Proton magnetic resonance spectroscopy of brain in congenital myotonic dystrophy

Volume selective proton magnetic resonance spectroscopy of brain was performed on a 1.5 T magnet in 5 patients with congenital muscular dystrophy and compared to the results in 46 healthy children and 1 healthy adult. Peaks of N-acetyl aspartate, choline, and creatine but not lactate, were observed in both groups on proton magnetic resonance spectroscopy. Spectroscopy of controls revealed an increase with advancing age in the ratio of N-acetyl aspartate/choline and N-acetyl aspartate/creatine and a decrease in the choline/creatine ratio. In patients with congenital myotonic dystrophy, the N-acetyl aspartate/choline ratio did not increase with advancing age, but the N-acetyl aspartate/creatine ratio did. The choline/creatine ratio decreased with advancing age, which matched the results of controls. At any age older than 4 years, the N-acetyl aspartate/choline and N-acetyl aspartate/creatine ratios were lower in patients with congenital myotonic dystrophy than in controls. The choline/creatine ratio did not differ between congenital myotonic dystrophy and controls. These results suggest that in patients with congenital myotonic dystrophy N-acetyl aspartate decreases and there exists a developmental disorder of neurons in brain.

Thyroid ultrasonography in congenital isolated thyroid stimulating hormone deficiency

The effects of thyroid stimulating hormone (TSH) deficiency on thyroid development was examined using ultrasonography in a child with congenital isolated TSH deficiency. Ultrasound revealed the thyroid gland was one sixth normal volume, suggesting that TSH plays an important part in thyroid growth, but not a critical role in differentiation.

Increased serum type IV collagen 7-S levels in patients with hepatic metastasis

OBJECTIVE

The purpose of this study was to assess serum type IV collagen 7-S domain (IV 7-S) levels in colorectal cancer patients with hepatic metastasis and to investigate the relation between serum IV 7-S levels and type IV collagenase activities in tumor tissue.

METHODS

Tissue type IV collagenase activity and serum IV 7-S were measured in 50 colorectal cancer patients without hepatic metastasis and in 26 patients with hepatic metastasis.

RESULTS

Type IV collagenase showed significantly higher activities in colorectal cancer (n = 36) than in colorectal normal mucosa (n = 36) (p < 0.001), but significantly lower activities were shown in the hepatic metastatic tumor (n = 18) than in the primary tumor (n = 36) and normal liver tissue (n = 18) (p < 0.001). No significant correlation was found between type IV collagenase activities in the tumor and serum IV 7-S levels. Colorectal cancer patients with hepatic metastasis (n = 26) had significantly higher serum IV 7-S levels than those without hepatic metastasis (n = 50) (p < 0.001). Moreover, serum IV 7-S levels correlated significantly with hepatic metastatic tumor volume in patients with synchronous (r = 0.719, p < 0.001, n = 26) and in patients with metachronous (r = 0.910, p < 0.001, n = 16) hepatic metastasis.

CONCLUSION

We suggest that serum IV 7-S levels may increase in hepatic metastasis, not by the degradation of type IV collagen in the primary and secondary tumors, but by the enhanced production of type IV collagen responsive to hepatic metastasis. The measurement of serum IV 7-S levels might be a useful tumor marker of hepatic metastasis reflecting hepatic metastatic tumor volume.

[Clinical evaluation of 99mTc-MAG3 as a radiotracer to assess the function of transplanted kidney: comparison with 123I-OIH]

99mTc-MAG3 (mercaptacetyl glycilglycilglycine) is a newly developed radiopharmaceutical for the functional imaging of kidneys. We evaluated the clinical usefulness of 99mTc-MAG3 in 12 cases (7 men and 5 women, aged from 18 to 57 years old) with transplanted kidney, and compared it with 123I-OIH (o-iodohippurate). Immediately after bolus injection of 300 MBq of 99mTc-MAG3, first pass images (1 frame/3 sec for 1 min) and dynamic renal images (1 frame/60 sec for 30 min) were recorded. In 10 of 12 cases, the same examination was carried out using 37 MBq of 123I-OIH within 2 weeks. Because of its larger dose and suitable gamma-ray energy, 99mTc-MAG3 provided much better images than 123I-OIH, particulary among first pass images. Effective renal plasma flow (ERPF) calculated from the clearance of 99mTc-MAG3 was less (about 70%) than that of 123I-OIH, however, a strong correlation (r = 0.98, p < 0.001) was observed between the ERPF values of the two radiotracers. No adverse effects were caused by 99mTc-MAG3. Our data suggested that 99mTc-MAG3 was a promising radiopharmaceutical with which to evaluate regional dynamic renal function.

