Dysembryoplastic neuroeptihelial tumor (DNT): an immunohistochemical and ultrastructural study

To assess the range of differentiation of the cells comprising dysembryoplastic neuroepithelial tumor (DNT), particularly the oligodendrocyte-like cells (OLC), 14 DNT were immunochemically studied with a spectrum of neuronal and glial markers. Eight tumors were also studied ultrastructurally. Neurofilament protein, class III beta-tubulin, and synaptophysin preparations stained a few OLC in two, six and one lesion, respectively. In addition, many OLC within a single cortical nodule were reactive for class III beta-tubulin. The vast majority of OLC were strongly S-100 protein positive. Glial fibrillary acidic protein labeled a fair number of OLC in two cases and one nodule consisted almost entirely of immunoreactive astrocytes. Ultrastructurally, many OLC resembled oligodendrocytes in exhibiting microtubules, prominent Golgi and short cell processes; pericellular lamination of cell processes, a characteristic of oligodendroglia, was noted in only one tumor. In two cases, OLC with astrocytic features were seen to contain small numbers of intermediate filaments. In four cases, a few OLC resembled immature neurons with scant dense-core granules or synapses. This study confirms the glioneuronal nature of DNT, a lesion composed of heterogeneous cells, many resembling oligodendrocytes and a few showing early astrocytic and neuronal differentiation. Although their relation to OLC is unclear, the presence and peculiar distribution of mature neurons is nonetheless an integral diagnostic feature of the lesion.

[Studies on immune response in mouse model of experimental Chlamydia trachomatis intrauterine infections]

An experimental model of Chlamydia trachomatis (C. trachomatis) intrauterine infections was established in mice. Using this model, studies were conducted on the immune response at the site of infection by applying the ABC staining method and monoclonal antibodies directed against each of the various species of immunocompetent cells. At the same time, the serum levels of C. trachomatis-specific IgA and IgG antibodies were also measured. The immunological correspondence of these serum antibodies to C. trachomatis elementary bodies was also investigated. 1. With regard to the immunological response at the site of infection, there was greater infiltration by T cells than by B cells. Determination of the subsets of the T cells revealed that CD8+ T cells outnumbered CD4+ T cells. In addition, among the B cell lineage, there was moderate infiltration by IgA-positive B cells, whereas the infiltration by IgM-positive B cells and IgG-positive B cells was very slight. 2. C. trachomatis-specific IgA and IgG antibodies came to be detected beginning on the 7th day of infection. When the immunological correspondence of these serum antibodies to C. trachomatis elementary bodies was investigated by western blot analysis, one band reacted with the major outer membrane protein (MOMP; 39.5 Kd), while a second band reacted with a 60-Kd protein. On the basis of these findings, it was surmised that, as the immunological response to C. trachomatis infections, the host recognizes the MOMP and a 60-Kd protein in C. trachomatis elementary bodies, thus initiating a series of immune responses. It was also surmised that, at the sites of infection, cells belonging to the T-cell lineage, especially CD8+ cells, play an important role in the host's defense mechanism against the infection by C. trachomatis.

[Therapeutic study on biofilm of the urinary tract using a severely complicated bladder model (biofilm model of the urinary tract)--experimental study using an automatic simulator of urinary antimicrobial agent concentration, and clinical study]

