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.

Significance of high levels of serum IgA and IgA-class circulating immune complexes (IgA-CIC) in patients with non-insulin-dependent diabetes mellitus

Significance of serum IgA and IgA-class circulating immune complexes (IgA-CIC) elevation in patients with non-insulin-dependent diabetes mellitus (NIDDM) was described. Seventeen patients with NIDDM and 17 patients with diffuse mesangial proliferative glomerulonephritis without deposition of IgA (DPGN) as controls were examined. The levels of serum IgA in patients with NIDDM were significantly higher than those in patients with DPGN (p < or = 0.01). The levels of IgA-CIC in patients with NIDDM were also significantly higher than those in patients with DPGN (p < or = 0.01). Production of IgA derived from B cells and the proportion of IgA bearing B cells in patients with NIDDM were not significantly higher than those in patients with DPGN. Furthermore, the levels of IgA in pharyngeal washings from diabetic patients were not significantly higher than those for DPGN patients. Duration of diabetes, the level of HbA1c, and the presence of hypertension, microalbuminuria, or retinopathy showed no significant correlations with the levels of serum IgA or IgA-CIC in patients with NIDDM. It was postulated that the elevations of serum IgA and IgA-CIC were based on subclinical infection of the mucosa and/or deterioration of IgA clearance in patients with NIDDM.

A sensitive postcolumn derivatization/UV detection system for HPLC determination of antitumor divalent and quadrivalent platinum complexes

A sensitive postcolumn derivatization/UV detection system has been developed for HPLC analysis of antitumor divalent and quadrivalent platinum complexes. It is based on the derivatization of platinum complexes by reaction with sodium bisulfite to corresponding product(s) which has enhanced absorptivity at 280-300 nm. Platinum complexes examined in this study were cisplatin, carboplatin and oxaliplatin (divalent platinum complexes) and oxoplatin and tetraplatin (quadrivalent ones). The proposed detection system was sensitive to all these complexes. Under the detection conditions optimized for individual complexes, the HPLC gave linear relationships between the complex concentration and the peak height. Detection limits at 290 nm with 100 microliters injection were 20 nM for cisplatin, 40 nM for oxoplatin, 60 nM for carboplatin and tetraplatin and 100 nM for oxaliplatin (S/N = 3 at 0.005 AUFS). The proposed system was successfully applied for the determination of cisplatin and oxoplatin in plasma and urine. Pharmacokinetic behavior of oxoplatin and its reduced product cisplatin following a single intravenous injection of oxoplatin in rabbits has been discussed.

Infantile spasms with predominantly unilateral cerebral abnormalities

To investigate the pathogenesis of infantile spasms, 12 children underwent a combination of neurophysiologic and neuroimaging studies including brainstem evoked potentials and single photon emission computed tomography with 99mTcHMPAO. Three of the children had localized cerebral abnormalities on neuroimaging, i.e. right frontotemporal cortical microdysgenesis, left frontotemporal polymicrogyria, and right parietooccipitotemporal porencephalic cyst. Neurophysiologic studies also indicated that a single cerebral hemisphere was predominantly involved, while the other hemisphere and the brainstem were relatively spared, a result compatible with the clinical findings of hemiparesis and hemiconvulsion. In these three patients, administration of carbamazepine was followed by marked improvement of the clinical and electroencephalographic findings. Our results suggest that a combination of noninvasive examinations can distinguish a particular subtype of infantile spasms associated with a localized cerebral abnormality and responsive to carbamazepine.

Identification as beta-adducin of a protein interacting with rabphilin-3A in the presence of Ca2+ and phosphatidylserine

Rabphilin-3A is a putative target protein for Rab3A small GTP-binding protein implicated in neurotransmitter release. We have previously identified a Rabphilin-3A-interacting protein with a Mr of about 115 kDa in bovine brain. We have attempted here to purify this protein and to determine its primary structure. Amino acid sequence analysis has revealed that this protein is a bovine counterpart of human beta-adducin which is known to be a good substrate for protein kinase C. The Rabphilin-3A-interacting protein also binds to protein kinase C in the presence of Ca2+ and phosphatidylserine. These results indicate that Rabphilin-3A binds to beta-adducin in the presence of Ca2+ and phosphatidylserine.

