[Surgical treatment of atlanto-axial dislocation in a patient of athetoid cerebral palsy]

The authors report a case of successful surgical treatment of atlanto-axial dislocation (AAD) secondary to athetoid cerebral palsy. A 61-year-old woman was admitted to our hospital in July 1993 complaining of progressive weakness in the right upper extremity and gait disturbance. She had been suffering from athetoid movements of her face, neck and arms due to cerebral palsy. Neurological examinations on admission revealed down-beat nystagmus on downward gazing, motor weakness of extremities, pallhypesthesia, hyperreflexia exaggerated in the right side and bilateral positive pathological reflexes. Lateral tomogram of the upper cervical spine demonstrated instability of the atlanto-axial joint, increased atlanto-dental interval (ADI) by 5.5 mm (in flexion), and narrowed canal at C1 level. Myelogram showed narrowed dural sac and angulation of the spinal cord at C1 level. A halo vest was applied two days before operation for reduction of the atlanto-axial junction and external fixation. She underwent posterior internal fixation using a Hartshill Ransford Loop combined with posterior decompression. This loop was secured to the occiput, C1, C2 and C3 by sublaminar wiring, and foramen magnum decompression and laminectomy of C1 were performed. Postoperative course was uneventful. Postoperative plain X-ray film, tomogram and computed tomography demonstrated good fixation (ADI was 2.5 mm) and excellent stability. There has been no problem during 6 months since the operation. It is known that involuntary movements in patients with athetoid cerebral palsy sometimes cause cervical spondylosis (especially at C3/4 and C4/5 level). Recently, AAD due to athetoid cerebral palsy has been reported. Almost every case of AAD secondary to athetoid cerebral palsy is combined with incompetence of the odontoid process.(ABSTRACT TRUNCATED AT 250 WORDS)

Interleukin-4 acts as a potent stimulator for expression of monocyte chemoattractant JE/MCP-1 in mouse peritoneal macrophages

The recruitment of monocyte/macrophages to inflammatory sites is one of the important events in inflammatory reactions. We show herein that interleukin-4 (IL-4) acts as a potent stimulator for expression of monocyte chemoattractant JE/MCP-1 in mouse peritoneal macrophages. IL-4 induced the JE/MCP-1 gene expression in dose and time dependent fashion. Run-on assay suggests that IL-4 stimulates the JE/MCP-1 gene expression at transcriptional level. Monocyte chemotactic activity was detected in culture medium of the cytokine-treated cells. The chemotactic activity in the culture supernatant was completely neutralized by anti-JE/MCP-1 antiserum.

[A case of dumbbell-shaped hypoglossal neurinoma]

The authors report a case of dumbbell-shaped hypoglossal neurinoma. A 46-year-old female was admitted to our clinic with a history of right hemiatrophy of the tongue for more than 10 years and bilateral paresthesia on the face and legs for half a year. Neurological findings on admission were right hypoglossal palsy, attenuation of right gag and palatal reflex, mild truncal ataxia, right Bruns nystagmus, bilateral paresthesia on the face and legs (left > right), bilateral hyper-reflexia on the extremities. No sign of increased intracranial pressure was noted. Conventional computed tomography demonstrated the bone destruction around the right hypoglossal canal, and three-demensional computed tomography clearly revealed the extent of the bone destruction. Magnetic resonance imaging showed a large dumbbell-shaped mass extending both intra-and extra-cranially through the right hypoglossal canal, which severely compressed the brainstem postero-medially. Right suboccipital craniotomy with C1 laminectomy was performed in the prone position, and the occipital bone was drilled far-laterally around the Foramen Magnum with right occipital condyle rongeured to expose the intracanallicular mass. The mass was totally removed except around the IX Xth cranial nerves near the jugular foramen. Hypoglossal neurinoma is rare, and our case is the 62nd case, and the 15th dumbbell-shaped case in the literature. Hypoglossal nerve palsy is characteristic in dumbbell-shaped hypoglossal neurinoma. Enlargement of the hypoglossal canal can be detected by conventional and three-dimensional CT. MRI is more effective than CT in revealing the mass. Total removal of the dumbbell-shaped tumor requires that the hypoglossal canal can be exposed sufficiently.(ABSTRACT TRUNCATED AT 250 WORDS)

