Purification and characterization of a novel growth factor (FF-GF) synthesized by a rat hepatoma cell line, FF101

A rat hepatoma cell line, FF101, established in serum-free, protein-free medium, synthesizes a growth factor(FF-GF). FF-GF was purified by gel filtration chromatography, cation-exchange chromatography and isoelectric focusing. Purified FF-GF was revealed as a single band on SDS-gel electrophoresis and its molecular weight was estimated to be 70 KDa. FF-GF stimulated DNA synthesis of various cells from different origins. The growth-promoting activities of FF-GF were abolished by treating with protease, dithiothreitol, acid and heating, whereas its activity was not inhibited by antibodies against acidic and basic fibroblast growth factors. These results indicate that FF-GF is a novel growth factor.

Chiba Spinal System in the operative management of scoliosis

The Chiba Spinal System was developed for three-dimensional correction of scoliosis. The system consists of a 7-mm diameter smooth solid rod, closed and open hooks, and specially designed conical sleeves. The rod does not have ratchets or threads, thus minimizing stress concentrations. The closed and open hooks are attached to the rod using the conical sleeves. The sleeves have longitudinal slits permitting compression during insertion. The outrigger system with a torque wrench is used to correct the deformity in the frontal plane. When correcting lordosis with vertebral rotation, a sagittal correction device may be used. Fifty-two patients with idiopathic scoliosis were operated on with this system from 1986 through 1989. The average correction of the scoliosis was 58%. For the 21 patients with thoracic lordosis less than 0 degrees, the mean preoperative lordosis was -8 degrees, which was corrected to +7 degrees. The mean correction of the vertebral rotation was 24%. Two patients complained of paresthesia of the thoracic region after operation, but this disappeared within 2 weeks. In 32 patients with more than 2 years' follow-up, the mean loss of correction was 3 degrees. One case with instrumentation failure was noted.

Micturitional disturbance in tumors of the lumbosacral area

Neurourological studies were performed on 15 patients with tumors at or below the first lumbar vertebra. Micturitional history revealed that 14 patients (93%) had voiding symptoms. Four patients had incontinence and three had urinary retention. Urodynamic studies revealed that three of six patients tested had abnormal uroflowmetrograms. Urinary residuals greater than 100 ml were observed in 6 of 12 patients. Detrusor hyperreflexia occurred in 3 of 15 patients, 4 of 15 had low-compliance detrusor, and 2 of 15 had detrusor-sphincter dyssynergia. There were no differences in lower-extremity neurological signs in patients with or without incontinence, and patients with or without large residual urine and urinary retention.

Mechanical stability of the pedicle screw fixation systems for the lumbar spine

Five different pedicle screw systems: AO Fixator Interne, VSP Steffee plate, Luque ISF, modified Zielke, and Chiba-type plate screw system (experimental device), were evaluated for biomechanical strength. A fatigue test for the screw, compressive, and torsional tests for the pedicle screw systems and a pull-out test of the pedicle screw were done. Even the Schanz screw, which showed the highest endurance limit, may be broken under the continuous loading condition in the body. The AO Fixator Interne and Steffee plate system themselves are rigid and are indicated for injuries that need reduction. The Luque ISF, modified Zielke, and Chiba-type plate screw systems, however, are indicated for degenerative lumbar disease requiring in situ fusion. There was a linear positive correlation between the bone mineral density of the vertebral body and the pull-out strength of the pedicle screw (correlation coefficient, 0.68). The fixation strength of the pedicle screw to the bone decreased remarkably in osteoporosis.

Micturitional disturbance in ossification of the posterior longitudinal ligament in the cervical spine

Neurourological studies were performed on 39 patients with cervical myelopathy due to ossification of the posterior longitudinal ligament. Micturitional history revealed that 30 patients (77%) had voiding symptoms: obstructive in 8, irritative in 11, and both obstructive and irritative symptoms in 11. Ten patients had urge incontinence and 4 had urinary retention. Urodynamic studies revealed that 7 of 19 had abnormal uroflowmetrogram, 16 of 35 had residual urine, 18 of 39 had detrusor hyperreflexia, and 10 of 39 had detrusor-sphincter dyssynergia. There were no statistical differences in lower extremity neurological signs in patients with incontinence, and patients with residual urine or urinary retention.

Long-term results of anterior interbody fusion for treatment of degenerative spondylolisthesis

Thirty-nine patients, 34 women and five men, underwent anterior decompression and interbody fusion for degenerative spondylolisthesis between February 1958 and August 1988. Their average age at surgery was 51 years (range, 34-74 years), and their average follow-up period was 12 years 7 months (range, 6 months to 30 years). Clinical evaluation was done by the score rating system of the Japanese Orthopaedic Association (JOA Score). Patients with JOA scores of 25 points or more were rated as "satisfactory." Survivorship was analyzed by the method of Kaplan and Meier to determine the cumulative percentage of patients with satisfactory results. The following results were obtained: Seventy-six percent of the patients had satisfactory results for 10 years after the anterior interbody fusion, 60% for 20 years, and 52% for 30 years. Irrespective of their age at surgery, the patients generally maintained satisfactory results up to 65 years of age.