Up-regulation of hepatic LDL receptor gene expression by monatepil, a novel calcium antagonist, in high cholesterol diet-fed Japanese monkeys

The action of the novel antihypertensive calcium antagonist monatepil on the hepatic LDL receptor was investigated at the gene expression level to clarify the mechanism of its hypolipidemic effect. In cholesterol-fed control monkeys, the LDL receptor mRNA level decreased to approximately 30% of that in the normal diet-fed monkeys. However, the administration of monatepil increased LDL receptor mRNA to normal levels (three- to fourfold stimulation). It is suggested that monatepil raises the number of LDL receptors in liver tissue and that this increase may accelerate the removal of plasma LDL. Treatment with prazosin, an alpha 1-adrenoceptor antagonist, also increased the LDL receptor mRNA level, but this restorative effect was much weaker than that of monatepil, suggesting that mechanisms additional to its alpha 1-adrenoceptor blocking activity are involved in the hypolipidemic effect of monatepil.

Elongation factor 1 alpha is a component of the subcortical actin bundles of characean algae

Antibodies to elongation factor 1 alpha (EF1 alpha), a known 50 kDa actin-bundling protein in Dictyostelium, identified a protein in a whole cell extract of the characean alga Nitella pseudoflabellata that had an apparent molecular weight of 51 kDa. Indirect immunofluorescence microscopy revealed labelling by the EF1 alpha antibodies of the subcortical actin bundles, even after the motile organelles of the endoplasm were removed by perfusion with ATP-containing solutions.

Serum hyaluronate in the assessment of liver endothelial cell function after orthotopic liver transplantation in the rat

This study was designed to evaluate the use of serum hyaluronate as a marker of liver endothelial cell function after liver transplantation. We performed orthotopic liver transplantation in both isogeneic and allogeneic rejector models. After transplantation, hepatocyte function was assessed on the basis of serum ALT and total bilirubin levels, and liver endothelial cell function was judged on the basis of serum hyaluronate levels. Significant increase of hyaluronate in the rejector model, compared with the isogeneic model, was seen before any significant results could be obtained from conventional liver function tests. The impaired metabolism of hyaluronate in the rejector model was observed after intravenous injection of trace amounts of radioactive material. Serial studies demonstrate that the endothelial cell is a more susceptible target for the immune response than the hepatocyte. Serum hyaluronate concentration may be a better indicator in the early assessment of graft function. We also examined serum hyaluronate levels to evaluate cold ischemia-reperfusion injury to the liver endothelial cells in the isogeneic model. At 2 hr after reperfusion, hyaluronate levels in the 6-hr cold ischemia (nonviable allograft) group were significantly higher than in the 1-hr and 3-hr cold ischemia (viable allograft) groups. However, there was little difference between the viable allograft groups. After an intravenous injection of 1 mg/kg hyaluronate, the hyaluronate elimination rate in the 3-hr group was distinctly slower than that in the 1-hr group. These data indicate that the hyaluronate elimination rate may be a more sensitive marker of liver endothelial cell function in viable liver after a short period of ischemia.

The effect of the partial pressure of oxygen on blood glucose concentration examined using glucose oxidase with ferricyan ion

Glucose oxidase with ferricyan ion (GOD-F) is widely applied in clinical settings as a glucose sensor. However, blood oxygen concentration affects this blood glucose value because oxygen, at increased concentrations, consumes blood glucose, which cannot then be measured by this sensor. We investigated the effect of PO2 on blood glucose concentration in 48 patients who were breathing high concentrations of oxygen. Arterial and pulmonary arterial blood glucose values were analyzed using the GOD-F method and, as a control, the hexokinase method. The respective PO2 values were also measured. The blood glucose concentrations measured by the GOD-F method show a significant linear relation with that measured by the hexokinase method in both arterial (y = -24.4 + 1.01x, r = 0.99) and pulmonary arterial blood (y = -3.4 + 1.01x, r = 0.96). The difference of intercepts is statistically significant, but because of the relatively large limits of agreement indicating any hidden extraneous variabilities, the error of the GOD-F method could not be assessed just by the difference. The equation defining the effect of PO2 on the percent change between blood glucose measured by the GOD-F method and that measured by the hexokinase method is -19.8/(1 + 203900/PO2(2.68) (r = 0.62). This formula generally follows our measured materials and introduces the relationship among blood glucose value, PO2, and the error of the GOD-F method. We hesitate to suggest that the arterial blood glucose concentration when measured by the GOD-F method could be underestimated by as much as 20% in patients with high arterial oxygen pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

[Development of the brainstem and cerebellum in autistic children]

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, these structures were significantly smaller in autistic patients than in controls. Although the brainstem and cerebellum significantly increased in size with age in both groups, the development of the pons, cerebellar vermis I-V and cerebellar vermis VI-VII was significantly more rapid in autistic patients than in controls. However, the 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. These results suggested that significant anatomical changes took place in the posterior fossa brain structures in the prenatal period in autistic children, but were not progressive.