[Proton MR spectroscopy of the brain in patients with congenital myotonic dystrophy]

Volume selective proton MR spectroscopy (1H-MRS) of the brain was performed on a 1.5T magnet in five patients with congenital muscular dystrophy (CMyD), 46 healthy children, and one healthy adult. Peaks of N-acetylaspartate (NAA), choline (Cho) and creatine (Cr) were observed in both patients and control groups on 1H-MRS, but lactate was not observed. 1H-MRS revealed an increase in the ratio of NAA/Cho and NAA/Cr, and a decrease in Cho/Cr ratio with age in control subjects. In patients with CMyD, the values of NAA/Cho ratio did not increase with age. The values of NAA/Cr ratio decreased with age. The values of Cho/Cr ratio decreased with age in both patient and control groups. At age more than 4 years, the values of NAA/Cho and NAA/Cr ratios were lower in patients with CMyD than in controls. The values of Cho/Cr ratio did not differ between CMyD and controls. These results suggest that in patients with CMyD, there is an NAA decrease and a developmental disorder of neurons in the brain.

Pulmonary edema induced by angiotensin II in rats

We performed this study to demonstrate the experimental procedure for inducing pulmonary edema by angiotensin II (AT II) in rats and to determine the mechanism of hemodynamic pulmonary edema. In the pilot study, 10 micrograms/ml of AT II was found to be adequate as the edematogenic dose for inducing pulmonary edema. The edematogenic dose of AT II was intravenously given to rats pretreated with 20 mg/kg of an AT II-receptor antagonist, E 4177 (3-[(2'-carboxybiphenyl-4-yl)methyl]-2-cyclopropyl-7-methyl-3H- imidazo[4,5-b]pyridine), and to rats given 10 mg/kg of an alpha-adrenergic blocker, phentolamine. Similarly, pulmonary edema was induced by 25 micrograms/ml of adrenaline in rats pretreated with E 4177 (20 mg/kg) and rats with no pretreatment. E 4177 completely suppressed the development of AT II-induced pulmonary edema, whereas phentolamine could not. On the contrary, E 4177 could not suppress the development of adrenaline-induced pulmonary edema. We concluded that AT II-induced pulmonary edema will develop via the specific AT II receptor without the indirect action of adrenaline.

Polymorphism of immunoglobulin heavy chain switch region gene in children with severe IgA nephropathy

We examined restriction fragment length polymorphisms (RFLPs) of the switch region genes of the IgM (S mu) and IgA1 (S alpha 1) heavy chain in 78 Japanese children with IgA nephropathy and 88 normal Japanese controls. Genomic DNA obtained from patients and controls was digested with the restriction endonuclease SacI, transferred to nylon membrane using Southern blot procedure, and hybridized with a DNA probe homologous to S mu. This probe detects RFLPs at the S mu and S alpha 1 loci by enhanced chemiluminescence. The genotypic frequency of the S mu and S alpha 1 alleles in patients with IgA nephropathy was similar to normal controls. However, there was a significant association of genotypes with the pathological severity. There was a decreased frequency of the 2.6/2.1 kb S mu heterozygous genotype in patients showing diffuse mesangial proliferation compared to controls or patients showing minimal or focal mesangial proliferation. Our results suggest that immunoglobulin heavy chain switch region genes may not influence susceptibility to IgA nephropathy in children, but may influence the pathological expression of childhood IgA nephropathy.

Dimeric chemotactic peptides discriminate between chemotaxis and superoxide production of human neutrophils

A series of dimeric fMLPs were synthesized by cross-linking with hydrophilic linkers, mono-, di-, tri-, and tetraethylene glycols. All of the dimers showed higher activities than monomeric fMLP in chemotaxis assays for human neutrophils. The magnitude of the activity enhancement was dependent on the linker length. On the other hand, production of superoxide anion was not as enhanced as chemotaxis. The experimental results indicate that these dimers, especially the triethylene glycol-bridged fMLP dimer, D-fMLP-G3, are selective agonists for chemotaxis. In order to distinguish between biological activities and intracellular signaling, rapid mobilization of the intracellular calcium was also measured. D-fMLP-G3 strongly enhanced the calcium mobilization. These results suggest that chemotaxis was correlated with the increase of the intracellular calcium concentration, whereas NADPH oxidase was not activated to generate superoxide by this elevation of cytoplasmic calcium caused by the dimeric ligand, D-fMLP-G3. The dimeric fMLPs might act as useful ligands for studying the intracellular signaling mechanisms of human neutrophils.

