Ultrasonographic study and long-term follow-up of Takayasu's arteritis

BACKGROUND AND PURPOSE

Takayasu's arteritis is an inflammatory vasculopathy involving the aorta and its major branches. Little information is available on the natural history and temporal profile of changes in the carotid vessels, the major vessels involved in Takayasu's arteritis. Duplex ultrasonography may provide a reliable and efficient tool for the characterization and follow-up of the brachiocephalic vascular changes in Takayasu's arteritis.

METHODS

Sixteen female patients fulfilling the clinical diagnostic criteria for Takayasu's arteritis were studied. Mean age at onset was 23.6 years (SD = 6.0), and mean duration of follow-up was 17.1 years (SD = 11.9). The clinical features were analyzed. Only one patient had had a stroke. They had undergone at least one duplex scanning examination to evaluate the brachiocephalic vessels, including the extracranial carotid, vertebral, and subclavian arteries. Six patients underwent sequential duplex examination and long-term clinical follow-up.

RESULTS

All the studied patients had subclavian artery involvement, and 11 (69%) had common carotid artery involvement. The percentage of bilateral concomitant involvement was 100% in the common carotid artery and 33% in the subclavian artery. Homogeneous circumferential intima-media thickening was commonly seen in stenotic common carotid arteries (89%). Four patients had internal carotid artery involvement (all on the left side). In the serial duplex follow-up study, 2 of 6 patients had progressive vascular stenosis with concentric thickening, rather than longitudinal spreading, in the bilateral common carotid arteries. Left-side lesions were more prominent. Most were clinically stationary, despite severe stenosis or occlusion of the common carotid arteries.

CONCLUSIONS

The characteristic vascular lesions and progression changes in Takayasu's arteritis detected by duplex ultrasonography are quite different from those seen in ordinary atherosclerosis. Homogeneous circumferential intima-media thickening of the common carotid arteries is a highly specific ultrasonographic finding in patients with Takayasu's arteritis, particularly young women. Sequential duplex scanning showed vascular progression to be unpredictable and unrelated to medication in our patients. Further clinical investigations of vascular progression are warranted, and duplex scanning may provide a simple, safe, and accurate long-term means of follow-up.

Prenatal diagnosis in a Chinese family with type Ia glycogen storage disease by PCR-based genetic analysis

Type Ia glycogen storage disease (GSD), an autosomal recessive metabolic disorder, is caused by a deficiency in glucose-6-phosphatase (G6Pase). We had previously identified the nature of the causative mutations in a Chinese family whose first two children were affected with type Ia GSD. Two different point mutations in the G6Pase gene, a guanine to adenine substitution at base position 327 in exon 2 and a thymine to adenine substitution at base position 1101 in exon 5, change the restriction sites for the enzymes Fok I and Hinc II. Family study revealed that both parents were heterozygous carriers: the father with a mutant G6Pase allele at exon 2 and the mother with another mutant G6Pase allele at exon 5. This paper deals with a prenatal diagnosis on the fetus of this family who is at risk of type Ia GSD. Genomic DNA was extracted from a chorionic villus biopsy sampled at the tenth week of gestation. Exons 2 and 5 of the G6Pase gene were amplified by the polymerase chain reaction (PCR) followed by restriction enzyme digestion and direct sequence analysis. DNA analysis indicated that the fetus was a heterozygous carrier of type Ia GSD with a mutant G6Pase allele at exon 2 and a normal G6Pase allele at exon 5. The diagnosis was further confirmed by the same method with cultured amniocytes and with a blood sample after the baby was born. This is the first report of prenatal carrier detection of type Ia GSD at the gene level.

Neoplastic response in Japanese medaka and channel catfish exposed to N-methyl-N'-nitro-N-nitrosoguanidine

Japanese medaka (Oryzias latipes) and channel catfish (Ictalurus punctatus) were investigated for carcinogenic response following a 28-day, 3 x/wk pulse exposure to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Five-wk-old medaka were exposed at concentrations of 0, 0.5, and 1.0 mg/L, and 5-mo-old catfish at concentrations of 0, 0.1, and 0.5 mg/L. In medaka, a total of 19 tumors including 2 branchioblastomas, 6 thyroid follicular adenomas and 1 adenocarcinoma, and 11 subcutaneous fibrosarcomas were observed in 16 of 96 MNNG-exposed fish. In catfish, a total of 37 tumors including 4 squamous cell carcinomas and 16 papillomas, 3 lipomas, 1 fibroma, 1 osteosarcoma, 4 branchioblastomas, 6 thymic epithelial tumors, and 2 generalized lymphosarcomas were observed in 34 of 172 MNNG-exposed fish. The induction of neoplasms in medaka was primarily in the gill, thyroid, and subcutis of the cervical and trunk regions, whereas in catfish skin, thymus, oro-pharynx, and hemopoietic tissues were also commonly affected. In both species, the neoplastic response was considered to be related to direct exposure of the tissues to MNNG. Some of these tumors have not been reported in the literature in either natural or experimental fish. The results also suggest species-specific differences in carcinogenic response following MNNG exposure.

