Facial nerve parasympathetic preganglionic afferents to the accessory otic ganglia by way of the chorda tympani nerve in the cat

The distribution of accessory otic ganglia and connections between the ganglia and the chorda tympani nerve were investigated in the cat in order to determine the parasympathetic preganglionic facial nerve afferents to the otic ganglia using whole mount acetylthiocholinesterase (WATChE) histochemistry. The otic ganglia consist of a single main prominent ganglion and many small accessory ganglia lying on a plexus around the origins of the branches of the mandibular nerve and near the junction of the chorda tympani nerve and lingual nerve. In cell analysis of Nissl-stained preparations, the neurons composing the accessory otic ganglia were morphologically similar to the main otic ganglion neurons. Connecting branches from the chorda tympani nerve to the peripherally located accessory otic ganglia were found and they were not stained by WATChE histochemistry. WATChE-positive connecting branches from the ganglia to the inferior alveolar, lingual, and mylohyoid nerves were also found in the same preparations. The WATChE histochemistry on various autonomic nervous tissues revealed that autonomic postganglionic nerve fibers are selectively stained darkly and that preganglionic fibers remain unstained. Therefore, it is considered that the WATChE-negative connections from the chorda tympani nerve consist chiefly of autonomic preganglionic fibers, whereas the WATChE-positive connections to the branches of the mandibular nerve are mainly postganglionic fibers. This suggests that some of the facial nerve parasympathetic preganglionic fibers in the chorda tympani nerve are mediated in the accessory otic ganglia and then join the branches of the mandibular nerve to supply the target mandibular tissues.

Rapid identification of Leishmania species from formalin-fixed biopsy samples by polymorphism-specific polymerase chain reaction

The precise identification and classification of Leishmania species is important for public health surveillance since different species cause different clinical features of the disease. A highly specific polymerase chain reaction (PCR) panel was developed to enable the identification of the five major Leishmania species that cause New World cutaneous leishmaniases. The primers used for this panel were designed to distinguish the polymorphism in sequences of commonly amplified DNA bands of the parasites produced by arbitrarily primed PCR. These polymorphism-specific PCR diagnoses were performed with formalin-fixed biopsy specimens of the leishmanial lesions from four patients in Ecuador and one hamster skin lesion, and these lesions were determined to be caused by Leishmania (Viannia) panamensis, L. (Leishmania) mexicana, and L. (L.) amazonensis. The PCR panel may offer an important and practical approach to the standardized identification of Leishmania species in field examinations.

Golgi vesiculation and lysosome dispersion in cells lacking cytoplasmic dynein

Cytoplasmic dynein, a minus end-directed, microtubule-based motor protein, is thought to drive the movement of membranous organelles and chromosomes. It is a massive complex that consists of multiple polypeptides. Among these polypeptides, the cytoplasmic dynein heavy chain (cDHC) constitutes the major part of this complex. To elucidate the function of cytoplasmic dynein, we have produced mice lacking cDHC by gene targeting. cDHC-/- embryos were indistinguishable from cDHC+/-or cDHC+/+ littermates at the blastocyst stage. However, no cDHC-/- embryos were found at 8.5 d postcoitum. When cDHC-/- blastocysts were cultured in vitro, they showed interesting phenotypes. First, the Golgi complex became highly vesiculated and distributed throughout the cytoplasm. Second, endosomes and lysosomes were not concentrated near the nucleus but were distributed evenly throughout the cytoplasm. Interestingly, the Golgi "fragments" and lysosomes were still found to be attached to microtubules. These results show that cDHC is essential for the formation and positioning of the Golgi complex. Moreover, cDHC is required for cell proliferation and proper distribution of endosomes and lysosomes. However, molecules other than cDHC might mediate attachment of the Golgi complex and endosomes/lysosomes to microtubules.

Chronic lithium treatment robustly protects neurons in the central nervous system against excitotoxicity by inhibiting N-methyl-D-aspartate receptor-mediated calcium influx

Lithium is the most commonly used drug for the treatment of manic depressive illness. The precise mechanisms underlying its clinical efficacy remain unknown. We found that long-term exposure to lithium chloride dramatically protects cultured rat cerebellar, cerebral cortical, and hippocampal neurons against glutamate-induced excitotoxicity, which involves apoptosis mediated by N-methyl-D-aspartate (NMDA) receptors. This neuroprotection is long-lasting, occurs at therapeutically relevant concentrations of lithium with an EC50 of approximately 1.3 mM, and requires treatment for 6-7 days for complete protection to occur. In contrast, a 24-h treatment with lithium is ineffective. The protection in cerebellar neurons is specific for glutamate-induced excitotoxicity and can be attributed to inhibition of NMDA receptor-mediated calcium influx measured by 45Ca2+ uptake studies and fura-2 fluorescence microphotometry. The long-term effects of lithium are not caused by down-regulation of NMDA receptor subunit proteins and are unlikely related to its known ability to block inositol monophosphatase activity. Our results suggest that modulation of glutamate receptor hyperactivity represents at least part of the molecular mechanisms by which lithium alters brain function and exerts its clinical efficacy in the treatment for manic depressive illness. These actions of lithium also suggest that abnormality of glutamatergic neurotransmission as a pathogenic mechanism underlying bipolar illness warrants future investigation.

Association of human papillomavirus type 16 with malignant melanoma

We report a case of malignant melanoma associated with human papillomavirus (HPV) in a 37-year-old woman. The patient has had numerous brown papular and nodular tumors, 5 to 30 mm in diameter, on her left leg for > 15 years, some of them coalescing rapidly in the last 12 months to a multilobulated black nodule diagnosed as malignant melanoma by histology and immunohistochemistry. HPV type 16 DNA was detected in the melanoma specimen by reverse transcriptase polymerase chain reaction (rt-PCR) and in situ hybridization (ISH) of the tumor tissues. This is the first report of melanoma associated with HPV 16.