[Intraportal infusion of 5-FU and lipiodol-aclarubicin after hepatic resection for colorectal liver metastasis]

Fifty-five patients with hepatic metastasis from colorectal cancer underwent curative hepatic resection. Postoperative intraportal infusion of 5-fluorouracil (500mg per day) for 14 days from 21 postoperative days (POD) and lipiodol-aclarubicin (40mg) at 35 POD was carried out in twenty-eight patients for reducing the recurrence in the remnant liver and improving the prognosis. Twenty-seven patients had hepatectomy alone as controls. Intraportal infusion chemotherapy did not induce any hepatotoxicity and hematologic severe abnormalities. The cumulative survival rates for the infusion group and the control group, respectively, were 89.3% and 63.0% at 1 year; 55.2% and 43.3% at 2 year; 27.0% and 27.5% at 3 year. The survival rate for the infusion group was significantly higher than that for the control group at 1 year (p < 0.05). No difference of the recurrent rate in the remnant liver was found between the two groups. It is suggested that intraportal infusion chemotherapy after curative hepatic resection for colorectal liver metastasis might improve survival rate at the early postoperative period. Intraportal infusion chemotherapy could be an effective adjuvant therapy especially in the patients with bilateral and multiple hepatic metastasis.

Epidemiological characteristics of human immunodeficiency virus type-2 infection in Africa

There are things yet to be clarified about African HIV-2 infection, compared to HIV-1 infection. However, the epidemiological characteristics have gradually been elucidated through various studies. HIV-2 infection is believed to have existed in the 1960s in Africa and is presently epidemic in West Africa. The HIV-2 seropositive rate for the general population is higher in urban regions than in rural areas. The peak age of persons infected with the HIV-2 tends to be higher than that of persons infected with the HIV-1, but no sex difference was recognized between the HIV-2 and HIV-1 seropositive rates. Sexual contact, mother-to-child transmission and blood transfusion have been confirmed as HIV-2 transmission modes. Prostitutes and patients with other STD are recognized as being high-risk groups for the HIV-2 infection. Patients who are infected with both HIV-1 and HIV-2 have also been identified, but it is suggested that the pathogenicity of HIV-2 is lower than that of HIV-1.

Endoscopic ultrasonographic abnormalities and lower esophageal sphincter function in reflux esophagitis

Endoscopic ultrasonography of the lower esophagus was performed in 25 patients with reflux esophagitis and 13 age-matched controls. Thickening of the esophageal wall and abnormalities of its architecture were detected. As these morphological changes became more extensive, the lower esophageal sphincter pressure and the decrease of sphincter pressure on relaxation were both progressively reduced. There was a significant correlation between morphological abnormalities and lower esophageal function. Our results suggest that inflammatory damage to the muscle layer of the lower esophagus may impair lower esophageal sphincter function further, especially in patients with advanced esophagitis.

Development of the brainstem and cerebellum in autistic patients

Studies of magnetic resonance images have revealed morphological disorders of the brainstem and cerebellum in autistic children and adults. When we studied development of the brainstem and cerebellum in autistic patients, we found that although the brainstem and cerebellum significantly increased in size with age in both autistic patients and controls, these structures were significantly smaller in autistic patients than in controls. The speed of development of the pons, the cerebellar vermis I-V and the cerebellar vermis VI-VII was significantly more rapid in autistic patients than in the controls. However, the speed of development of the other brain structures in the posterior fossa did not differ between autistic patients and controls. The regression intercepts of the brainstem and cerebellum as well as those of their components were significantly smaller in autistic patients than in controls. Results suggest that brainstem and vermian abnormalities in autism were due to an early insult and hypoplasia rather than to a progressive degenerative process.