Colorimetric microdetermination of l-lactate in deproteinized blood

The method by MacQueen and Plaut was modified to devise simple microdetermination method of l-lactate which is applicable to deproteinized blood sample. Blood was deproteinized with addition of 25% (w/w) trichloroacetic acid (TCA), and 0.075 M 2-amino-2-methyl-1, 3-propanediole (AMPD) was used to make pH of the reaction mixture optimal. It was validated in recovery and precision study, and showed good correlation with usual UV method; correlation coefficient was 0.985, and slope was 0.994. TCA-blood mixture may be kept at room temperature for at least 2 hr without centrifugation, and the supernatant may be preserved for at least 2 weeks at 4 degrees C.

Increased plasma gluconeogenic and system A amino acids in patients with pancreatic diabetes due to chronic pancreatitis in comparison with primary diabetes

We examined the plasma amino acid profiles of 17 patients with pancreatic diabetes in comparison with those of 14 healthy subjects and 16 patients with primary diabetes of similarly poor glycemic control. We also measured fasting plasma glucagon and free insulin levels in patients with pancreatic diabetes and in those with primary diabetes. The fasting plasma amino acid level was highest in patients with pancreatic diabetes. Furthermore, the plasma glucagon level in patients with pancreatic diabetes was significantly low, and negative correlations were found between glucagon and glucagon-related System A and gluconeogenic amino acids. On the other hand, the levels of branched-chain amino acids (BCAA) and System L amino acids, which are subjected to change in the state of diabetes mellitus, increased in patients with pancreatic diabetes. From the above results, we determined that the amino acid profile in patients with pancreatic diabetes resembled that in patients with total pancreatectomy. It is our opinion that the increases of amino acid levels (gluconeogenic and System A amino acids) in patients with pancreatic diabetes is not dependent on maldigestion/malabsorption under treatment, but is mainly dependent on glucagon deficiency.

The role of cerebrospinal fluid cytology in radiotherapy planning for intracranial germinoma

PURPOSE

The association between the cerebrospinal fluid cytology findings and the clinical features of patients with intracranial germinoma was investigated to determine whether cerebrospinal fluid cytology could be helpful in determining the optimal radiation treatment volume.

METHODS AND MATERIALS

Between 1976 and 1992, cerebrospinal fluid cytology was performed in 42 germinoma patients using a cytocentrifugation method. Forty patients received irradiation and 2 received chemotherapy with cisplatin and etoposide.

RESULTS

Cerebrospinal fluid cytology was positive in 22 of the 42 patients (52%). Dissemination via cerebrospinal fluid (intraventricular or spinal) was present at the initial diagnosis in eight (36%) of the 22 cytology-positive patients and none of the 20 negative patients. After treatment, cerebrospinal fluid dissemination developed in four (18%) of the cytology-positive patients and one (5%) of the negative patients. Two of the former four patients had received chemotherapy alone as initial treatment. Five patients with positive cytology received irradiation to a smaller volume than the cerebrospinal axis (primary tumor site plus spinal axis in three and whole brain in two), but they have not developed recurrence in the 4 to 14 years since therapy. The 5-year survival rate was 93% for the cytology-positive patients and 94% for the negative patients.

CONCLUSION

Cerebrospinal fluid cytology-positive patients have a higher risk of cerebrospinal fluid dissemination and it seems reasonable to give them low-dose (20-24 Gy) prophylactic craniospinal irradiation. When properly irradiated, the prognosis of cytology-positive patients is as good as that of negative patients.