Lombard reflex during PAG-induced vocalization in decerebrate cats

The Lombard reflex occurs when a speaker increases his vocal effort while speaking in the presence of ambient noise. The purpose of this study was to clarify whether the Lombard reflex can be evoked during controlled vocalization in an animal model. In decerebrate cats, repetitive electrical stimulation was applied to the midbrain periaqueductal gray (PAG) to evoke vocalization. Pure tone auditory stimulation was delivered through a loudspeaker. The activities of the laryngeal adductor muscle, diaphragm and external oblique abdominal muscle and the voice intensity were measured during PAG stimulation, in the presence and absence of the auditory stimulation. To clarify the effects of the auditory laryngeal reflex on the activity of laryngeal adductor motoneurons, the amplitude of the laryngeal reflex evoked by single shock stimulation of the superior laryngeal nerve was also measured during respiration, in the presence and absence of auditory stimulation. The sound made by the cats due to PAG-induced vocalization was augmented by exposure to auditory stimulation, and the activities of the laryngeal adductor muscle and external oblique abdominal muscle were also augmented. During respiration, auditory stimulation also increased the amplitude of the laryngeal reflex evoked in the laryngeal adductor muscle. These results demonstrate that the essential neuronal mechanisms for evoking the Lombard reflex exist within the brainstem.

Squamous cell carcinoma arising from lupus vulgaris on an old burn scar: diagnosis by polymerase chain reaction

A 66-year-old Japanese woman with a squamous cell carcinoma (SCC) arising from lupus vulgaris (LV) on an old burn scar on the left lower extremity is described. Ziel-Neelsen stain of a direct smear from the surface exudate showed acid-fast bacilli. Repeated culture for tubercle bacilli was negative, probably due to a technical error. The diagnosis of LV was successfully made by polymerase chain reaction (PCR). LV and burn scar are common preceding diseases for SCC. The former is rare in the U.S., Europe, and Japan. We were unable to determine whether only one of the two conditions or a combination of both was the true predisposing factor responsible for the development of this SCC. However, this case may be the first report of SCC arising from coexistent LV and a burn scar in which the diagnosis was confirmed by PCR.

Functional role of ventral respiratory group expiratory neurons during vocalization

The activities of expiratory neurons of the caudal ventral respiratory group (cVRG) (n = 31) were recorded extracellularly during vocalization in unanesthetized, decerebrate cats. Vocalization was induced by electrical stimulation (0.2 ms, 20-80 microA, 100 Hz, lasting for 2-5 s) of the periaqueductal gray (PAG). The firing rates of more than two-thirds of the neurons (24/31) increased during periods of vocalization induced by stimulation of the PAG, with an increase in abdominal muscle activities. The axons of most of these neurons (19/24) projected to the contralateral lumbar spinal cord, and one-third of the bulbospinal neurons (6/19) were orthodromically activated by stimulation of the PAG. Even after sectioning of the axons of bulbospinal cVRG neurons by midsagittal lesion between the obex and the C1 spinal cord, stimulation of the PAG still induced adduction of the vocal cords and vocalization. However, activities of abdominal muscles during vocalization were abolished. These results indicate that the efferent signals for vocalization from the PAG may be relayed at the cVRG neurons and converted into adequate activation of these neurons, contributing to the activation of the abdominal muscles for vocalization.

Modulation of vomiting by the medullary midline

Studies were conducted to investigate the possible role of the brainstem midline region as a source of facilitatory input for the vomiting process. Experiments were conducted using the "fictive vomiting' model in decerebrate, paralysed cats. Dysfunction of the medullary midline region produced by localized injections of the neurotoxin kainic acid abolished or greatly attenuated fictive vomiting. In addition, some respiratory-related midline neurons were found to fire in synchrony with co-active phrenic and abdominal nerve discharge during fictive vomiting. These experiments demonstrate the importance of the medullary midline for the normal occurrence of the vomiting process. An explanation for the post-lesion elimination of vomiting is that the lesions remove an important source of facilitatory input to spinal respiratory motoneurons and/or to the brainstem circuitry that mediates vomiting.

Activities of expiratory neurones of the Bötzinger complex during vocalization in decerebrate cats

Repetitive electrical stimulation of the midbrain peri-aqueductal grey (PAG) terminates quiet breathing and initiates inspiration that precedes vocalization. To understand the neuronal mechanisms underlying this phenomenon, activities of expiratory neurones (n = 39) of the Bötzinger complex (BOT) were examined in decerebrate cats. Most augmenting expiratory (E-aug) neurones (20/22) of the BOT, including 15 bulbospinal neurones, decreased their activities (9/20) or ceased to discharge (11/20) after the onset of stimulation of the PAG. This suggests that suppression of E-aug neurones of the BOT, which project to phrenic motoneurones, results in disinhibition of these neurones, and, in turn, terminates expiration and initiates inspiration preceding vocalization.

[A fundamental study of relationships between rhinomanometry and acoustic rhinometry]

A cylindrical model consisting of a single or plural acrylic plates with holes of various cross-sectional areas was ventilated by a Harvard pump. Pressure flow curves of the combinations were drawn and analyzed according to the percent expression method. The length of the cylinder through the same cross-sectional area did not influence the ventilatory resistance. Divergent flow toward the downstream part decreased the resistance, but convergent flow from the upstream part did not. Simultaneous setting of convergent flow from the upstream part and divergent flow to the downstream part decreased the resistance most effectively, as much as approximately 70% of the original resistance. Two separately positioned cross-sectional areas in a respiratory circuit increased the resistance about 1.4 times when the separation length was more than 3 cm, while the resistance remained between 1 and 1.4 times when the separation was shorter than 3 cm. The average values of the minimum areas measured by acoustic rhinometry were usually much larger than expected from the present study. One of the factors affecting this difference may be that the axis from the nostril to the choana is complicated enough to significantly modify the aerodynamics of the nasal cavity.

Relationship between N-acetyltransferase (NAT) activity and liver protoporphyrin level in experimental porphyria

The results of our previous studies demonstrated that isonicotinic acid hydrazide (INH) can aggravate griseofulvin (GF)-induced protoporphyria in mice. To elucidate this phenomenon, we studied the relationship between liver protoporphyrin (PP) levels and N-acetyltransferase (NAT) activity, which is known to be a major catabolic enzyme of INH metabolism in the liver. The results revealed a significant correlation between liver PP levels and NAT activity in the mice fed 0.1% GF and 0.05% INH. In this group, mice with high NAT activity developed severe protoporphyria. There was no correlation, however, between liver PP levels and NAT activity in the mice fed GF alone or INH alone. The result suggested that INH metabolites formed by NAT enhance the hepatotoxicity of GF in mice.