Genetic analysis of the glucose-6-phosphatase mutation of type 1a glycogen storage disease in a Chinese family

Type 1a glycogen storage disease (GSD) is an autosomal recessive metabolic disorder caused by a deficiency in glucose-6-phosphatase (G6Pase). Polymerase chain reaction (PCR) and nucleotide sequence analysis were used to identify the location and nature of mutations at the G6Pase locus in two siblings affected with type 1a GSD. Both patients are compound heterozygotes with two different single nucleotide substitutions in the two G6Pase alleles. A guanine to adenine transition was identified at base position 327 in the exon 2, converting an arginine to a histidine at codon 83. The second substitution was a thymine to adenine transversion at base position 1101 in the exon 5, converting an isoleucine to an asparagine at codon 341. Family study reveals that both parents are heterozygous carriers: the father with a mutant G6Pase allele at exon 2, the mother with another mutant G6Pase allele at exon 5. This is the first family study in Taiwan on type 1a GSD identified by molecular analysis. The mutations identified herein are novel substitutions in the G6Pase gene. In addition, an adenine to guanine substitution was observed at base position 653 in the exon 5 of G6Pase gene in both sibling patients and their parents, as well as in 15 normal Chinese subjects and three normal Caucasian subjects.

Reverse jugular flow in a case of thrombosis of the brachiocephalic vein with an artificial arteriovenous fistula

Thrombosis of the thoracic inlet veins following placement of a central venous catheter is a well-known complication, and several findings have been reported by color Doppler sonography. However, reverse jugular flow resulting from this complication is rarely mentioned and should be differentiated from another complication of iatrogenic arteriovenous fistula between neck vessels. The authors here describe a uremic patient with an artificial arteriovenous fistula in the forearm complicated with thrombosis of the ipsilateral brachiocephalic vein. Factors permitting the differential diagnosis by coloer Doppler sonography and clinical conditions are proposed.

Zinc supplementation aggravates body fat accumulation in genetically obese mice and dietary-obese mice

A perturbation of zinc metabolism has been noted in numerous laboratory animals with diabetes and obesity. The effects of zinc supplementation on body fat deposition in two types of experimental obese mice: genetically obese (ob/ob) mice and high-fat diet-induced ICR obese (HF) mice were investigated in this study. Their lean controls were +/? mice, and ICR on basal diet, respectively. The mice in the zinc-supplemented groups were administered 200 mg/kg zinc in their diets for 6 wk. Both the ob/ob mice and the HF mice, that were fed a diet containing a marginal zinc dosage (4-6 mg/kg), had lower zinc levels in their serum and carcass, and higher body fat content than their respective lean controls (p < 0.01). After zinc supplementation, ob/ob mice and the HF mice significantly (p < 0.05) increased their body fat by 49.4% and 18.9%, respectively. This study revealed that body fat deposition can be aggravated by zinc supplementation in both types of obese mice. Zinc may be associated with the energy homeostasis of obesity, via its interaction with dietary fat consumption.

Restoration of lung compliance with calf lung surfactant extract and a surfactant analog in an in situ model of surfactant deficiency in rats

We have developed a standardized in situ lung surfactant deficiency model in the rat by using a single bronchoalveolar lavage (BAL). The purpose of this study was to assess the usefulness of surfactants and surfactant analogs in terms of their in vivo physiological properties. Calf lung surfactant extract (CLSE) was shown to improve lung compliance in a dose-dependent manner in this surfactant deficiency model when administered intratracheally immediately after BAL. In addition, CLSE formulated with a diether (palmityl) phosphonolipid surfactant analog significantly improved the compliance post-BAL as compared to CLSE alone. We propose that this in situ bioassay may be useful for the assessment of physiological capabilities of surfactants, surfactant analogs and surfactant formulations.

Diagnosis and follow-up of carotid-cavernous fistulas by carotid duplex sonography and transcranial color Doppler imaging

To investigate the suitability of extracranial carotid duplex (ECD) and transcranial color Doppler imaging (TCDI) in the diagnosis and follow-up of treatment in patients with carotid-cavernous fistulas (CCF), combined ECD and TCDI examinations were studied in seven patients with traumatic CCF. According to angiography, four patients had direct CCF, two indirect CCF and one both direct and indirect CCF. In ECD, hemodynamic parameters of the feeding artery showed an abnormally increased flow volume and decreased resistivity indices in five direct CCFs from the internal carotid artery and one indirect CCF from the external carotid artery. Direct visualization of the CCF was achieved in patients with direct CCF only, and revealed itself as a heterogeneous mosaic flash resulting from high flow velocities and turbulence. Patterns of venous drainage were detected via the transorbital and transforaminal windows in seven and five patients (four direct and one indirect CCF patients), respectively. These abnormal findings were improved or even normalized after successful treatment. In conclusion, combined ECD and TCDI examinations appear to be useful for the diagnosis and follow-up of CCF.