Differential induction of mRNA species encoding several classes of stress proteins following focal cerebral ischemia in rats

We report here the time-dependent expression of several classes of HSP mRNAs following focal cerebral ischemia in rats. HSP70, GRP78, HSP27, HSP90 and HSP47 have been reported to possess distinct functions under normal and/or stress conditions. These different classes of HSP mRNAs were differentially induced by ischemia, as determined by Northern blot analysis. Messenger RNAs of the HSP70 family proteins were induced within 4 h after ischemia and then rapidly decreased, whereas HSP27 and HSP47 mRNAs reached a maximum level of expression at 24 h and 48 h after ischemic treatment, respectively. In situ hybridization showed that the expression of inducible HSP70 mRNA was observed predominantly in regions adjacent to the ischemic core except during the early periods of ischemia. HSP27 mRNA was expressed over a broad area of the ipsilateral cerebral neocortex except for the ischemic center 24 h after ischemia. The unique induction kinetics for each HSP mRNA species may reflect their distinct roles in the brain during various physiological stresses. We will also discuss that stress proteins may be involved in the central nervous system after ischemia in two important aspects: early protection against stress and restoration of damaged lesions in the brain at later stages after ischemia.

Immunohistochemical reactions for fibroblast growth factor receptor in arteries of patients with moyamoya disease

The cause of moyamoya disease remains unknown, and pathophysiological mechanisms remain uncertain. Basic fibroblast growth factor (FGF) is a pluripotent polypeptide that has been shown to play roles in angiogenesis, tumorigenesis and many other processes. In a previous study, we demonstrated immunohistochemically that the amount of basic FGF was increased above normal in the superficial temporal artery (STA) of patients with moyamoya disease. To clarify the function of basic FGF in moyamoya disease, we have performed an immunohistochemical study of the STA using a polyclonal antihuman FGF receptor antibody and also have tested immunohistochemical reactions for basic FGF. Twelve surgical specimens of the STA from patients with moyamoya disease were studied. Twelve specimens of the STA from skin flaps of patients with other neurological diseases were also investigated for comparison. The sections of the STA from patients with moyamoya disease showed dense and strong FGF receptor and basic FGF immunoreactivity in endothelial cells, in cells scattered in the thickened intima, and in smooth muscle cells in the media. In contrast, the sections of the STA of control patients showed faint basic FGF immunoreactivity. The statistical analysis revealed a significant difference of basic FGF immunoreactivity between moyamoya disease and other neurological diseases (chi 2 = 23; P = 0.0001). Moderately intense FGF receptor immunoreactivity was observed in most control patients. However, the statistical analysis revealed a significant difference of FGF receptor immunoreactivity between moyamoya disease and other neurological diseases (chi 2 = 13.382; P = 0.0012).(ABSTRACT TRUNCATED AT 250 WORDS)

Interferon-gamma induces a decrease in the susceptibility of human glioma cells to lysis by lymphokine-activated killer cells

We studied the effect that treating two types of glioblastoma cell lines, U-87 MG and U-251 MG, with interferon (IFN)-gamma had on their susceptibility to lysis by lymphokine-activated killer (LAK) cells. We also examined the participation of cell-adhesion molecules and major histocompatibility complex (MHC) class I and II antigens present on the target cells in lysis by LAK cells. Treatment with IFN-gamma (1000 U/ml) for 48 hours resulted in the increased expression of both intercellular-adhesion molecule 1 and MHC class I antigens on tumor cells. In addition, untreated tumor cells expressed neural-cell-adhesion molecules and MHC class II antigens highly, but their expression was not affected by IFN-gamma treatment. These changes in expression were accompanied by a decreased susceptibility to lysis by LAK cells. Treatment with antisense-intercellular-adhesion molecule-1 oligonucleotide further inhibited LAK lysis of target cells, following treatment with IFN-gamma. In contrast, acid treatment of tumor cells after treatment with IFN-gamma increased their susceptibility to lysis by LAK cells. These findings suggest that treatment of glioblastoma cells with IFN-gamma decreased their susceptibility to lysis by LAK cells, and that this decrease in susceptibility is attributable principally to the increased expression of MHC class I antigen on target cells.