[A case of tuberculous mesenteric lymphadenitis and peritonitis with symptoms of acute abdomen]

Both of tuberculous mesenteric lymphadenitis and tuberculous peritonitis are now rather rare in parallel with the decrease of the incidence of tuberculosis as a whole. Here, we report a case of tuberculous mesenteric lymphadenitis complicated with tuberculous peritonitis. A 28-year-old man was admitted to our hospital with pulmonary tuberculosis. Antituberculous chemotherapy was started and his chest X-ray findings were improved. After 11 weeks of the treatment, high fever of 39.0 degrees C developed suddenly and he complained right lower abdominal pain. During laparotomy performed on suspicion of acute appendicitis, swelling of mesenteric lymph-nodes, numerous miliary tubercles on mesentery and turbid ascites were noticed. Diagnoses of tuberculous mesenteric lymphadenitis and tuberculous peritonitis were confirmed by bacteriological and histological examinations of lymph-nodes and tubercles. Ileocecal resection was performed and clinical course after the surgery was favourable.

In vivo transfection of genes for renin and angiotensinogen into the glomerular cells induced phenotypic change of the mesangial cells and glomerular sclerosis

Locally activated renin angiotensin system plays an important role in the progression of the glomerular diseases. In order to understand the local effect of overexpressed angiotensin II in the glomerulus in situ, we introduced human genes for renin and angiotensinogen into the rat kidney by hemagglutinating virus of Japan-liposome procedure. Three days after transfection human renin was detected in the glomeruli by immunohistochemistry. Seven days after transfection, extracellular matrix was expanded in the glomeruli and alpha-smooth muscle actin was expressed in the mesangial cells. These results suggest that locally activated renin angiotensin system induces glomerular sclerosis and a phenotypic change in mesangial cells.

The effect of a cerebral vasodilator, vinpocetine, on cerebral vascular resistance evaluated by the Doppler ultrasonic technique in patients with cerebrovascular diseases

Changes in cerebral vascular resistance were examined in patients with cerebral circulatory diseases by the Doppler ultrasonic technique after administration of a cerebral vasodilator, vinpocetine, for two months. Continuous index (CI) and pulsatility index (PI) of the blood flow pattern in the internal carotid artery were used as objective parameters for changes in cerebral vascular resistance. 1. The CI and PI changed significantly after administration of the drug; ie, the CI increased while the PI decreased. 2. An inverse correlation was noted between the rate of change of the CI (delta CI) and that of the PI (delta PI). 3. The results suggest that measurement of the CI and PI by the Doppler ultrasonic technique is useful in investigating the effect of drugs on the cerebral circulation.

Inhibition of hepatic regeneration after 70% partial hepatectomy by simultaneous resection of the bowel in rats

This study was aimed to evaluate bow simultaneous resection of the bowel influences hepatic regeneration after partial hepatectomy (HTX). Two hundred and sixty-four rats underwent 70% partial HTX, ileocecal resection (ICR), transverse colon resection (TR), colon amputation and simulatenous resection of the liver and the bowel (HTX+ICR, HTX+TR). Hepatic DNA synthesis was remarkably suppressed by simultaneous resection compared with the 70% HTX group (p < 0.01). In simultaneous resection groups, delayed enhanced hepatic protein synthesis (HPS) was observed after the operation as compared with the 70% HTX group, which showed an early postoperative peak of HPS. Postoperative anastomosis leakage occurred more frequently and survival rates were significantly lower in simultaneous resection groups. Higher plasma endotoxin levels of the portal and the peripheral veins were found in simultaneous resection groups as compared with other groups (p < 0.01-0.001). This study suggested that simultaneous resection of the bowel with partial HTX might inhibit hepatic regeneration and result in the increased risk of anastomosis leakage and high surgical mortality rate by increased plasma endotoxin levels and delayed enhanced HPS.

Neuroimaging study of myotonic dystrophy. I. Magnetic resonance imaging of the brain

Magnetic resonance imaging scans of the brain were obtained in 13 patients with myotonic dystrophy, seven with congenital myotonic dystrophy and six with adult-type myotonic dystrophy. All seven patients with congenital myotonic dystrophy had ventriculomegaly and a low IQ (DQ). Cerebral white matter lesions were observed in six cases, a small corpus callosum in four cases, a small brainstem in two cases, and a cerebellar white matter lesion in one case. Cerebral white matter lesions were observed in five of the six cases with adult-type myotonic dystrophy of which one had ventriculomegaly. The IQ (DQ) was significantly lower in patients with congenital myotonic dystrophy than in those with adult-type myotonic dystrophy. The incidence of a small corpus callosum or ventricular enlargement was higher in congenital myotonic dystrophy than in adult-type myotonic dystrophy. These findings may be related to the presence of neurologic impairment in congenital myotonic dystrophy.