For the purpose of conducting a therapeutic study on biofilm of the urinary tract, we devised a computer-controlled severely complicated bladder model (biofilm model of the urinary tract) enabling us to simulate the time-course of the concentration of antimicrobial agents in the urine. Using this model, we investigated clarithromycin (CAM), which has been reported to have anti-biofilm action, at concentrations close to its urinary levels at the time of clinical use in order to predict its effect on biofilm of the urinary tract. On the basis of those experimental results, we also conducted a clinical examination. The following results were obtained. 1. The action of ciprofloxacin (CPFX, MIC: 8 micrograms/ml) alone, which shows anti-P. aeruginosa activity, caused apparent elimination of P. aeruginosa from the model. However, regrowth of the microbes occurred when CPFX was removed from the bladder model. Moreover, the biofilm was not eliminated by the antimicrobial action of CPFX, and this was surmised to be the cause of the regrowth. 2. CAM (MIC: above 128 micrograms/ml), which has no anti-P. aeruginosa activity, was similarly tested as anti-biofilm agent when added alone to the biofilm model. The P. aeruginosa recovered to its initial concentration within 48 hours, but the biofilm disappeared due to the action of CAM. 3. The combined action of CPFX and CAM caused microbial elimination from the bladder model without microbial regrowth, even after these antimicrobial agents were removed from the bladder model. After the action of CPFX and CAM, the biofilm disappeared, and no microbial adherence was noted. 4. Measurement of time-course of the alginate content, which is the main component of P. aeruginosa biofilm, in the presence of CAM found that the alginate content decreased below the limit of detection after day 5. 5. The clinical study of complicated urinary tract infection revealed the microbial elimination rate and the efficacy rate to be higher in the combined CPFX-CAM administration group than in the CPFX-only administration group. 6. Based on the above results, we surmise that the combined use of an antimicrobial agent which is active against the causative microbe and anti-biofilm agent such as CAM will show some degree of efficacy in eliminating biofilm of the urinary tract.

[The current epidemics of nosocomial infection in the field of surgery]

We studied retrospectively the hospital acquired MRSA and Pseudomonas aeruginosa infections in patients of surgery field. The causative bacteria of nosocomial infections were mainly MRSA and P. aeruginosa. MRSA was mainly cross-infected via the route of medical staffs' hands. P. aeruginosa was mainly infected through indirect contact by wet hospital environment. Therefore, MRSA nosocomial infections can be prevented by washing and disinfecting hand, and disinfecting the dry regions of hospital environment around patients with MRSA infection. P. aeruginosa nosocomial infections can be prevented by washing and disinfecting hands, and disinfecting the wet regions of hospital environment. Urinary indwelling catheter must be aseptically managed for preventing the infection. These various preventive measures controlled the nosocomial infection by MRSA or P. aeruginosa.

Electroretinogram b/a wave ratio improvement in central retinal vein obstruction

The electroretinogram (ERG), especially the b/a wave ratio, is considered a good indicator of retinal ischaemia in central retinal vein obstruction (CRVO). Seven CRVO patients who showed b/a wave ratio improvement from < 1.0 [negative type (-) ERG] to > or = 1.0 and one from 1.07 to 1.53 were studied. Three mechanisms of change were observed: firstly, the b-wave amplitude increased without an a-wave amplitude decrease (group A, n = 2); secondly, the b-wave amplitude increased with an a-wave amplitude decrease (group B, n = 4); and, thirdly, both decreased, but the a-wave amplitude decreased more markedly (group C, n = 2). In group A, the visual acuities improved markedly. In group B, the visual acuities improved in two cases in which the b-wave amplitude reached the normal range; the visual acuities did not improve in two cases in which the b-wave amplitude did not reach the normal range. In group C, the visual acuities remained poor. The negative (-) ERG or significantly reduced b/a wave ratio is associated with ischaemic CRVO and did not occur because of the filtering effect of the haemorrhage, which may reduce the stimulus light for the ERG. Improvement of the reduced b/a wave ratio with an increased b-wave amplitude was accompanied by improvements in fundus appearance and visual acuity in CRVO. The results suggest that the retinal ischaemia in CRVO, as revealed by the ERG and fluorescein angiogram, may be reversible in some cases.