Measurement of nitric oxide in human nasal airway

The nasal output of nitric oxide (NO) is known to be high, but there have been varying reports of the exact level. We attempted to establish a quantitative measurement of nasal NO, and looked for a possible relationship with nasal resistance, at rest and during exercise. Nasal airway ventilation was performed by using an air pump at a constant flow rate, whilst the soft palate was elevated voluntarily. In a preliminary study, the flow rate for sampling was changed and concentrations of NO were measured. After determination of flow rate, rhinomanometry for nasal resistance and measurement of nasal NO by chemiluminescence were carried out before and after moderate exercise. The concentration of NO ([NO]) exhibited a hyperbolic relationship with flow rate of ventilation (V'E), indicating [NO] x V'E = net nitric oxide output (V'NO) = constant. Hence, nasal NO was expressed quantitatively as V'NO (nL.min-1). For 1 L.min-1 of ventilation, [NO] varied between 2 and 500 parts per billion (ppb) (mean = 323 ppb). The average nasal V'NO in 12 healthy male subjects was 323 +/- 91 nL.min-1 (mean +/- SD). After exercise on a treadmill (10 degrees, 5 km.h-1) for 4 min, nasal V'NO decreased to 229 +/- 63 nL.min-1. At rest, expiratory and inspiratory nasal resistance was 0.27 +/- 0.04 and 0.27 +/- 0.06 Pa.s.cm-3, respectively. After exercise, expiratory and inspiratory nasal resistance decreased to 0.17 +/- 0.04 and 0.16 +/- 0.04 Pa.s.cm-3, respectively. These data indicate that nasal NO can be measured quantitatively as V'NO and might be involved in the control of nasal resistance.

Quantitative analysis of ferrochelatase mRNA in blood cells of erythropoietic protoporphyria patients

Ferrochelatase (FC; heme synthetase, EC 4.99.1.1.) catalyses the synthesis of heme from protoporphyrin IX, the final step in the heme synthetic pathway. The hereditary deficiency of this enzyme gives rise to erythropoietic protoporphyria (EPP). We developed a rapid, non-radioactive means of measuring human FC mRNA levels in the EPP patients. It is based on the reverse transcriptase-polymerase chain reaction (RT-PCR) performed on the RNA obtained from peripheral blood. The amplified DNA was detected by agarose gel electrophoresis with ethidium bromide staining and the fluorescent intensity was measured by scanning densitometry applied directly to Polaroid 665 negative film. The relative expression level of FC mRNA, compared with that of glyceraldehyde 3-phosphate dehydrogenase (GAPDH) mRNA, was estimated at several points in the exponential phase of PCR cycles or at a point in the exponential phase of PCR performed on serially diluted the cDNA samples. The estimate of the FC mRNA by this method correlated well with the level of the FC mRNA measured by Northern blotting in the EB virus-transformed lymphocytes of the same patients. The level of the FC mRNA appeared to vary among the patients in whom a decreased level of enzymatic activity was indicated.

Histochemical properties of intrinsic laryngeal muscles in cats

As one means in elucidating the contractile properties of the intrinsic laryngeal muscles, we examined the histochemical properties of the posterior cricoarytenoid (PCA), thyroarytenoid (TA), lateral cricoarytenoid (LCA), arytenoid (A) and cricothyroid (CT) muscles in cats using the reaction for myosin ATPase following acid and alkali preincubation. The muscle fiber compositions of the intrinsic laryngeal muscles differed not only across the muscles but also across the muscle fascicles within a single muscle. The relative frequency of type-1 fibers was the smallest (9%) in the TA and the largest (45%) in the CT, and that of type-2A fibers was 39-48% in each muscle. The relative frequency of type-2B fibers was the smallest (9%) in the CT and the largest (42-45%) in the TA, LCA and A, and that of type-2C fibers was less than 1.0% in each muscle. Across the muscle fascicles, the TA was the most heterogeneous in muscle fiber distribution. The mediocaudal part of the TA was mainly composed of the muscle fascicles with type-1 fibers, while the laterocaudal and rostral parts of the TA were mostly composed of the muscle fascicles without type-1 fibers. The PCA was the most homogeneous in muscle fiber distribution. Our results demonstrate that the contractile properties of the intrinsic laryngeal muscles differ across the muscles and across the muscle fascicles within a single muscle and suggest that the delicate laryngeal movements are established by the coordinated activities of the intrinsic laryngeal muscle fibers with different contractile properties.

Multifunctional ventral respiratory group: bulbospinal expiratory neurons play a role in pudendal discharge during vomiting

Pudendal motoneurons are activated in phasic bursts during the retching and expulsion phases of vomiting. The resulting contraction of the anal and urethral sphincters serves to maintain continence during the large increase in abdominal pressure that occurs during vomiting. We evaluated the contribution of bulbospinal expiratory neurons located in the portion of the ventral respiratory group (VRG) caudal to the obex (nucleus retroambigualis) to the control of pudendal motoneurons during fictive vomiting in decerebrate, paralyzed cats. Pudendal nerve discharge is abolished by cutting the axons of caudal VRG expiratory neurons as they cross the midline between the obex and C1 before descending in the spinal cord. All caudal VRG expiratory neurons that were antidromically activated from the sacral spinal cord, where the pudendal motor pool (nucleus of Onuf) is located, discharged strongly during the end of the expulsion phase of vomiting. However, only a small proportion of these neurons was active in phase with pudendal discharge during the retching phase. The apparent involvement of caudal VRG expiratory neurons in the control of pudendal motoneurons during vomiting is another example of the multifunctional role that can be played by respiratory-related neurons in the mammalian nervous system.

Fastigiofugal projection to the brainstem nuclei in the cat: an anterograde PHA-L tracing study

Fastigial projections to brainstem nuclei were studied using an anterograde neural tracer, Phaseolus vulgaris leucoagglutinin (PHA-L). Microinjections of PHA-L were made into the rostral pole, and middle and caudal parts of the left fastigial nucleus in cat. In addition to fastigioreticular and fastigiovestibular projections, fastigiofugal projections to cranial motor nuclei (IV, VI and VII) and those nuclei involved in autonomic control were identified. At the medullary level, a topographic arrangement of fastigioreticular projection was observed. Rostral and caudal parts of the fastigial nucleus projected to the ventral and dorsal parts of the medial reticular formation, respectively. Fastigiofugal fibers which originated from the rostral part of the fastigial nucleus innervated heavily the nucleus reticularis gigantocellularis (NRGc), nucleus reticularis magnocellularis (NRMc) and the ventral paramedian reticular nucleus (PRN). Those fibers from the middle part innervated heavily the ventrolateral vestibular nucleus (VLV), NRGc, NRMc, ventral and dorsal PRN and parasolitary tract nucleus. From the caudal part of the fastigial nucleus, projections to the cranial motor nuclei (IV, VI and VII), VLV and inferior vestibular nucleus were observed.