Long-term results of spinal instrumentation surgery for scoliosis five years or more after surgery, in patients over twenty-three years of age

From 1967 to 1981, 311 scoliotic patients treated at Chiba University, with a minimum follow-up of 5 years and aged more than 23 years, were selected for this study. Seventy-two were males and 239 were females, whose age at operation ranged from 9 to 44 years, with an average of 16.5 years. The operative procedures were one-stage Harrington procedure in 179 cases, staged procedure in 108 cases, anterior procedure in 20 cases, and combined anteroposterior fusion in four cases. Including 198 patients examined physically, a total of 263 patients (54 males and 209 females) have responded to a questionnaire or were interviewed by telephone. In general, 85% of the patients were satisfied with the result of the operation for the control of spinal deformity, improvement of the cosmesis, and increase in physical and social activity.

Disturbances of micturition in patients with a spinal arteriovenous malformation

Neuro-urological studies were performed on 9 patients with a spinal arteriovenous malformation (S-AVM). The micturitional history revealed that all 9 patients had voiding symptoms, obstructive in 9 and irritative in 3 patients. All patients still had obstructive symptoms after treatment of S-AVM. Six of the 9 patients had a large volume of residual urine before treatment; 5 showed urinary retention. Four of the 5 patients (80%) for whom urodynamic studies were performed before treatment had micturitional dysfunction; 2 patients had detrusor hyperreflexia, 1 with detrusor external urethral sphincter dyssynergia (DSD) and 1 with a normal sphincter, 1 patient had an autonomous bladder with DSD and 1 patient had an atonic bladder with DSD. Only 1 patient had a normal bladder and sphincter. Findings of the urodynamic studies after treatment in 9 patients showed detrusor hyperreflexia in 3 patients (2 with DSD and 1 with normal sphincter), autonomous bladder in 1 patient with DSD, atonic bladder in 4 patients (2 with DSD, 1 with incompetent sphincter and 1 with normal sphincter) and normal bladder with normal sphincter in 1 patient. Lower urinary function after treatment of S-AVM was improved in 2 patients, unchanged in 4 patients and worsened in 3 patients. The above results showed 80% of S-AVM had a severe neuropathic bladder manifested mainly by disturbance of micturition. Treatment of S-AVM does not necessarily improve the lower urinary tract function.

School screening for scoliosis by the Chiba University Medical School screening program. Results of 1.24 million students over an 8-year period

The screening program for scoliosis started by Chiba University in 1979 consists of using moiré topography, low-dose roentgenography and a final ordinary x-ray examination. The number of children screened through this Chiba University Medical School (CUMS) screening program to 1986 amounted to 1,246,798. The incidence of scoliosis of more than 15 degrees increased linearly according to age from the fifth grade primary school children (0.07% in boys, 0.44% in girls) to the second grade junior high school students (0.25% in boys, 1.77% in girls). The female predominance of scoliosis cases with curvatures of more than 20 degrees detected during the total period was 10:1 and this female predominance was the same for primary school children and junior high school students. According to a study of the incidence of scoliosis by districts, (areas were divided according to population density and urbanization) there were no significant differences in the fifth grade primary school children between the sparsely and densely populated areas. In the cases of children beyond the fifth grade primary school level, however, the incidence in the densely populated areas were significantly higher than those in the sparsely populated districts. The incidence of scoliosis of more than 20 degrees decreased significantly every year among junior high school students, because they were screened periodically in school and the scoliotic students who had already been detected were left out of the next screening. This study establishes that screening for scoliosis by the CUMS screening program is cost-effective with a low risk of radiation hazards.

The change in color matches with retinal angle of incidence of the colorimeter beams

Differences between W.D.W. chromaticities of monochromatic lights obtained with all colorimeter beams incident on the retina "off-axis" and those found for lights striking the retina normally have been studied throughout the visible spectrum on 4 normal trichromats. The results are inconsistent with: (i) the assumption in Weale's theories of the Stiles-Crawford hue shift that the sets of absorption spectra of the visual pigments catching normally and obliquely incident photons are identical, and (ii) "self-screening" explanations for the change in color with angle of incidence on the retina. The color matching functions of a protanomalous trichromat are inconsistent with the hypothesis that the absorption spectra of the visual pigments catching normally incident photons in his retina are those catching obliquely incident photons in the normal retina.