[Study on MIC breakpoint and method of antimicrobial chemotherapy for moderately complicated urinary tract infection--study using an automatic simulator of urinary antimicrobial agent concentrations]

We experimentally investigated an efficient administrating method of antimicribials prior to the clinical treatment of complicated urinary tract infection without catheter. An experimental model of moderately complicated urinary tract infection, which can simulate changes in the urinary concentration of antimicrobials by means of previously reported computer control method, was used for the experiment. The following results were obtained. 1. At first, for complicated UTI cases without an indwelling catheter, an investigation was made of the clinical therapy results to determine the upper MIC range of bacteria, including isolated strains, that can be nearly eliminated following treatment, by the administration method. We then estimated the clinical breakpoint. 2. By adjusting the size of the diverticulum in a urinary bladder model, we prepared a model which gave comparatively good agreement between the clinical and experimental breakpoints. 3. The clinical therapy results revealed that by the clinical breakpoint was higher in degree of coverage of the MIC distribution of causative bacteria associated with a higher actual clinical elimination rate and a higher efficacy rate. 4. It was surmised that an efficient administration method for complicated UTI without an indwelling catheter can be established if the urinary bladder model and the following approach are applied: prior to clinical treatment it should be determined what would be high enough to cover 70% of the MIC distribution of the estimated causative bacteria of UTI, and then an administration method which would yield that concentration as the experimental breakpoint should be devised.

[An experimental examination of the significance of the peak antimicrobial concentration value in urine and time above MIC on the effect of antimicrobial agents--an examination using a severely complicated in vitro bladder model with an autosimulation system for antimicrobial concentration in urine]

Using a severely complicated in vitro bladder model with a computer-controlled autosimulation system for antimicrobial concentration in urine, we examined the significance of the peak concentration value and time above MIC, and obtained the following results. 1. Regarding the initial bactericidal speed, the higher the peak concentration value was, the more quickly the bacterial concentration decreased. 2. Concerning the minimum value of bacterial concentration in the model bladder, the higher the peak concentration value was, the more the level tended to decrease. 3. Regarding inhibition of regrowth of bacteria (ERT) 1) When a particular antimicrobial agent had no PAE on bacteria, the viable bacterial count curve was similar in cases of peak antimicrobial concentration values of higher than 8 MIC. 2) On the other hand, when an antimicrobial agent had PAE on bacteria, regrowth of bacteria occurred quickly below a certain peak concentration (24 MIC or 64 MIC value), although there was some difference depending on the type of antimicrobial agents. Thus, it was suggested that the peak concentration above that level be attained and maintration above that level be attained and maintained for some time were in order to obtain PAE adequately. 4. It is concluded from the aforementioned facts that two factors, a certain high concentration and a certain continued time are necessary for both antimicrobial agent with metabolic disorder and antimicrobial agent with cell wall synthetic inhibition to obtain proper antimicrobial effect. The condition of their necessity differed slightly according to the two different agents.

Investigations of mental health of school teachers for the mentally retarded and staff members in social welfare facilities for the mentally retarded: using a Japanese version of the General Health Questionnaire (GHQ)

The mental health of 70 school teachers for the mentally retarded, 60 direct care staff in social welfare facilities for the mentally retarded, 124 nurses and 369 general office workers was investigated by means of General Health Questionnaire (GHQ). The results were: 1) The incidence of mental unhealthiness was 44.6% among staff serving the mentally retarded, tending to be higher than among nurses, and significantly higher than among general office workers. 2) Among staff serving the mentally retarded, females tended to be more mentally unhealthy than males; among school teachers for the mentally retarded, the incidence among females was significantly higher than among males. 3) As to the incidence by age and experience, among staff serving the mentally retarded, the younger the age and the shorter the experience, the higher the incidence of mental unhealthiness.

[Genetic diagnoses of Chlamydia trachomatis--DNA probe and PCR method]

Chlamydial infections such as male urethritis or female cervicitis, although not receiving as much attention as the AIDS epidemic, are on the increase around the world as sexually-transmitted diseases (STD). A number of diagnostic methods i.e., direct fluorescence antibody method and enzyme immunoassay (EIA) methods, have been developed for detecting Chlamydia trachomatis (C. trachomatis) infection, but they each have a defect in terms of sensitivity or specificity. Then, to overcome these disadvantages, the genetic diagnostic method such as DNA-RNA hybridization (DNA probe) method, PCR method and LCR method have been clinically introduced. In in vitro studies, the PCR method has higher sensitivity than the EIA method or DNA probe method. All genetic diagnostic methods have specificity superior over the EIA method. In clinical studies, the PCR method was the most useful for detection of C. trachomatis from various infectious lesions.