[Porphyria cutanea tarda and hepatoerythropoietic porphyria]

Porphyria cutanea tarda (PCT) is induced by an enzyme deficiency of hepatic uroporphyrinogen decarboxylase activity. As the result of this enzyme deficiency, uroporphyrin and coproporphyrin accumulate to the skin and other organs. These porphyrins are excreted into urine because of their easy solubility in water. Exposure to the sunlight of the porphyrin-rich skin induces cutaneous changes. Porphyria cutanea tarda develops mainly in middle-aged males, sometimes in females. Ethylalcohol, estrogenic hormones, and hemodialysis are reported as provocative factors. Hyperpigmentation on exposed areas, skin fragility, vesicles and erosions are common in PCT. Histopathologically, subepidermal bulla is a characteristic finding in PCT. PAS positive materials are also prominent around the small blood vessels in the dermis and dermo-epidermal junctions. Hepatoerythropoietic porphyria (HEP) is usually manifest in early childhood with dark urine and reveals severe cutaneous photosensitivity. This disease is a homozygous form of type II PCT.

[Porphyria in dermatology]

Porphyrins are fluorescent chemicals excited by visual light. Skin changes in patients with porphyrias develop when the skin is exposed to sunlight and porphyrins have precipitated. This reaction is phototoxic. Since the phototoxic reaction varies with each porphyria, each porphyria demonstrates different skin changes. Conversely, skin changes do not develop if skins are completely protected from exposure to the sun in patients with porphyrias with show severe abnormalities in the metabolism of porphyrin pathways. In Japan, relatively popular porphyrias in dermatology clinic are porphyria cutanea tarda (PCT), erythropoietic protoporphyria (EPP) and congenital erythropoietic porphyria (CEP). Histopathologically, one of the most important findings in porphyria is a deposition of PAS positive materials at the dermo-epidermal junction and around the small blood vessels in the dermis.

Cutaneous malignant hemangioendothelioma: clinical and histopathological observations of nine patients and a review of the literature

Nine patients with cutaneous malignant hemangioendothelioma (CMHE) were reported in Okinawa. All the patients were elderly, between 75 and 93 years of age. Four patients were males and five were female. The onset of the disease ranged from 1 to 9 months before the first visit. Eight patients had lesions on the scalp, and one, on the face and cheek. The lesions were in the form of exudative erythematous purpura, erythematous purpuric ulcers, and tumors. One patient developed a systematic metastasis involving the lungs, heart and intestine, and two patients had local metastasis to the cervical lymph nodes. Histopathologically, the tumor vessels were proliferated irregularly and showed anastomosis. The lumens were lined by large and atypical endothelial cells. Most of the specimens were infiltrated with large numbers of red blood cells. By electron microscope, Weibel-palade bodies were found inside the tumor cells located at the peripheral part of the lesion. The patients were treated by irradiation, IL-2 injection, and/or surgery. They were treated for 3 months to 2 years. Eight patients died between 4 to 24 months after the onset of disease and one has survived. The prognosis was poor.

[Stromelysin-1 (MMP-3) level in the sera from patients with rheumatoid arthritis and other connective tissue diseases--clinical significances in early onset rheumatoid arthritis]

Stromelysin-1 (MMP-3) is a metalloproteinase that degrades articular cartilage matrix in patients with rheumatoid arthritis (RA). We measured MMP-3 in the sera from patients with RA and other connective tissue diseases using specific sandwich EIA and studied its clinical significance in early onset RA. MMP-3 level in healthy control (n = 170) was significantly higher in male than in female. The level of MMP-3 in RA was significantly and dramatically higher than in healthy control, osteoarthritis, systemic lupus erythematosus, progressive systemic sclerosis, primary sjogren's syndrome, mixed connective tissue disease, gouty arthritis and traumatic arthritis. Serum MMP-3 significantly correlated with serum BUN or serum creatinine levels in SLE patients but not in RA patients. In early onset RA, serum MMP-3 level was significantly elevated. Furthermore, when the relationship between the serum MMP-3 level and X-ray findings of the joints in RA was studied, it was found that MMP-3 level was elevated even in stage I or II and that there was no statistical differences between stage I or II and stage III or IV, suggesting that serum MMP-3 level is elevated in the early stage of initial inflammatory process when only mild cartilage degradation is seen. These results suggest that measurements of serum MMP-3 is an important tool for establishing diagnosis of early onset RA, and that serum MMP-3 level may be a marker of cartilage destruction and of estimating therapeutic efficacy in early onset RA.

[Amyloidosis of the small intestine secondary to rheumatoid arthritis and juvenile rheumatoid arthritis: report of two cases]

We herein report two cases of gastrointestinal amyloidosis, secondary to juvenile rheumatoid arthritis (JRA) in one, and rheumatoid arthritis (RA) in the other. A 21-year-old woman, who has been suffering from JRA for the past 12 years, was transferred to our hospital due to intense pain in the epigastrium and back, diarrhea, high fever, and paralytic ileus. Treatment by corticosteroid, antibiotics, protease inhibitor, and total parenteral nutrition was not effective. The laparoscopic surgery was performed because of repeated melena followed by an episode of hypovolemic shock. The resected specimen of the ileum showed histologically marked amyloid deposition in the arteriolar walls. A 83-year-old man with RA for 14 years, was admitted to our hospital with complaints of abdominal pain, nausea, and diarrhea. He underwent an emergency operation for perforation of the ileum. The resected specimen revealed amyloid deposition and non-caseating granulomas. The fragility and impaired blood supply caused by amyloid deposition in the vascular walls may have terminated in the severe intestinal lesion. Further clinicopathological studies along this line are keenly desired in order to establish therapeutic modalities for gastrointestinal amyloidosis.