Aberrant CYP1A1 induction: discrepancy of CYP1A1 mRNA and aryl hydrocarbon hydroxylase activity in mutant cells of mouse hepatoma line, Hepa-1

We have isolated new benzo[a]pyrene-resistant clones, cl-21 and cl-32, of the mouse hepatoma line, Hepa-1. CYP1A1-dependent aryl hydrocarbon hydroxylase activity is not inducible by 2,3,7,8-tetrachlorodibenzo-p-dioxin or 3-methylcholanthrene in these two cell lines. However, mRNA of CYP1A1 is inducible in cl-21 and cl-32 cells, as in the wild-type cells, in spite of an undetectable level of cytosolic Ah receptor. The cl-21 cDNA of Cyp1a-1 was found to have a single mutation leading to an amino acid substitution from Leu (118) to Arg (118). However, the CYP1A1 protein band was not detected on Western immunoblots. The cDNA of cl-32 was found to have a single mutation leading to an amino acid change from Arg (359) to Trp (359). The presence of the mature protein in cl-32 was confirmed by Western blot analysis. Somatic cell hybridization experiments demonstrated that the phenotype of cl-21 and cl-32 is recessive and that these clones belong to the same complementation group. These data suggest that there may be a non-Ah receptor-mediated mechanism of CYP1A1 induction.

Characteristics of ethylene vinyl alcohol copolymer (EVAL) mixtures

PURPOSE

To determine physical characteristics of mixtures of ethylene vinyl alcohol copolymer (EVAL) and metrizamide dissolved in dimethyl sulfoxide, liquid materials developed for embolization of arteriovenous malformations.

METHODS

EVAL and dimethyl sulfoxide were mixed in various proportions and sterilized. The viscosity and density of each mixture was measured. Precipitation times were determined by dropping the mixtures into saline or human blood. The mixtures were filtered and the filtrates weighed.

RESULTS

Densities and viscosities of the various mixtures differed significantly, proportionally to the concentration of EVAL. Precipitation times also differed significantly, in inverse proportion to the concentration of EVAL. Temperature and aqueous solution did not affect precipitation times significantly. The weight of the filtrate significantly increased with time but was constant for each precipitation time. Temperature significantly affected filtrate weight; aqueous solution did not.

CONCLUSIONS

Because of their different physical properties, the various EVAL mixtures are suited to embolizing different types of arteriovenous malformations.

Transfection with a bcl-2 expression vector protects transplanted bone marrow from chemotherapy-induced myelosuppression

The use of cytokines such as granulocyte-colony-stimulating factor (G-CSF) to ameliorate chemotherapy-induced myelosuppression may not only stimulate the recovery of normal hematopoietic cells but may also enhance the proliferation of the tumor cells with functional receptors for these cytokines. In this study, we show that administration of recombinant human (rh) G-CSF decreased the in vitro and in vivo cytotoxic effects of Adriamycin or etoposide on L1210 murine leukemic cells with receptors for rhG-CSF. Transplantation of bone marrow cells expressing high levels of bcl-2 from a retroviral construct [MPZenNeo(bcl-2)] (bcl-2-BMT) did not decrease the in vivo cytotoxic effect of etoposide on L1210 cells, but enabled recovery of myelopoiesis following etoposide-induced myelosuppression to almost the same extent as did the administration of rhG-CSF. These findings suggest the possibility that bcl-2 transfection could be used to protect transplanted bone marrow from chemotherapy-induced myelosuppression on behalf of administration of rhG-CSF, in case of treatment of tumors with functional receptors for rhG-CSF.

Decreased gastric secretory functions in diabetic patients with autonomic neuropathy

A total of 37 subjects consisted of 10 healthy subjects (Group III), 15 diabetic patients without autonomic neuropathy (Group II), and 12 diabetic patients with autonomic neuropathy including gastroparesis in 6 cases (Group I). All three groups were comparable in age. In order to clarify the gastric function in diabetic patients with autonomic neuropathy, secretion of serum gastrin, gastric secretory function, endoscopic Congo red test of fundic glands, and coefficiency of variance of electrocardiographic beat-to-beat intervals (C.V. R-R) were examined. In Group I, 5 patients had hypergastrinemia, but its elevation was inhibited when an acid solution was injected into the stomach. Gastric secretion and C.V. R-R were markedly lower in Group I, compared with Groups II and III. In Group I, the area of fundic glands (parietal cells) was reduced considerably. The C.V. R-R was significantly correlated with fasting serum gastrin concentration and with maximal acid output. From these results, in diabetic patients with autonomic neuropathy (vagal neuropathy), gastric acid secretion in response to tetragastrin stimulation was lowered with a reduction in area of fundic gland distribution. Hypergastrinemia may reflect a negative feedback mechanism responding to decreased acidity of gastric content in the antrum.