Genetic analysis of the HPRT mutation of Lesch-Nyhan syndrome in a Chinese family

BACKGROUND

The Lesch-Nyhan syndrome is an X-linked recessive inherited disease caused by a complete deficiency of hypoxanthine guanine phosphoribosyl-transferase (HPRT) activity. Many different mutations throughout the HPRT coding region of Lesch-Nyhan patients have been described, including single base substitutions, partial or entire gene deletions, gene insertions or endoduplication of exons. However, study of gene mutation in Chinese patients has rarely been reported in Taiwan.

METHODS

Polymerase chain reaction (PCR) and nucleotide sequence analysis were used to identify the location and the nature of the mutation at the HPRT locus in two brothers affected with Lesch-Nyhan syndrome. The HPRT cDNA, amplified from total RNA of patient's peripheral blood by reverse transcription-polymerase chain reaction, was cloned into a pGEM-3Zf(-) vector and then sequenced. Family study involved initial screening using single-strand conformation polymorphism, and further confirmation by direct sequencing of the exon encompassing the mutation.

RESULTS

The mutation identified in these two affected siblings was a single nucleotide substitution, from cytosine to guanine, in exon 3 of the HPRT coding region. This transversion putatively caused a single amino acid substitution from phenylalanine to leucine at codon 74 in the translated protein. This base change was further confirmed by direct sequencing of both the HPRT cDNA fragment and the exon 3 of HPRT gene amplified from genomic DNA. The family study revealed that the patient's mother was a heterozygous carrier, and the mutation seemed to have occurred de novo in a germinal cell from one of the maternal grandparents.

CONCLUSIONS

This is the first family study on Chinese patients with Lesch-Nyhan syndrome identified by molecular analysis in Taiwan. The mutation described herein is a novel substitution which occurs in a suggested "hotspot" of mutation (exon 3) of the HPRT gene. The application of molecular analysis of HPRT-gene allows not only DNA diagnosis by directly detecting the mutant alleles, but also prenatal diagnosis and carrier identification within individual families affected by Lesch-Nyhan syndrome.

Dietary copper supplementation increases the catecholamine levels in genetically obese (ob/ob) mice

The interactive relationship between Cu deficiency and depressed synthesis of certain neurotransmitters has been recognized. To investigate the effects of dietary Cu supplementation on the catecholamine levels in genetically obese mice, male obese (ob/ob) mice and their lean (+/?) counterparts were administered either a control diet (4.0 mg/kg) or a Cu-supplemented diet (50 mg/kg) for 4 wk. The ob/ob mice that were fed a control diet showed lower liver and higher plasma levels of Cu. Depressed levels of plasma and brain catecholamines were also found in ob/ob mice that were fed the control diet. The ob/ob mice that received a Cu-supplemented diet showed significant increases in the levels of catecholamine in the plasma and brain. This study showed that catecholamine levels in ob/ob mice can be increased by dietary Cu supplementation. However, the interaction between Cu and sympathetic nervous activity in obesity was not elucidated in this study.

Selected metals status in patients with noninsulin-dependent diabetes mellitus

In order to investigate the relationships between metals zinc [Zn], copper [Cu], magnesium [Mg], or Calcium [Ca] and noninsulin-dependent diabetes mellitus, 65 patients of newly diagnosed noninsulin-dependent diabetes mellitus and 54 nondiabetic healthy controls were studied. The concentrations of selected metals in fasting blood samples and 24-h urine collections were determined. Hyperzincuria and hypermagnesuria were detected in diabetic patients (p < 0.01). The diabetics also had lower Zn and Mg, and higher Cu, and Ca levels in their plasma than those of the controls, but the statistical differences in Ca and Mg were not significant. Significantly lower Zn and higher Ca levels in erythrocytes were found in diabetic patients (p < 0.01). There is evidence of a significant difference in metals status between diabetic patients with or without the specific complications. This study further indicates that patients with NIDDM on Taiwan also have distinct changes in their metals status, and these perturbations are associated with some diabetic complications.