Nonspecific congenital myopathy (minimal change myopathy): a case report

A 28-month-old male with generalized hypotonia and muscle weakness, a myopathic face, skeletal dysmorphism and delayed motor milestones from birth is reported. He gradually developed the ability of sitting and rolling over, but could not stand without support until 28 months. There was no intellectual impairment or seizures. Deep tendon reflexes were absent. The serum CK value, peripheral nerve conduction velocity and EMG were within normal limits. A muscle biopsy specimen showed mild variation in fiber size, and an increased number of type 2C fibers on histochemical examination, but no apparent abnormalities on electron microscopy. The baby was tentatively diagnosed as having minimal change myopathy or nonspecific congenital myopathy which is thought to be one of the congenital nonprogressive myopathies.

Parathyroid carcinoma visualized by gallium-67 citrate scintigraphy

An abnormal uptake of [67Ga]citrate by a palpable neck tumor was observed in a patient with primary hyperparathyroidism. The pathological diagnosis of the surgically resected specimen was parathyroid carcinoma invading the thyroid. The uptake was negative in nine patients with parathyroid adenoma. These results suggest that 67Ga scintigraphy may be useful to differentiate parathyroid carcinoma from benign parathyroid tumor.

An enzyme-linked immunosorbent assay for detection of antibodies to exogenous avian leukosis virus

A microplate enzyme-linked immunosorbent assay (ELISA) for detecting antibodies to avian leukosis virus (ALV) of subgroups A and B in infected chickens was developed with the use of Rous-associated virus (RAV)-1 (subgroup A) and RAV-2 (subgroup B) antigens purified by sucrose-gradient centrifugation. The antigen was used for ELISA after treatment with Triton X-100. In the ELISA, the subgroup viral antigen reacted strongly with homologous antiserum but also reacted with heterologous antiserum. Tests with serum absorbed with purified homologous and heterologous virus and tests for antigen-blocking by group-specific antibodies to ALV revealed that the reaction was caused mainly by subgroup-specific antibodies. The ELISA was 8 to 32 times more sensitive than the virus-neutralization (VN) test and detected antibodies to ALV earlier than the VN test in chickens infected experimentally with RAV-1 and RAV-2. In field application of the ELISA, 44.2% of 484 chicken sera were positive for RAV-1 and/or RAV-2 antigen, and 80.4% of flocks were positive. These findings indicate that ELISA is superior to the VN test in sensitivity, simplicity, rapidity, and applicability for large-scale field surveys for ALV infection.

[Pituitary-thyroid function in patients with Cushing's syndrome--comparative study before and after extirpation of adrenal cortex tumor]

The pituitary-thyroid function and the metabolism of the thyroid hormones in the blood were investigated in 19 patients with Cushing's syndrome before and after an adrenalectomy, 16 patients had adrenal adenomas and 3 patients had modular adrenal hyperplasias. Serum T4, free T4 (FT4), T3, reverse T3 (rT3), TBG and TSH were measured in all patients by radioimmunoassay, and changes in serum TSH, PRL and HGH following the injection of TRH 500 micrograms in 10 out of 19 patients were observed to evaluate the pituitary functions. Serum T4, FT4 and rT3 were within normal limits and not significantly changed after the surgical treatment. Serum TBG levels in patients before the surgical treatment were also within the normal range. After the treatment, a small but significant increase in TBG levels was observed. Serum TSH levels were suppressed before the surgery and increased after the surgery, but a coefficient of correlation between serum cortisol and TSH levels was not statistically significant. The serum T3 levels were abnormally low in Cushing's syndrome and increased significantly (p less than 0.001), accompanying the normalization of serum cortisol levels, after the surgical treatment. Moreover, there was a negative correlation between serum T3 and cortisol levels before the treatment (r = -0.586), but it was not statistically significant (before the treatment: T3 0.71 +/- 0.04 ng/ml, cortisol 30.2 +/- 2.1 micrograms/dl, after the treatment: T3 1.58 +/- 0.15 ng/ml, cortisol 7.5 +/- 2.0 micrograms/dl). To evaluate further the metabolic changes in circulating thyroid hormones, T3/T4, T3/rT3, TBG/T4 and TBG/T3 were compared before and after the adrenalectomy. Significant decreases in T3/T4 (p less than 0.001) and T3/rT3 (p less than 0.05) and a significant increase in TBG/T3 (p less than 0.05) were observed before the surgery. On the other hand, TBG/T4 was not significantly different before or after the surgery. The TSH response to TRH was significantly higher in postoperative patients than in preoperative patients (p less than 0.05). Before the surgical treatment no responses of serum HGH to TRH were observed in any patients, while after the treatment, abnormal increases from 4.5 +/- 1.4 ng/ml to 10 +/- 1.1 ng/ml at 15 min. after TRH administration were observed. There was no difference between PRL response to TRH before or after the surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Comparative study of bioavailabilities of different phenytoin preparations

