) and that of hypertriglyceridaemia was 19.0% (n = 475). The prevalence of syndrome X as characterized by an association of glucose intolerance, hypertension and hypertriglyceridaemia was 1.6% (n = 39) in all subjects examined and 17.4% in subjects showing glucose intolerance. 3. Fasting serum insulin levels were significantly higher in patients with syndrome X than in normal subjects. Furthermore, the levels were significantly correlated with blood levels of frucutosamine, fasting glucose and triglyceride, and with body mass index as well. 4. In conclusion, insulin resistance syndrome (syndrome X) is also found among the larger Japanese population, and fasting serum insulin levels can be a useful marker of this metabolic disorder.

Nigrofrontal dopaminergic function as assessed by 18F-dopa PET

The existence of the nigrofrontal dopaminergic pathway has been demonstrated in neuroanatomical studies. We evaluated the presynaptic nigrofrontal dopaminergic function using 18F-dopa (FD) positron emission tomography (PET). The multiple time PET data in the frontal cortex from 20 to 70 min post-injection for FD were evaluated by Patlak analysis using the cerebellar time-activity curve as an input function. The frontal FD uptake rate constants could not be determined in 5 of 12 normal volunteers because of large deviations in the plots. There were no significant differences between the subjects among whom the frontal FD uptake rate constants could or could not be determined regarding the amount of FD injected, the frontal 18F counts, or whether or not they were pretreated with carbidopa. The uptake constants were determined in 9 or 12 patients with parkinsonian syndrome. While the mean (+/- S.D.) uptake constants in patients with Parkinson's disease (2.89 +/- 0.06 x 10(-3), n = 4) and in patients with progressive supranuclear palsy (2.81 +/- 0.10 x 10(-3), n = 3) were not significantly different from those in the normal volunteers (2.93 +/- 0.14 x 10(-3)), those in two patients with corticobasal degeneration (2.42 and 2.46, respectively) decreased in comparison to the control values. Differences in the nigrofrontal presynaptic dopaminergic function as assessed by FD-PET may explain the different pathogenesis and also help to differentiate between corticobasal degeneration and other parkinsonian syndromes, such as Parkinson's disease and progressive supranuclear palsy.

CT manifestations of pediatric intrathoracic desmoid tumors

We describe the CT findings in two pediatric cases of intrathoracic desmoid tumor arising from the chest wall. In both cases, CT showed heterogeneously enhanced intrathoracic masses with destruction of the ribs.

Combination chemotherapy with intra-arterial cisplatin and doxorubicin plus intravenous methotrexate and vincristine for locally advanced bladder cancer. Kyushu University Urological and Radiological Oncology Group

PURPOSE

We evaluate the usefulness of neoadjuvant chemotherapy for bladder cancer.

MATERIALS AND METHODS

The usefulness of neoadjuvant, modified methotrexate, vinblastine, doxorubicin and cisplatin chemotherapy was evaluated in 36 patients with locally advanced bladder cancer.

RESULTS

Of 36 patients 12 achieved a clinical complete response and 17 had a partial response. Of the 12 patients who achieved a clinical complete response the bladder was preserved in 11 and all patients were disease-free at a median of 33 months. No significant toxicity was observed.

CONCLUSIONS

This chemotherapy is useful for locally advanced bladder cancer and the feasibility of bladder preservation in patients with a clinical complete response was suggested.

[Selective intra-arterial injection of calcium for localization of insulinomas: proposed new criteria]

To elucidate whether noninvasive arterial stimulation venous sampling (ASVS) is helpful for localizing insulinomas, calcium gluconate (0.02-0.025 mEq Ca2+/kg) was injected directly into the gastroduodenal, splenic and superior mesenteric arteries of six patients with episodic hypoglycemia. In all six patients, there was a greater than 26-fold increase in serum insulin levels in blood samples obtained from the hepatic vein after the infusion of calcium into the artery supplying the tumor. However, in four of the six patients, such an injection into an artery not supplying the tumor resulted in a greater than twofold increase in insulin concentration. Accurate localization of the insulinomas was verified at surgery in all patients. We believe that these false positive results were caused mainly by the influx of calcium via branches of intrapancreatic anastomoses. In order to minimize false positive results, we have recommended the following new criteria for ASVS: maximum insulin concentrations exceeding 150 microU/ml in blood samples obtained from the hepatic vein, and greater than twofold increases in insulin concentration. We concluded that noninvasive ASVS is helpful in determining the location of insulinomas.

Time dependency of the acetazolamide effect on cerebral hemodynamics in patients with chronic occlusive cerebral arteries. Early steal phenomenon demonstrated by [15O]H2O positron emission tomography

BACKGROUND AND PURPOSE

The acetazolamide effect is thought to reach a maximum at 10 to 20 minutes after administration. However, we sometimes encountered patients who showed a transient deterioration of ischemic symptoms several minutes after acetazolamide administration. We therefore considered that a steal phenomenon may occur before the acetazolamide effect reaches a maximum. We evaluated the time dependency of the acetazolamide effect on cerebral hemodynamics in patients with severe stenosis or occlusion of the unilateral internal carotid artery.

METHODS

The subjects consisted of 13 patients with severe stenosis or occlusion of the unilateral internal carotid artery. Regional cerebral blood flow was measured at the resting state and at 5 and 20 minutes after the intravenous administration of 1 g acetazolamide by the use of the [15O]H2O bolus-injection method and positron emission tomography. The steal phenomenon was interpreted as positive when the regional cerebral blood flow values decreased by more than 10% after the administration of acetazolamide in more than one region of interest.

RESULTS

A steal phenomenon was observed in 5 of 13 patients at 5 minutes after acetazolamide administration on the occlusive side, whereas it was observed in only 1 patient at 20 minutes. Thus, this phenomenon was observed more frequently in the early phase of the acetazolamide test. It was also observed more frequently in patients with poorly developed collateral circulation.

CONCLUSIONS

Our acetazolamide [15O]H2O positron emission tomography study revealed an early steal phenomenon at 5 minutes after intravenous administration of acetazolamide, which may be a cause of the transient deterioration of ischemic symptoms during the acetazolamide test.