Prognostic value of initial electroretinogram in central retinal vein obstruction

We retrospectively studied the correlation between the initial electroretinogram (ERG) recordings and the final visual acuities (VA) of 47 patients with central retinal vein obstruction (CRVO) after follow-up of more than 1 year. The a- and b-wave amplitudes and the b/a ratio with white flash were significantly larger in patients with good vision (VA > 20/200) than in those with poor vision (VA < or = 20/200). The b/a ratio and b-wave amplitude with white flash showed sensitivity and specificity of more than 78% for visual prognosis. The latest VA was < or = 20/200 in all 20 patients with a subnormal b-wave amplitude and in all 15 with b/a ratio < 1.05. These results suggest that the ERG recorded soon after (CRVO) onset correlates strongly with visual prognosis.

Snellen visual acuity versus pattern reversal visual-evoked response acuity in clinical applications

We compared the best-corrected Snellen acuity (SA) and the pattern reversal visual-evoked response (PVER) acuity in normal subjects and patients. Forty-two eyes of 42 normal subjects were controls; 457 eyes of 329 patients comprised the patient group. A steady-state stimulus with five check sizes ranging from 160 to 10 min in 1.0-octave steps was used. The PVER acuity was derived from the best-fit linear function relating the amplitude to the log-adjusted check size. Three intercepts of 0, 1 and 2 microV were used in both groups, and the PVER acuities were called P0, P1 and P2. The SAs in normal subjects ranged from 20/15 to 20/20 (mean, 20/18.3) and in patients from 20/15 to 20/1,600 (mean, 20/56.9). In normals, the P0 showed the best agreement with the SA (mean acuity difference, +0.34 octave). The SA and P0 agreed within +/- 2.0 octaves in 33/42 (78.6%) eyes. In patients, the P0 also showed the best agreement with the SA; 306/457 (67.0%) eyes showed an acuity difference within +/- 2.0 octaves. Unlike normals, 83/457 (18.2%) eyes showed an acuity difference > -3.0 octaves. These eyes mostly had optic nerve disease with a flattened PVER amplitude-check size function curve. The P0 seems to correlate better with SA than P1 and P2, but this analytical method may be less effective in the presence of certain pathologic conditions.

Mechanism of pain and cytoskeletal properties in angioleiomyomas: an immunohistochemical study

Angioleiomyoma is a solitary subcutaneous tumor characterized by pain in about half of patients with this tumor, and the pathogenesis of this pain has been a cause of much debate. To clarify the mechanism of pain and cytoskeletal property of tumor cells, 50 angioleiomyomas were studied clinicopathologically and immunohistochemically. The tumors occurred preferentially on the extremities, particularly the lower leg (46%), and the female to male ratio was 1.9:1. They were classified into three histological subtypes: (i) solid (30 cases); (ii) venous (15 cases); and (iii) cavernous (five cases). The pain and/or tenderness were present in 26 out of 49 patients (52%), in which small nerve fibers immunoreactive for S-100 protein and PGP9.5 were identified within the capsule of 20 tumors (77%) and the tumor stroma of 18 (69%), irrespective of the histological subtypes. In 24 patients where the pain was absent or unknown, nerves were observed within the capsule of 19 tumors (79%) and tumor parenchyma of 10 (42%). Many cells in all 50 tumors were positive for alpha-smooth muscle actin, and a relatively large number of cells in many tumors were positive for vimentin, desmin and collagen type IV. Also, cytokeratin (CAM5.2) reactivity was scattered in a few cells of four tumors. From these findings, the peculiar pain of angioleiomyomas could be mediated by the nerve fibers especially located within the tumor parenchyma. Although the expression of intermediate filaments in angioleiomyomas was heterogeneous, the overall cytoskeletal features were of smooth muscle cell differentiation.