A comparative study of the serum phenytoin (PHT) concentration levels during the treatment with different PHT preparations (powders or tablets) manufactured by two Japanese pharmaceutical companies gave the following results: 1) The serum PHT concentration levels (S in microgram/ml) of children (aged 7-11) who were taking Company A's powder and phenobarbital were less than 2.0 microgram/ml in 21 out of 24 (87.5%) cases without correlation with the dosage (D in mg/kg). The levels in 19 children of the same ages taking Company A's tablets showed significant correlation with the dosage, and the regression line was S = 1.9D - 2.65 (r = 0.86). 2) In 33 cases, previously administered Company A's powder was substituted with different PHT preparations of the same or a lesser dosage; Company A's tablet in group I; powderized Company A's tablet in group II: Company B's powder in group III; and Company B's tablet (solid or powderized) in group IV. In all cases, the PHT S/D ratio increased after the substitution and the mean increase +/- SD was 1.3 +/- 1.2 (p less than 0.001) for group I, 1.0 +/- 0.1 (p less than 0.001) for group II, 0.45 +/- 0.1 (p less than 0.005) for group III, and 1.6 +/- 0.4 (p less than 0.015) for group IV. 3) Tested in five patients using three specially prepared phenytoin powders with different particle sizes clearly demonstrated the fact that the smaller the PHT particle, the higher the PHT S/D ratio. 4) It was suggested that the factors other than particle size of the drug should be taken into consideration in the interpretation of different bioavailabilities of different PHT preparations.

Correlation of T4 to T3 converting activity with T3 concentration in rat tissues

The correlation between T4 5'-deiodinase activity and thyroid hormone concentration in rat tissues was sought. Studies with normal and thyroidectomized rats indicated a significant correlation of the hepatic T3 concentration with the enzyme activity in liver homogenate (r = 0.80, p less than 0.01) or in liver microsomes (r = 0.08, p less than 0.01). The correlation between the hepatic T4 concentration and activity of the enzyme was less significant (r = 0.55, p less than 0.05 for homogenate, and r = 0.66, p less than 0.01 for microsomes). The degree of T4 5'-deiodinase activity in various organs was found to increase in line with tissue concentration of T3. It seems likely that the level of T4 5'-deiodinase activity is controlled by the tissue concentration of T3.

[Morphological observations on trabecular microfractures in the lumbar vertebrae (author's transl)]

Trabecular microfractures have been described in the bodies of the lumbar vertebrae (Vernon-Roberts, 1973). The author started this study to clarify the possibility of the participation of such microfractures in the physiological remodelling of the vertebral body. The number, distribution and microstructure of the trabecular microfractures were assessed in the 5mm thick macerated slices of lumbar vertebral bodies taken from 36 post mortem subjects mainly above the age of 40 years. The characteristics of the vertebral bodies with microfractures were further examined by a semiquantitative histology and soft X-ray radiography of the 2mm thick macerated specimens. Trabecular microfractures had little displacement. The repair process, however, might be very slow. The number of microfractures were increased in the vertebral body with decreased bone mass. It was, however, predominantly denoted in the almost normal vertebral body comparing with the deformed one. Microfractures were not regularly distributed within each vertebral bodies. The appearance of microfractures was therefore a little different from the usual fatigue fracture. In conclusion, the trabecular microfracture might be caused by relatively hyper-loading that could not be resorbed in normal turnover of formation and resorption as a remodelling process. The healing of microfractures might be related to the compensatory hypertrophy of the trabeculae.

The use of arthroscopy for follow-up in knee joint surgery

Fifty-three joints in 48 patients were examined arthroscopically after surgery in order to evaluate postoperative results and particularly to reveal the causes of poor results. The chief arthroscopic findings in unsatisfactory cases were the following: recurrence of synovitis or osteoarthritic changes after synovectomy for rheumatoid arthritis, residual meniscal or osteoarthritic changes after meniscectomy, loose ligamentous or meniscal lesions after ligamentous repair or reconstruction, and poor regeneration of cartilage after high tibial osteotomy.

Histochemical study of the human intervertebral disc

The human intervertebral discs which were obtained by cadavers and anterior discectomy are investigated histochemically. Chondroitin-4S, chondroitin-6S, dermatan sulfate, hyaluronic acid and keratan sulfate were detected in the human intervertebral disc by various histochemical methods. pH2.5, pH1.1 toluidin blue metachromasia and 0.4M MgCl2 alcianophilia became weaker with increasing age, and the herniated disc were weaker than controlled discs in the same age group. Chondroitin-4S and chondroitin-6S were distributed throughout the discs. There was no clear localization of the various glycosaminoglycans in the human intervertebral disc, with the exception of keratan sulfate. There was no histologically and histochemically observable difference in the cervical and lumbar discs.