A case of trichorrhexis nodosa developed in winter

A young Japanese man developed localized trichorrhexis nodosa (LTN) of the scalp hair in the winter season. To investigate the roles of shampoo, severe sunlight exposure and/or mechanical injuries, we performed the following studies. Hair was collected from the patient and from a control. The study was performed in two steps. In the first step, hair was put into shampoo, rinsed with saline water, and then exposed to ultraviolet B (UVB) radiation once a day for one week. In the second step, the hair was similarly treated, but each shaft was bent gently with forceps before UVB exposure. Scanning electron microscopic studies revealed cuticular changes when the hair was treated only with shampoo and UVB. When it was treated with shampoo, UVB, and mechanical bending, the patient's hair developed longitudinal and transverse fractures of the hair shafts, while the control hair showed only partial damage to the hair shaft. On the basis on the above findings, we conclude that mechanical bending may damage the hair shaft.

Postnatal development of locomotor movements in normal and para-chlorophenylalanine-treated newborn rats

The contribution of the serotonergic system to postnatal development of locomotor movements in newborn Sprague-Dawley rats was studied from PND 1 to PND 15. To deplete serotonin (5-HT), p-chlorophenylalanine (PCPA) (200 mg/kg) was intraperitoneally administered at PND 1, 4, 7, 10 and 13, and the results obtained from PCPA-treated pups (n = 20) and control pups (n = 20) were compared. Locomotor movements of the pups on the surface of a digitizer table were measured by attaching a miniature coil to the abdomen of the pups. Video-recordings were made to study the locomotor movements. From PND 1 to PND 5, no significant difference in body weights and locomotor movements was observed across control and PCPA-treated pups. After PND 6, the development of PCPA-treated pups was slightly retarded although both groups of pups opened their eyes at PND 14. Throughout PND 6 to PND 15, the total distance and mean velocity of locomotor movements were significantly lower in PCPA-treated pups than in the control pups. In addition, forelimb and hindlimb movements were not well coordinated in the former. These results suggest that retardation of locomotor movements in the PCPA-treated pups is due to a possible failure in the postnatal development of 5-HT and other neural mechanisms related to postural and locomotor control, and not due to that of general development of the pups themselves.

The effects of Tripterygium wilfordii extract on adjuvant arthritis in rats

The effects of the extract of Tripterygium wilfordii. (TWE) on experimental adjuvant arthritis (AA) in the rat was studied. Lewis rats induced with AA were administered with TWE at 50 mg/kg/day for 10 weeks. The paw volume, its ratio to the body weight (paw ratio) and the radiologic changes in the feet of the rats with AA taking TWE were compared with those in the rats taking indomethacin (0.5 mg/kg/day) and no additional drugs. The rats taking TWE showed a smaller paw volume, a lower paw ratio and milder radiologic changes than the rats taking no drugs, however, the beneficial effects were weaker than those of indomethacin. We concluded that the beneficial effects of TWE on rats with AA was suggested. However, these results still need to be further confirmed by additional experiments.

Rheumatoid arthritis in the northeastern area of the People's Republic of China and western Japan

The clinical features of 134 consecutive hospitalized patients with rheumatoid arthritis in the northeastern area of the People's Republic of China and 251 consecutive hospitalized patients from western Japan were compared. A total of 91.8% of the Chinese patients were of Han nationality, while all of the patients from Japan were Japanese. The patients in the People's Republic of China showed more inflammatory articular disease and more frequent subcutaneous nodules than did the Japanese patients in the presence of a less elevated ESR value and less radiographic joint destruction. The clinical features of the patients of Han nationality and the Japanese did not change even after adjusting the patients' age and disease duration. The reasons for the contradictory features in the Chinese patients still remain to be clarified. This study is hopefully a first step in promoting more precise studies on rheumatoid arthritis in the People's Republic of China.

Increased IL-1 receptor antagonist (IL-1ra) production and decreased IL-1 beta/IL-1ra ratio in mononuclear cells from rheumatoid arthritis patients

In order to investigate the possible role of IL-1 receptor antagonist (IL-1ra) in patients with rheumatoid arthritis (RA), this study was undertaken to measure the amounts of IL-1ra and interleukin-1 beta (IL-1 beta) protein produced by mononuclear cells (MNC) and to investigate the relationship between production of these cytokines and clinical parameters. The MNC were cultured for 24 h and the supernatants were measured for IL-1ra and IL-1 beta by ELISA kits. MNC from peripheral blood (PB) and synovial fluid of RA patients produced significantly higher amounts of IL-1ra than normal PBMNC (P < 0.01 and P < 0.05, respectively). When the IL-1 beta/IL-1ra ratio was calculated, IL-1 beta/IL-1ra ratios of RA PBMNC were significantly lower than those of normal PBMNC (P < 0.001). The IL-1 beta/IL-1ra ratio of RA PBMNC was significantly higher in active RA patients than in RA patients in remission (P < 0.02). The amounts of IL-1ra produced by stimulated RA PBMNC positively correlated with the joint score (P < 0.05), serum CRP levels (P < 0.05) and the amounts of IL-1 beta produced (P < 0.01). The amounts of IL-1ra produced by unstimulated RA PBMNC did not correlate with any of the clinical parameters studied. Gold sodium thiomalate (GST), but not auranofin, increased IL-1ra production in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

[Nasal decongestion evaluated by acoustic rhinometry]