[Investigation of Chlamydia trachomatis-specific IgA, IgG antibody with EIA method]

Recently, two new kits, HITAZYME (Hitachi Chemical Co., Ltd.) and SERO IPALISA (Savyon Diagnostics, Ltd.), for the assay of anti-C. trachomatis antibodies by the enzyme immunoassay (EIA) method have been developed and put into clinical application. In the study reported here, the authors investigated the clinical usefulness of these assay kits, together with the IPAzyme and micro-IF test, in the diagnosis of cases of urogenital tract C. trachomatis infections. 1. The positive rates for IgA antibodies, which are considered to be an indicator of active infection, obtained with the HITAZYME and SERO IPALISA kits in the 82 antigen-positive cases were significantly (p < 0.005) higher than the rates obtained with the IPAzyme and micro-IF test. These results showed the usefulness of the HITAZYME and SERO IPALISA kits for detecting C. trachomatis infections. 2. A comparison was made of the assay results obtained with the HITAZYME and SERO IPALISA kits, and it was found that there was a large number of cases (142) that tested negative for IgA antibodies with the HITAZYME but positive with the SERO IPALISA kit. We carried out a confirmatory test on the specimens of cases for which the results obtained with the HITAZYME and SERO IPALISA kits were not in agreement. This test employed the Western blotting method using COMC (the antigen extracted from EB of C. trachomatis strain L2 and used in the HITAZYME kit) and whole EB of C. trachomatis strain L2 (the antigen used in the SERO IPALISA kit). The results showed a significantly higher degree of agreement between the HITAZYME kit data and the Western blotting data than between the SERO IPALISA kit data and the Western blotting data. 3. In addition, with the objective of investigating the existence of cross reactivity with anti-C. pneumoniae antibodies, we performed Western blotting using as the antigen crude whole EB of C. pneumoniae strain TW-183. The results showed that anti-C. pneumoniae antibodies were detected in 25 of 35 (71.4%) cases that were negative with C. trachomatis antigen and the HITAZYME kit and positive with the SERO IPALISA kit. These findings indicate a strong possibility that these cases positive with the SERO IPALISA kit are due to a cross reaction with anti-C. pneumoniae antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)

Nail plasty in the treatment of duplicated thumb

We present refinements in the treatment of duplicated thumb. When applying the modified Bilhauts procedure including the nail, this design based on a lunula is useful to construct a natural looking nail in Wassel types 2 to 4. No bone fixation of each segment is also effective to produce an even transverse curvature of the reconstructed nail.

Giant cell tumor of tendon sheath. An immunohistochemical observation on the characteristics and the capacity of proliferation of tumor cells

To investigate character and proliferation of tumor cells of giant cell tumor of tendon sheath (GCTTS), we studied 25 cases of GCTTS by light and electron microscopic immunohistochemistry. Mononucleated stromal cells (SC) of GCTTS could be divided into three types according to their antigenic features. The first type was the histiocytic SC expressing antigens recognized by KP1, Mac387 and Ham56. The second type was the fibroblastic SC showing fibronectin immunoreactivity. The third type was the intermediate SC expressing both KP1 and fibronectin. The presence of intermediate SC suggested that the different types of SC of GCTTS would be of common origin, i.e. from the mesenchymal cells of the synovium and represented different functional phases or phenotypic alterations. The expression of proliferating cell nuclear antigen (PCNA) was observed only in SC and occasionally, in binucleated cells, but multinucleated giant cells (GC) were negative for PCNA, suggesting that GC were non-dividing cells.

The 4F9 antigen is a member of the tetra spans transmembrane protein family and functions as an accessory molecule in T cell activation and adhesion