Rabphilin-3A binds to a M(r) 115,000 polypeptide in a phosphatidylserine- and Ca(2+)-dependent manner

Rabphilin-3A is a putative target protein for Rab3A/Smg 25A, which is a member of the Ras-related small GTP-binding protein and implicated in neurotransmitter release from the synapse. Rabphilin-3A is composed of two functionally different domains: the N-terminal Rab3A-binding and the C-terminal phosphatidylserine- and Ca(2+)-binding domains. The C-terminal domain has two copies of an internal repeat that are homologous to the C2 domains of protein kinase C, synaptotagmin, and phospholipase A2 and C-gamma 1, which are known to bind phosphatidylserine and Ca2+. In this study, we attempted to identify the Rabphilin-3A-interacting molecule in bovine brain by use of an overlay assay technique. The 32P-labeled C-terminal fragment of Rabphilin-3A (281-704 amino acids) bound to a protein molecule with a M(r) of about 115 kDa which was immobilized on a nitrocellulose sheet. This protein was highly purified and characterized. The binding of the 32P-labeled C-terminal fragment to this protein was dependent on both phosphatidylserine and Ca2+, and inhibited by an excess amount of the C-terminal fragment and the C2 domain fragment (396-704 amino acids) but not by the N-terminal fragment (1-280 amino acids). These results indicate that Rabphilin-3A binds to a protein molecule with a M(r) of 115 kDa through the C2 domain in the presence of phosphatidylserine and Ca2+.

Effect of carbachol on the release of peptide YY from isolated vascularly and luminally perfused rat ileum

Possible cholinergic control on the release of PYY from intestine into the lumen or blood vessel was studied by radioimmunoassay in the isolated perfused rat ileum. The basal release of PYY into the lumen was 43.1 +/- 8.9 pg/min, which was comparable with that into the vasculature (35.2 +/- 2.6 pg/min). The administration of 1 microM carbachol into the vascular perfusate resulted in a more than 40-fold increase of the luminal release but only a twofold increase of the vascular release. Carbachol-induced release of PYY into both lumen and vasculature was completely blocked by atropine, but not by hexamethonium. Tetrodotoxin abolished carbachol-induced release of PYY into lumen and vasculature. These data suggest that the ileal PYY release, into either lumen or vasculature, is under the control of postganglionic cholinergic neurons via muscarinic receptors.

Influence of irradiation sequence on dentin bond of resin inlays

The relationship between the order in which a dual-cured resin cement is light activated and the bond strength of resin inlay materials to dentin was examined. Also evaluated was the setting time with various irradiation sequences. Lite-Fil CR/Imperva Bond (Shofu) and Clearfil CR/CR Cement (Kuraray) were employed. Ten specimens, 4 mm in diameter by 4 mm deep, were made with each material for each condition and bonded to bovine dentin with the respective bonding agent and cement. Order of light activation was: 1) no light activation; 2) premix activation of only the liquid prior to mix, 3 seconds for Lite-Fil and 25 seconds for Clearfil; 3) postplacement activation, 30 seconds for Lite-Fil and 40 seconds for Clearfil; and 4) premix and postplacement activation, 3 seconds and 30 seconds for Lite-Fil and 25 seconds and 40 seconds for Clearfil. Samples were stored in water for 24 hours and shear strength tested. The setting time with no activation and premix activation was measured according to the ISO #7489 standards. Bond strengths (MPa) were 1) 4.41, 2) 13.07, 3) 6.34, and 4) 14.81 for Lite-Fil, and 1) 0.37, 2) 2.44, 3) 0.52, and 4) 2.51 for Clearfil. No light activation or only postplacement activation resulted in lower bond strengths with a 4.0 mm-thick specimen. The setting time of the cement mix with premix activation was shorter than with no activation. Light activation of these dual-cure cements is essential. Premix activation of only the liquid resulted in bond strengths similar to those obtained with combined pre- and postplacement activating.

Neuroimaging study of myotonic dystrophy. II. MRI measurements of the brain

The brain of patients with adult type myotonic dystrophy was measured using MRI, and compared with age- and sex-matched controls. The width of the cerebrum, and the areas of the corpus callosum, pons and pituitary gland were significantly smaller in adult-type myotonic dystrophy than in the controls. The IQ of the patients with adult-type myotonic dystrophy was lower than that of controls. These results demonstrate a decreased volume of the brain and pituitary glands in myotonic dystrophy. These findings suggest a causal relationship for the mental retardation and endocrine dysfunction that may occur.