Acoustic rhinometry measures the cross-sectional area of the nasal cavity based on changes in acoustic impedance. The volume of the nasal cavity can be calculated by mathematical integration of the cross-sectional areas. One of the advantages of this procedure is that repeated measurements can be quickly performed non-invasively. In this study, we analyzed the mechanisms of nasal mucosal decongestion after applying vasoactive agents. The experiments were performed in normal adult volunteers (17 males, 3 females) who gave their informed consent to participate in this study. Three vasoactive agents (0.1% epinephrine, 0.5% phenylephrine hydrochloride, 0.5% oxymetazoline hydrochloride), two alpha-receptor antagonists (0.2% phenoxybenzamine, 0.4% yohimbine) and a local anesthetic (4% lidocaine) were used. In order to apply the agents precisely and safely, we attached a 6mm diameter disc moistened with 0.1 ml of solution to the anterior portion of the inferior turbinate unilaterally for fifty seconds. After removing the disc, acoustic measurements were performed for an hour. To analyze data we divided the nasal cavity into three portions, i.e., anterior, middle and posterior. Volume changes in each portion are expressed as percentages. Immediately after applying phenylephrine and oxymetazoline, ipsilateral volume in the anterior portion began to increase, and then extended posteriorly. The level of decongestion remained unchanged for an hour. Contralateral volume decreased in all portions. When epinephrine was applied, mucosal decongestion occurred first followed by congestion in all portions of the ipsilateral side after 20 minutes. Mucosal congestion occurred in all portions of the contralateral side. After applying phenoxybenzamine or yohimbine for ten minutes, we administered vasoactive agents topically. Pretreatment with alpha-1 antagonist almost totally suppressed the mucosal decongestion caused by phenylephrine and oxymetazoline. Contralateral congestion was decreased by antagonizing the suppression of ipsilateral decongestion. After application of lidocaine for ten minutes, phenylephrine still caused ipsilateral decongestion only in the anterior portion, but decongestion of the middle and posterior portion and congestion on the contralateral side totally disappeared. These findings suggest the following conclusions: 1) decongestion evoked by adrenergic agents is probably caused by direct activation of alpha-1 receptors, 2) decongestion of the middle and posterior portions is evoked by drug particles conveyed by ciliary movement, and 3) the contralateral response is probably related to the activation of sensory nerves on the ipsilateral side.

The effects of sunscreens on UVB erythema and Langerhans cell depression

Langerhans cells (LCs) are epidermal antigen-presenting cells capable of initiating a specific T lymphocyte-mediated immune response. It is a well known fact that ultraviolet light B (UVB) suppresses LC number and function. In this study, we confirmed that the sunscreens CITY BLOCK, and TOTAL SUN SHIELD 28 (Clinique Laboratories Tokyo, Japan) protected the epidermis against the depletion of LC number. We also investigated whether or not sunscreens could provide LC protection from ultraviolet ray (UVR) damage other than the prevention of the decrease in the total number of cells. Our data showed that the LC population was depressed after irradiation by 100 mJ/cm2 or 10 mJ/cm2 of UVB, but recovered to within normal levels after 16 days. Both sunscreens provided protection against erythema and LC depression due to UVB irradiation. However, despite the fact that these sunscreens had completely suppressed UVB erythema, shrinkage of LC dendrites was seen. Apparently, sunscreens prevent UVB erythema, but do not protect against functional changes in LC due to UVB. Recently, it has been reported that sunscreens are less effective in protecting against systemic immunosuppression that against inflammation. The shrinkage of LC dendrites despite sunscreen application may help explain this discrepancy.

A case of double cancer: a squamous cell carcinoma arising from a long pierced site on the left earlobe and a solid tubular carcinoma of the left breast

A 43-year-old woman presented with a well differentiated squamous cell carcinoma of the left earlobe where a small hole for pierced type earrings had been made about 20 years earlier. A year after the removal of the tumor, a metastasis of a moderately differentiated squamous cell carcinoma to the left cervical lymph nodes was detected. A month later, a solid tubular carcinoma of the left breast was found. A modified radical neck dissection and a quadrantectomy with an axillary lymph node dissection were performed. A total of 5 courses of peplomycine-mitomycine combinated therapy with 26 Gy of radiotherapy was administered for the cervical lesion. A month of postoperative chemotherapy with tegafur-uracil and medroxyprogesterone acetate and a total of 56 Gy of radiotherapy to the mammary lesion were added. She has been well without recurrence for about a year after the operations. This case is not only a rare double cancer, a combination of a squamous cell carcinoma and a solid tubular carcinoma, but may also be the first case of a squamous cell carcinoma arising at a long pierced site on an earlobe for pierced type earrings.

Additive two DMARD therapy of the patients with rheumatoid arthritis

From the beginning of 1987 to the end of 1989, 72 rheumatoid arthritis patients (RA) whose disease could not be controlled by a single disease modifying antirheumatic drug (DMARD) were selected for the trial treatment. They continued the DMARD treatment used initially at its regular dose, and then started another DMARD regimen at 1/3 to 1/2 of the regular dose as an additive DMARD treatment, which we have designated as Additive Two DMARD Therapy (ATDT). The patients were followed until the end of 1992. In the 3 months of ATDT, the effectiveness of ATDT was obtained in 42 (58.3%) patients who showed more than a 30% decrease in the initial Lansbury's activity index (AI). The rate of side effects at 3 months were 5.6%. Tiopronin, bucillamine or salazopirine added to gold sodium thiomalate or tiopronin were suggested as the recommended DMARD combinations for ATDT. The suppressive effects on AI, ESR, CRP and rheumatoid factor continued for as long as 18 to 24 months. The mean period of ATDT was 21.7 months and that at which ATDT proved useful was 31.9 months. A discontinuation of the first DMARD treatment without any following disease aggravation was obtained in 10 of 15 patients whose disease activity had been sufficiently suppressed for longer than a year. In conclusion, ATDT was suggested to be a useful way of treating RA patients whose disease activity could not be controlled by a single DMARD treatment, as well as a way of evaluating the next DMARD while the ongoing DMARD was observed to gradually lose its initial drug effect.

Extracellular levels of serotonin in the medial pontine reticular formation in acute decerebrate cats with a microdialysis technique

Extracellular levels of serotonin (5-HT) and 5-hydroxyindolacetic acid (5-HIAA) were measured in the medial pontine reticular formation of acute decerebrate cats. The mean basal levels of 5-HT and 5-HIAA were 26 fmol/20 microliters and 15 pmol/20 microliters. Perfusion of the dialysis probe with high K+ and Ca(2+)-free Ringer solution for 60 min resulted in 4.8-8.5 x increase and 25-48% decrease in the extracellular levels of 5-HT, respectively, in comparison to the basal 5-HT levels. Perfusion with TTX-added Ringer solution for 60 min resulted in a consistent decrease in the extracellular levels of 5-HT.