In this report, we describe a 43- to 50-kDa protein, which may function as a costimulatory molecule for full activation of human T cells. This Ag, defined by a mouse monoclonal antibody (mAb) anti-4F9, is primarily distributed on "helper/inducer" or "memory" CD4+CD45RO+ subset. Like mAbs against many other accessory/costimulatory molecules, coimmobilization of anti-4F9 with anti-CD3 resulted in synergistic T cell proliferation. In addition, immobilized anti-4F9 on plastic plates induced T cell spreading characterized by the development of prominent dendritic processes. A cDNA encoding the 4F9 Ag was isolated from a cDNA library constructed from PHA/PMA-activated T cells using a COS cell expression system. The sequence of the cDNA and a homology search revealed that the 4F9 Ag was identical to R2, a molecule recently cloned by subtractive hybridization. The 4F9/R2 Ag belongs to a newly identified supergene family (tetra spans transmembrane protein family) characterized by four putative transmembrane domains which are highly conserved between the members of this family. Based upon the phenotypical and functional studies described here, we propose that the 4F9 Ag is an integral membrane protein which can transmit signals involved in T cell proliferation and adhesion. The preferential distribution of this molecule on the CD4+CD45RO+ subset of T cells may contribute to the distinct activation profile and functional repertoire of these cells.

The innervation of intradermal nevi. On the nevus-axon relations

In the study of the histogenesis of intradermal nevi, the nevus cell-Schwann cell relationship has been a matter of long debate. We have demonstrated a dense axonal supply in the intradermal nevi by protein gene product 9.5 (PGP 9.5) immunohistochemistry. There were small nerve bundles between nevus cell nests and numerous individual axons in the nests of all the intradermal nevi studied. The distribution of these axons was more dense in the deeper and middle portions than in the superficial portion of the nevi. The significance and morphogenesis of this rich axonal supply in the intradermal nevi remain obscure, but this nevic neurotropism suggests an intimate mutual interaction between nevus cells and axons: possibly, some activities of nevus cells stimulating axonal proliferation, or nevus cell migration into the preexisting nerves. The presence of the proliferated axons may have some influences upon Schwannian transformation of the nevus cells. The mode of contact between nevus cell and axon, the presence of true Schwann cells surrounding the proliferated axons and the demonstration of myelin structure should be investigated by further electron microscopic study.

Effects of light scatter, defocusing, mean luminosity, contrast, and central scotoma on the PVER amplitude-check size function curve

We analyzed the effects of various stimulus parameters, ie, light scatter, defocusing, mean luminosity, contrast, and central scotoma, on the normal pattern reversal visual evoked response (PVER), amplitude-check size function curve in six normal subjects. The steady-state PVER was recorded with five check sizes ranging from 160 to 10 min in 1-octave increments. The PVER amplitude, especially with the smaller check sizes, was markedly decreased by light scatter induced by acrylic sheets. The function curve quickly changed to a low pass filter shape when +2.0 diopters of defocus were added, with the decrease most marked in the small check sizes. When the mean luminosity was decreased, the function curve maintained its normal inverted-U shape up to 5 cd/m2, but the shape flattened with lower luminosity. Amplitude decreases were seen with all check sizes in low luminosity. With contrast changes from 95 to 24%, the function curve maintained its normal shape, but with slightly reduced amplitudes. The amplitude decrease was moderate even with the lowest contrast. With a two-degree central scotoma, the PVER amplitude was reduced more with the smaller than the larger check sizes. The function curve became somewhat flatter, with its peak shifting to the larger check sizes. Results indicated that the shape of the PVER amplitude-check size function curve changes in response to different modes of stimulation.

Stargardt's disease/fundus flavimaculatus: psychophysical and electrophysiologic results

Retinal functions were analyzed psychophysically and electrophysiologically in 73 patients (146 eyes) with Stargardt's disease/fundus flavimaculatus. Patients were classified into types 1, 2, 3, and 4; patients with type 3 were subdivided into 3E and 3L (early and late onset of initial symptoms). Most had visual acuity (VA) of 20/200 or greater at initial testing. VA declined 0.25 octave/year during follow-up (mean, 6.1 years). Four of 16 patients (25%) older than 40 years had VA of 20/200 or less in the stronger eye. Psychophysical tests (flicker profile, central scotoma, dark adaptation) showed variable degrees of abnormalities. Electrophysiological tests showed significant photopic b-wave amplitude decreases, particularly in type 3E (42.2% of normal). The electro-oculogram light peak/dark trough ratio was abnormal in 60 of 132 eyes (45.5%), especially in type 3E (25 of 34 eyes, 73.5%). Visual prognosis and overall visual function varied depending upon disease type, location of retinal lesions, and age of onset. In Type 3E, overall retinal function was poorest and accompanied by the most severe decline of central vision and function in the surrounding macula.