[Clinico-epidemiologic study of infantile hydrocephalus in Japan]

A nation-wide survey on congenital hydrocephalus, including secondary hydrocephalus occurring within one year after birth, was carried out in 1988. The number of patients with congenital hydrocephalus treated during the previous one year was estimated to be 3,200-3,500 throughout Japan. The number of new cases of this disease which occurred during the year was calculated to be 800. This indicates a rate of 0.58 per 1,000 live births. Clinico-epidemiologic features were compared with regard to three subjects listed below. (1) The difference between the epidemiologic profile of term and preterm infants with hydrocephalus was investigated. As for etiology, the incidences of primary hydrocephalus and hydrocephalus complicated by Arnold-Chiari malformation type II and meningocele were significantly higher in term infants than in preterm infants. It was estimated that about 30% of the hydrocephalus in preterm infants and only 7.7% in term infants occurred as a consequence of intracranial hemorrhage. The degree of neurological impairment and the mortality rate were higher in preterm infants than term infants. (2) The changing panorama of infantile hydrocephalus in Japan was investigated comparing the epidemiologic data of four groups according to the birth year. As for pregnancy period, preterm infants with hydrocephalus were gradually increasing recently. Hydrocephalus secondary to intracranial hemorrhage was increasing and that secondary to intracranial infection was decreasing. The rate of shunt malfunction was decreasing significantly. (3) Clinico-epidemiologic features of intractable hydrocephalus based on the diagnostic criteria of the research committee was investigated comparing intractable with non-intractable groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Selective uptake of liposomes containing lactose mono-fatty acid derivatives by hepatic parenchymal cells

In this study we investigated the hepatic uptake of liposomes containing a novel synthetic glycolipid, lactose mono-arachidic acid amide (LAA). Liposomes containing LAA were aggregated by Ricinus communis agglutinin from caster bean, while the control liposomes were not, and the results suggested that the galactose residues of LAA were exposed to the outer surface of the liposomes. Next, the blood clearance and hepatic uptake of liposomes containing LAA after intravenous administration were compared with those of the control liposomes in rat. Hepatic uptake of liposomes containing LAA was greater than that of the control liposomes, rising significantly with dose. As a result of separation of the parenchymal and non-parenchymal cells, it was shown that the increase in hepatic uptake was mostly accounted for by a greater uptake by parenchymal cells. The inhibitory activity of asialofetuin on the hepatic uptake of liposomes containing LAA suggested that a galactose-specific recognition is involved in this uptake. These results demonstrate that the lactose mono-fatty acid amides (LFAs) are promising novel compounds for the introduction of carbohydrate residues onto the liposomal surface and that liposomes containing LFAs are potential carriers for the selective delivery of drugs to specific cells.

[Perioperative management of coagulation and fibrinolytic activity in endosaccular embolization of cerebral aneurysms]

Endosaccular embolization is an innovative and effective treatment for surgically formidable cerebral aneurysms. Platinum microcoils are soft, easily fit to complex configuration of aneurysms, highly thrombogenic, so that suitable for this purpose. Recently developed Guglielmi detachable coils have more advantages in terms of retrievability and electrothrombotic effect. However, distal migration of intraaneurysmal thrombus produces thromboembolism in normal cerebral arteries, leading to neurological deficits. Three cases are presented in which thromboembolic complications occurred during or after embolization of cerebral aneurysms with platinum microcoils. Emergent fibrinolytic treatment resolved neurological deficits in each case without any other complications. From these lessons, a protocol of intra- and postoperative anticoagulation and antiplatelet therapy is presented. In conclusion, perioperative management of fibrinolytic and coagulation activity is extremely important in preventing thromboembolic complication and obtaining successful result.