Coinfection of hepatitis C virus in patients with chronic hepatitis B infection

Enzyme-linked immunosorbent assays for detecting antibodies against hepatitis C virus and the polymerase chain reaction were tested in 82 chronic hepatitis B surface antigen carriers for their accuracy in diagnosing patients coinfected with hepatitis B and C viruses. To clarify the role of each virus in chronic hepatitis, serologic assays against hepatitis B virus were also tested. Thirteen (14.9%), 14 (17.1%) and 15 (18.3%) patients were anti-HCV positive using C100 (HCV1), JCC, and a second generation test (HCV2), respectively. HCV RNA was detected by polymerase chain reaction in 9 of 18 anti-HCV-positive cases. Although HCV1 assays were not sufficient, either the JCC or HCV2 assay detected all polymerase chain reaction-positive cases. Fifteen of 18 specimens that were positive in at least one of the three ELISA were seronegative for the hepatitis B e antigen. As judged by HBV DNA polymerase activity, titers of hepatitis B surface antigen and immunoglobulin A antibody against hepatitis B core antigen (IgA anti-HBc), activity of hepatitis B virus replication and immune response against hepatitis B virus in patients with coinfection was decreased to the level of hepatitis B virus asymptomatic carriers. These results show that hepatitis C virus appears to be the primary cause of active hepatitis in most patients with hepatitis B and hepatitis C virus coinfection.

Primary position upbeat nystagmus localizing value

Primary position upbeat nystagmus has been associated predominantly with lesions of the midbrain, midline cerebellum, and lower brainstem. However, the precise localization still remains unclear. We report one case of primary position upbeat nystagmus in which magnetic resonance imaging showed probable bilateral lesions of the prepositus hypoglossi nuclei. Morphological and physiological studies have shown that this nucleus plays important roles in vertical eye movements. We conclude that the dysfunction of bilateral prepositus hypoglossi nuclei causes the upbeat nystagmus in our patient.

Trilineage response to rhG-CSF with subsequent clonal hematopoiesis in a patient with severe bone marrow aplasia

We treated a patient with severe aplastic anemia with long-term administration of recombinant human granulocyte-colony stimulating factor (rhG-CSF). When a trilineage response of hematopoiesis was obtained after the first treatment, a chromosomal change [45XX, -7] was observed in 20 of the 20 metaphases examined. Later, we were able to show a monoclonal X inactivation pattern in the phosphoglycerate kinase (PGK) gene in the peripheral blood polymorphonuclear leukocytes and mononuclear cells, indicating the presence of clonal hematopoiesis regardless of the disappearance of the karyotype abnormality. We suggest that it is important to pay close attention to the appearance of clonal hematopoiesis during the administration of G-CSF to patients with idiopathic severe bone marrow aplasia.

Brain areas essential or non-essential for emesis

This study was undertaken to better delineate those brain regions that are either essential or non-essential for vomiting. Fictive vomiting, identified by a characteristic pattern of respiratory nerve discharge, was induced by a combination of emetic drugs and electrical stimulation of abdominal vagal afferents in decerebrate, paralyzed cats. Regions non-essential for coordinating vomiting included the entire cerebellum, structures rostral to the medullary retrofacial nucleus, and spinal cord. Fictive coughing was also elicited following cerebellar removal but was not studied after other procedures. The respiratory-related components of fictive vomiting were abolished by large lesions or kainic acid injections in the lateral medulla at the level of the retrofacial nucleus, where respiratory pre-motor and motor neurons are known to exist. Electrical stimulation of this region of the brainstem failed to evoke vomiting. The results of the present study are consistent with our previous electrical stimulation [Brain Res., 270 (1983) 154-158] and c-fos [J. Neurosci., 14 (1994) 871-888] studies and the hypothesis that emesis is coordinated not by a unique, well-defined 'vomiting center' but rather by a distributed control system located in the medulla between the levels of the obex and the retrofacial nucleus.

Relationship between porphyria cutanea tarda (PCT) and viral hepatitis

Recent reports have revealed the high prevalence of serological markers of viral hepatitis in porphyria cutanea tarda (PCT). We present two cases of PCT associated with hepatitis C and discuss the relationship between PCT and viral hepatitis. Case 1: A 50-year-old Japanese male noticed blisters, erosions, and fragility on sun-exposed areas of his skin in November of 1990. He had no history of excessive alcohol intake. He had been taking analgesics for eighteen years. Case 2: A 64-year-old Japanese male was referred in October of 1989 because of pigmentation on sun-exposed areas of his skin. He had been drinking alcohol excessively for 43 years. The hepatitis C virus (HCV) antibody was present in each case. Tests for the HCV antibody and hepatitis B serological markers were run in 5 other patients. HCV antibody was present in 3 of them. The two cases negative for the HCV antibody exhibited the hepatitis B antibody. We speculated that viral hepatitis infection may play an important role in precipitating PCT in cases with a history of a long term excessive intake of alcohol or chemicals.

[The comparison of clinical features between early rheumatoid arthritis and established rheumatoid arthritis]

Clinical features between 69 early RA patients (within a year duration) and 79 established RA patients (more than 3 years duration) were compared retrospectively. There were no significant differences about frequencies of morning stiffness (68.2% vs 54.4%) and rheumatoid nodules (20.2% vs 15.2%) between early RA and established RA. There were also no significant differences between two groups about elevation of ESR (92.8% vs 97.4%), positivity of CRP (97.1% vs 94.9%) and rheumatoid factor (RF) (82.6% vs 93.7%), and Lansbury activity index (AI) (mean 68.8% vs 78.8%). After hospitalization and treatment, all clinical indices (ESR, CRP, RF, AI) improved significantly in both groups. There, however, were clinically more "marked improvement" (39.1% vs 16.4%) and "remission" (8.7% vs none) in early RA group. We conclude that by hospitalization and treatment, clinical improvement can be expected in both early and established RA, but to secure satisfactory improvement, early detection and intervention of RA would be recommended.

Methotrexate for steroid-resistant systemic lupus erythematosus

We here report two patients with steroid-resistant systemic lupus erythematosus (SLE) who were successfully treated with methotrexate (MTX). In both cases, a steroid resistant high fever, associated with mild myositis and pancytopenia were the main common findings, and all these symptoms were alleviated within a few days either by 7.5 mg or 5 mg MTX per week. The number of CD4+ cells increased along with the clinical improvement, whereas the number of CD20+ cells and HLA-DR expressing cells also decreased. Taking into account the side effects of high dose corticosteroids and cyclophosphamides, treatment with a weekly low dose of MTX is known to contribute to an improvement in the long-term prognosis for patients with refractory SLE.