Antihypertensive, antiatherosclerotic, and plasma lipid-lowering effects of monatepil, a novel calcium antagonist with alpha 1-adrenoceptor-blocking activity in experimental animals

Traditional antihypertensive therapy has been shown to reduce the incidence of hypertension-related vascular injuries; however, it is not fully effective against cardiovascular abnormalities. In some animal models, calcium antagonists have been demonstrated to possess antiatherogenic properties but to have no effects on plasma lipid levels, whereas alpha 1-adrenoceptor blockers have been shown to reduce plasma lipid levels. Monatepil is a new type of calcium antagonist that also has alpha 1-adrenoceptor-blocking activity. Therefore, it is thought that monatepil may have both antiatherosclerotic and plasma lipid-lowering effects in addition to its slow-onset and long-lasting antihypertensive effect. To determine the antiatherosclerotic effects of monatepil, we examined its effect on experimental atherosclerosis induced by feeding a high-cholesterol diet to monkeys, whose lipid metabolism resembles that of humans. Monatepil, at a daily dose of 30 mg/kg, at which plasma levels are equivalent to those in clinical antihypertensive therapy, was administered orally for 6 months. Monatepil suppressed elevation of cholesterol in the aorta and reduced the atherogenic (sudanophilic) area. Histologic examination revealed that monatepil-treated monkeys exhibited little aggregation of foam cells in either the aorta or coronary arteries compared with vehicle-treated atherogenic monkeys. In addition, monatepil showed preventive effects against increases in total cholesterol and low density lipoprotein (LDL), and against decreases in high density lipoprotein in plasma caused by cholesterol loading. The plasma lipid-lowering effect may be mediated through up-regulation of the number of hepatic LDL receptors by the alpha 1-adrenoceptor-blocking activity, and the antiatherosclerotic effect may be produced by the combined calcium antagonist, alpha 1-adrenoceptor-blocking, and antilipid peroxidation activities. In summary, monatepil is an antihypertensive agent belonging to a new class with antiatherogenic properties and the ability to reduce plasma lipid levels.

Spectral analysis of electromyogram in lumbar muscles: fatigue induced endurance contraction

In the last few years, epidemiological studies have shown correlations between the low endurance capacity of the erector spinae muscle and low back pain (LBP). In this study, the function of the erector spinae muscle and localized muscle fatigue in LBP were investigated in both LBP patients and control subjects without LBP, using surface multi-channel electromyograms (EMG). Four positions (L1, L2, L4, L5) were chosen as representative locations for the different functions of the erector spinae muscle. Median frequency (fm) parameters of an EMG power density spectrum were monitored to quantify localized muscle fatigue. This research indicated a statistically significant difference (P < 0.05) in fm parameters between the LBP patients and the control subjects. The integrated electromyogram (iEMG) signals of LBP patients were considerably higher than for the control subjects during endurance isometric contraction. Our research suggested that human fatiguing erector spinae muscle, in submaximal voluntary contractions tests, induced a different firing order of motor unit spikes between two groups.

[Omental pedicle flap for chronic empyema]

We have used the omental pedicle flap (OPF) method to treat 10 patients with chronic empyema secondary to pulmonary tuberculosis. Since 1987 they included 9 men and one woman ranging from 48 to 70 years in age. Two patients were required re-operation because of residual bronchopleural fistulas, and the additional procedures (muscle plombage and thoracoplasty) performed in order to close residual dead space produced more severe thoracic deformity and pulmonary dysfunction. In our first successful case, complete thoracoplasty combined with the OPF method also produced pulmonary dysfunction. On the other hand, thoracic deformity was avoided in 3 other patients and 4 patients without thoracoplasty showed better pulmonary function postoperatively. A comparison of the re-operated patients with the successful cases highlighted two important points regarding the OPF method. One is the need for firm fixation of the OPF to a fistula. We usually place a muscular pedicle flap over the OPF, and add limited thoracoplasty as necessary. The other important point is the control of infection. Open window thoracostomy before the OPF method is effective in patients with active infection. The OPF method is an effective radical operation for severe empyema even when residual dead space is present, and it can also be applied to patients with poor pulmonary function.