Scintigraphic detection of neural-cell-derived small-cell lung cancer using glioma-specific antibody

Radiolabeled GA-17, a murine monoclonal antibody that reacts specifically with glioma cells, bound to a small-cell lung cancer (SCLC) cell line NCI-H69 derived from neural cells, both in vitro and in vivo. The affinity constant of GA-17 F (ab')2 fragment binding to NCI-H69 was 1.02 x 10(8)/M while that to the glioma cell line U87MG was 1.22 x 10(8)/M. Iodine-125-labeled GA-17 F(ab')2 fragments injected i.v. localized well in NCI-H69 cells xenografted in nude mice. The percentage of the injected dose per gram accumulated in the xenografted tumor was 6.87 +/- 1.34% g-1 (mean +/- SD, n = 5) 24 h after injection. On the other hand, control monoclonal F(ab')2 fragments accumulated in the xenografted tumor at 0.75 +/- 0.30% g-1. The tumor-to-blood ratio was 1.8 for NCI-H69, while that of control F(ab')2 was 0.60. In conclusion, the radiolabeled GA-17 F(ab')2 fragment is expected to be useful clinically to visualize the small-cell lung cancer and in radioimmunotherapy.

Immunohistochemical study for basic fibroblast growth factor and fibroblast growth factor receptor I in pituitary adenomas

Immunohistochemistry and RT-PCR of basic fibroblast growth factor (bFGF) and one of its receptors (FGFR-I) were performed in pituitary adenomas. Sixty percent of pituitary adenomas showed strong or moderate immunoreactivity to bFGF. The immunoreactivity for FGFR-I in tumor tissues showed positive correlation to that for bFGF (X2 = 6.176, P = 0.0456). Basic FGF-positive cells consisted of pituitary adenoma cells as well as folliculostellate cells and, their distribution was heterogeneous. Expressions of bFGF and FGFR-I were not related to cell proliferation of pituitary adenomas or hormones produced, suggesting that bFGF plays some role other than progression of pituitary adenomas.

Ischemia-induced changes in catecholamine release and their mechanisms: a study using cultured bovine adrenal chromaffin cells

Ischemia-induced changes in neurotransmitter release and their mechanisms were examined using cultured bovine adrenal chromaffin cells. When the cells were incubated in glucose-free media equilibrated with 0% O2/100% N2 (ischemia), ATP content decreased and reached the minimum level within 40 min. Control incubation was done in media equilibrated with 21% O2 in N2. After 10-min incubation under ischemic conditions, basal catecholamine (CA) release was elevated and the elevation persisted up to 90 min. High K(+)-evoked CA release was transiently enhanced at 10 min, but after that, it decreased to reach the minimum level at 60 min. At 10 min, cytosolic free Ca2+ concentration ([Ca2+]i) and 45Ca2+ uptake of the resting cells (basal values) and high K(+)-evoked increases in these two parameters were unchanged, but CA release from permeabilized cells in response to Ca2+ in media was augmented. After 60-min incubation under ischemic conditions, basal [Ca2+]i was elevated: the elevation was observed even in the absence of extracellular Ca2+. In contrast, high K(+)-evoked increases in [Ca2+]i and in 45Ca2+ uptake were suppressed, but basal 45Ca2+ uptake into intact cells and CA release from permeabilized cells were unchanged. These results suggest that in an early phase (10 min) of ischemia, both basal and stimulation-evoked CA release are augmented because of increased sensitivity of exocytotic machinery to Ca2+. In the late phase (60 min), basal CA release is augmented because of an increase in basal [Ca2+]i, which is due to accumulation of Ca2+ derived from intracellular Ca2+ pools: stimulation-evoked CA release is suppressed because of inhibition of stimulation-evoked increase in [Ca2+]i, which is due to functional disturbance of voltage-dependent Ca2+ channels.