[A 47-year-old woman with meningeal signs and consciousness disturbance]

We report a 47-year-old woman with SLE, who developed meningeal signs and consciousness disturbance. She noted an onset of fever, and swelling and pain in her face, hands and feet in 1990. She was seen in another hospital and the diagnosis of SLE was made. She was treated with prednisolone with marked improvement in her symptoms. She was well with 5 mg of oral prednisolone daily until January of 1991, when she developed fever, myalgia and weakness in her legs. She was admitted to the medical service of our hospital on August 5. She was receiving 15 mg of prednisolone daily. Gram positive rods were cultured from her blood on August 5. She became incoherent 2 days later, and had a convulsive episode on August 8. After the convulsion, she lost consciousness from which she did not recover. Her CSF contained 304/3 microliters cells, 29 of which were neutrophils, 6 lymphocytes, 90 others, and 179 destructed cells. The CSF protein content was 345 mg/dl, and glucose 23 mg/dl. A neurological consultation was asked on August 9. Physical examination at that time revealed a semicomatous woman. Respiration was 30/min and regular. BP 132/82 mmHg, heart rate 122/min and regular, and BT 39.6 degrees C. General physical examination was unremarkable. Pertinent neurologic findings were positive Kernig sign and spasticity in all four limbs. Brain stem reflexes were retained. Upon painful stimulation, withdrawal response was elicited both lower extremities. She was treated with pipiracillin, latamoxef and phenobarbital, however, she had frequent seizures. She was deeply comatose on December 10. She became flaccid and no more meningeal signs were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

cDNA structure, expression and nucleic acid-binding properties of three RNA-binding proteins in tobacco: occurrence of tissue-specific alternative splicing

Three cDNAs encoding RNA-binding proteins were isolated from a tobacco (Nicotiana sylvestris) cDNA library. The predicted proteins (RGP-1) are homologous to each other and consist of a consensus-sequence type RNA-binding domain of 80 amino acids in the N-terminal half and a glycine-rich domain of 61-78 amino acids in the C-terminal half. Nucleic acid-binding assay using the in vitro synthesized RGP-1 protein confirmed that it is an RNA-binding protein. Based on its strong affinity for poly(G) and poly(U), the RGP-1 proteins are suggested to bind specifically to G and/or U rich sequences. All three genes are expressed in leaves, roots, flowers and cultured cells, however, the substantial amount of pre-mRNAs are accumulated especially in roots. Sequence analysis and ribonuclease protection assay indicated that significant amounts of alternatively spliced mRNAs, which are produced by differential selection of 5' splice sites, are also present in various tissues. Tissue-specific alternative splicing was found in two of the three genes. The alternatively spliced mRNAs are also detected in polysomal fractions and are suggested to produce truncated polypeptides. A possible role of this alternative splicing is discussed.

Glaucoma as a cause of poor vision in severe retinopathy of prematurity

Despite surgical reattachment of the retina in infants with severe retinopathy of prematurity (ROP), visual acuity may decline. We performed gonioscopy and applanation tonometry on 26 eyes of 17 infants with severe ROP who were randomly selected and followed prospectively for 2 years. Of these 26 eyes, one eye of one patient had only peripheral retinocryopexy for threshold stage III disease and had an attached retina before enrollment into the study. Sixteen infants subsequently underwent vitrectomy, scleral buckle, or both. Retinal reattachment of the posterior pole was present in at least one eye each of 10 of the 17 infants. Glaucoma was diagnosed in 5 of the 10 patients; all 5 showed a decrease in visual acuity of greater than 1 octave. Of the 5 infants without glaucoma, 3 showed visual improvement, and 2 remained the same. Although we studied a small number of cases, our results suggest that glaucoma may be a cause of visual decline in infants with severe ROP. A decline in visual acuity in infants with severe ROP and surgical retinal reattachment may warn us of glaucoma, as this diagnosis is difficult to make in these small infants.