A case of acquired lymphangioma due to a suspected old filariasis and a review of literature

A 65-year-old man presented in 1992 with multiple papular lesions on the scrotum and foreskin. His medical history revealed that, at the age of 25, he was diagnosed as having filariasis and treated conservatively at a hospital in Hawaii. The histologic study of the scrotal skin showed large, dilated vascular spaces in the upper dermis lined with a single layer of endothelial cells that were negative for Factor 8-related antigen. The diagnosis was acquired lymphangioma due to a suspected old filariasis infestation, although serologic tests for filarial antibodies were negative. The paper also presents a review of the literature of acquired lymphangioma in Japan with a brief discussion of etiology and nomenclature.

Plasticity of emesis to a 5-HT3 agonist: effect of order of visceral nerve cuts

Serotonin type 3 receptors are critical for vomiting induced by radiation and cancer chemotherapy. To investigate the mechanisms involved, we analyzed the effects of abdominal visceral denervation using cats. Thresholds for vomiting induced by the serotonin-3 receptor agonist phenylbiguanide varied depending on the order of chronic nerve transections. Lower thoracic vagotomy, splanchnicectomy, and their sequential combination increased thresholds. However, when splanchnicectomy, which causes a large increase in threshold, was followed 14-51 days later by vagotomy, thresholds dropped by an average of 40%. These results demonstrate plasticity in, and potential for modulation of, the emetic reflex.

Histopathological and electron microscopical features of skin lesions in a patient with bartonellosis (verruga peruana)

Chronic verruga nodules taken from a patient with Bartonellosis (verruga peruana) were studied. Histologically, specimens of all the verruga nodules had features consistent with granulomatous lesions with extensive infiltration of various types of cells along with the proliferation of capillaries. The sections were predominantly infiltrated with neutrophils and endothelial cells; histiocytes, plasma cells, lymphocytes and mast cells were also visible to some extent. The blood vessels were dilated, and many rounded and swollen endothelial cells were located peripherally; a huge number of neutrophils invaded the vessels. Electron microscopically, large number of organisms were seen in different stages of the life cycle in the stroma. Furthermore, organisms were regularly seen either in close contact or existing inside the cytoplasm of neutrophils, suggesting the phagocytic role of these cells. No organism was found inside any endothelial cells or histiocytes.

Coexistence of ochronosis and rheumatoid arthritis

We describe a 64-year-old female patient with ochronosis and rheumatoid arthritis. Magnetic resonance imaging of the spinal column disclosed the destruction of vertebral disks, and a bony bridging in Th12 to L2. In addition, we observed joint space narrowing in the wrists as well as among the carpal bones, positive rheumatoid factor and the presence of rheumatoid nodules, in which the histological findings were compatible with those of rheumatoid arthritis. The co-existence of these two diseases has not yet been previously reported. Pre-existing ochronotic arthropathy might have masked the manifestation of rheumatoid arthritis and made the diagnosis of rheumatoid arthritis rather difficult.

A case of a giant schwannoma on the extremities

A 52-year-old Japanese female with a human head sized lump on the medial femoral region of her right thigh is described. The histopathological diagnosis after the excision of the tumor was an ordinary type of schwannoma composed of two types of tissue, Antoni types A and B. The tumor was 20 x 15 x 12 cm in size and 2250 g in weight; this is probably the biggest of all the reported cases of schwannoma on the extremities in Japan.

In vitro IgM rheumatoid factor production by peripheral blood mononuclear cells from patients with seronegative rheumatoid arthritis

OBJECTIVE

We investigated whether mononuclear cells (MNC) from patients with seronegative rheumatoid arthritis (SNRA) are able to produce rheumatoid factor (RF) in response to lectin stimulation, Staphylococcus aureus Cowan I (SAC) or pokeweed mitogen (PWM), and also we investigated the role of CD5+ B cells in the pathogenesis of in vitro IgM RF production.

METHODS

IgM RF production was measured by enzyme linked immunosorbent assay and CD5+ B cells by flow cytometry. Also, the effects of monocyte depletion and the inhibition of prostaglandin (PG) were compared in SNRA, seropositive RA (SPRA) and healthy controls.

RESULTS

Peripheral blood MNC of patients with SNRA were able to produce the same amount of IgM RF as patients with SPRA following stimulation and SAC. CD5+ B cells also increased in patients with SNRA as well as patients with SPRA compared to healthy controls. However, a definite contribution of the CD5+ B cells to SAC-induced IgM RF production could not be demonstrated. The role of macrophage and PG on in vitro IgM RF synthesis were insignificant.

CONCLUSION

MNC of patients with SNRA were able to produce IgM and IgG RF in response to SAC stimulation as well as that of the healthy controls. However, we could not find a significant role of CD5+ B cells and monocytes on in vitro IgM RF synthesis by MNC of patients with SNRA.

Experimental murine protoporphyria induced by griseofulvin (GF): the relationship between hepatic porphyrin levels and liver function test values in mice treated with GF

To investigate the hepatic abnormalities accompanying experimental protoporphyria due to griseofulvin (GF), liver function test values and porphyrin levels in mice were assayed at days 2, 4, 8, and 16 after starting the administration of 0.5% GF feed. Furthermore, in an attempt to elucidate the harmful effects of GF on liver functions, the above mentioned assay was also performed after the feed was discontinued in mice given 0.5% GF feed for 16 days. The hepatic protoporphyrin (PP) level had already risen by day 2, but the erythrocytic PP level was within normal limits at that time. Hepatic PP levels increased gradually, followed by an increase in erythrocytic PP levels. The variation in liver function test values roughly paralleled the porphyrin levels. Over the time span of the response to GF, the variations in the serum glutamate oxaloacetate transaminase (S-GOT) levels, serum glutamate pyruvate transaminase (S-GPT) levels, and leucine amino peptidase (LAP) levels resembled those in hepatic PP. On the other hand, the changes in alkaline phosphatase (ALP) levels paralleled those of the erythrocytic PP levels. Erythrocytic and fecal protoporphyrin levels decreased to the normal level one month after the discontinuation of GF administration, but the hepatic protoporphyrin level still was 53.6 times higher than the normal level two months after switching to normal feed. The values of liver function tests had returned to within the normal range after one month. By the fourth day after the administration of GF, a brown pigmented material could be observed around the hepatocytes and the Glisson sheath; the amount of this material increased day by day.(ABSTRACT TRUNCATED AT 250 WORDS)