LTP of mossy fiber-stimulated potentials in CA3 during learning in rats

The study was done to determine whether long-term potentiation (LTP) of the potentials occurs at mossy fiber (MF)-CA3 synapses with the advance of learning in unrestrained and unanesthetized rats. The rats were divided into two groups, the test and control groups. The test group was given daily learning tasks in the radial arm maze, whereas the control group was similarly handled without learning tasks. Complete acquisition of learning was observed in the test group on day 5, and the learning was maintained over 3 days. Under freely moving conditions, a significant increase in population spikes (PS) elicited by MF stimulation with the progress in learning was observed in the test group, and the PS potentiation remained stable after day 4. Furthermore, on day 7, when MF stimulation-induced PS in the test group were compared with that in the control group in pentobarbital-anesthetized rats, the responses were comparatively higher in the former. As the training-induced PS potentiation in CA3 occurred with the advance of learning, these findings suggest that LTP in CA3 induced by learning may be related to memory storage.

Tumour necrosis factor-alpha induces an increase in susceptibility of human glioblastoma U87-MG cells to natural killer cell-mediated lysis

The mechanism by which tumour necrosis factor (TNF)-alpha increases the susceptibility of U87-MG human glioblastoma cells to lysis by natural killer (NK) cells was studied. Treatment with TNF-alpha (100 units ml-1) for 48 h enhanced the susceptibility of tumour cells to lysis by NK cells. Increased susceptibility to lysis was associated with enhanced expression of intercellular adhesion molecule 1 (ICAM-1) and HLA class I antigen. Antisense ICAM-1 oligonucleotide inhibited lysis by NK cells of TNF-alpha-treated tumour cells. In contrast, acid treatment following TNF-alpha treatment increased lysis by NK cells. These findings indicate that TNF-alpha treatment of glioblastoma cells increased their susceptibility to lysis by NK cells, since ICAM-1 up-regulation would have more profound effects on NK susceptibility than would HLA class I antigen up-regulation.

Restriction fragment length polymorphism of the human CYP2E1 (cytochrome P450IIE1) gene and susceptibility to lung cancer: possible relevance to low smoking exposure

Polymorphic metabolism of certain chemical carcinogens may result in differences in susceptibility to cancers. Human CYP2E1 (cytochrome P450IIE1) is an enzyme involved in the metabolic activation of precarcinogens such as nitrosamines. We detected a restriction fragment length polymorphism (RFLP) of the human CYP2E1 gene for the restriction endonuclease Dra I. The distribution of this polymorphism was examined among lung cancer patients (n = 91), patients with cancer of the digestive tract (n = 45) and controls (n = 76). A significant difference in the distribution was observed between lung cancer patients and controls (chi 2 = 11.4 with 2 df; p < 0.005). On the other hand, there was no significant difference between patients between cancer of the digestive tract and controls (chi 2 = 4.87 with 2 df; NS). This finding suggests that the Dra I polymorphism of the CYP2E1 gene is associated with susceptibility to lung cancer. In addition, an association was found between the amount of lifelong smoking exposure and the distribution of the genotypes of the RFLP among lung cancer patients. The distribution pattern seemed deviated from that of controls especially in the population of low smoking exposure. Our Northern blot analysis data using RNA from human liver autopsy samples suggest that the Dra I polymorphism might be associated with the gene expression of CYP2E1 at mRNA level.

[Idiopathic normal pressure hydrocephalus in the aged]

Continuous lumbar cerebrospinal fluid pressure measurement was made in 19 cases of aged patients suspected of idiopathic normal pressure hydrocephalus. Based on the pressure study, they were divided into high pressure group (H group) and normal pressure group (N group). H group was composed of 11 cases and N group of 8 cases. Baseline pressures in H group and N group were 16.3 +/- 3.0 mmHg, 9.6 +/- 1.7 mmHg, respectively and the difference was statistically significant. Pulse pressure was high in H group and frequency of pressure waves was also significantly high in H group. There were no significant differences in clinical symptoms and CT findings between the two groups, except for clinical improvement after cerebrospinal fluid removal, which was noted in all of 6 cases examined in H group. No difference between them was noted on CT cisternography and cerebral blood flow measurement. Shunt surgery was carried out in the cases of H group and it was effective in 8 of 11 cases (72.7%). Thus, continuous lumbar cerebrospinal fluid measurement was useful for selection of idiopathic normal pressure hydrocephalus in the aged.