Expression of a Drosophila GATA transcription factor in multiple tissues in the developing embryos. Identification of homozygous lethal mutants with P-element insertion at the promoter region

GATA transcription factors are DNA-binding proteins that recognize the core consensus sequence, WGATAR. Previous studies indicated that GATA factors play ann important role in the development of tissue-specific functions in vertebrates. Here we report the identification of a new Drosophila melanogaster GATA factor, dGATAc, which displays a distinct expression pattern in embryos. The local concentration of dGATAc transcripts varies at different stages, being most prominent in the procephalic region at stages 6-10 and in the posterior spiracles, the gut, and the central nervous system at stages 11-13. On the basis of its predicted sequence, DNA-binding assays were performed to confirm that the dGATAc gene encodes a zinc finger protein that can bind the GATA consensus motif with predicted specificity. Two independent mutants carrying a P-element insertion at the dGATAc gene promoter region were identified that are homozygous lethal at the embryonic stage. Using a genetic scheme, it was demonstrated that the lack of dGATAc function can block normal embryonic development. Our results suggest that the dGATAc protein is a tissue-specific transcription factor that is vital to the development of multiple organ systems in D. melanogaster.

In vivo function of surfactants containing phosphatidylcholine analogs

Increased phospholipase A2 activity demonstrated in some forms of lung injury may contribute to surfactant dysfunction. Phospholipase A2-resistant analogs of dipalmitoylphosphatidylcholine (DPPC) with surfactant properties might therefore be useful lipid components of treatment surfactants for certain lung injuries. The in vivo function of surfactants containing DPPC or the phospholipase-resistant analogs dihexadecylphosphatidylcholine (DEPC) or dihexadecylphosphonotidylcholine (DEPnC), with or without surfactant proteins B and C (SP-B+C), was thus evaluated in preterm rabbits (27 days' gestation). Rabbits randomly received one of seven surfactants (DPPC, DEPC, DEPnC, DPPC+SP-B+C, DEPC+SP-B+C, DEPnC+SP-B+C, or lipid extract surfactant [LES]) or 0.45% NaCl (control) and were ventilated for 30 min. Lipid-only surfactants decreased ventilatory pressures (peak inspiratory pressures minus positive end-expiratory pressure) relative to control (p < 0.05). Addition of SP-B+C further decreased ventilatory pressures to levels similar to LES (p < 0.01 versus control, lipid-only surfactants). Lung dynamic compliances and postventilation pressure-volume curves improved in the following order: LES, SP-B+C lipid surfactants > lipid-only surfactants > control (p < 0.05). All surfactant preparations decreased intravascular 125I-albumin recoveries in the lungs relative to control (p < 0.01 for all surfactants versus control). These results indicate that DEPC and DEPnC were as effective as DPPC as lipid components of synthetic surfactants. And like DPPC, the analogs interacted with isolated SP-B+C and improved in vivo function to levels comparable to LES.

Effect of caffeine on the levels of brain serotonin and catecholamine in the genetically obese mice

BACKGROUND

Most obesities are known low in sympathetic activity, and brain neurotransmitters may play roles in the defective exhibitions of obesity. Caffeine, a stimulant, which can prompt lipolysis, has been applied on the therapy of obesity. Although the interactive combinations between caffeine and certain neurotransmitters has been appreciated recently, but its regulatory mechanisms are still obscure. This study investigated the effect of caffeine on the body fat deposition, and its interactions with brain serotonin and catecholamine in the genetically obese (ob/ob) mice.

METHODS

At 12-week of age, obese mice and their lean counterparts (+/?) were administered with caffeine (4 mg/d) in water for 4 weeks. The brain neurotransmitters levels and body fat content were measured.

RESULTS

The obese mice without caffeine treatment had lower brain norepinephrine and epinephrine levels than the lean controls. And there had no difference between obese and lean mice in brain levels of serotonin, tryptophan, and 5-hydroxyindoleacetic acid. Caffeine treatment showed no effect on the food intake, but decreased the body fat content significantly in obese mice. Mice with caffeine treatment showed increase of the levels of brain neurotransmitters in both phenotypes; this effect was more predominant in obese mice.

CONCLUSIONS

This study indicated that the effect of caffeine to decrease body fat deposition in the obese mice might be associated with the recovered increases of sympathetic activity.

Effect of manganese on tyrosylprotein sulfotransferase activity in PC12 cells

Recent studies in our laboratory have revealed that Mn2+ is capable of promoting cell spreading and neurite outgrowth in PC12 cells, a process which is dependent on Mn2+ stimulation of the interaction between extracellular matrix (ECM) components and their corresponding integrin receptors. Since the major ECM proteins implicated in the Mn(2+)-induced morphogenesis, fibronectin and vitronectin, are both tyrosine sulfated, it was of interest to determine whether Mn2+ can regulate the activity of the enzyme responsible for tyrosine sulfation, tyrosylprotein sulfotransferase (TPST). Results of the present studies demonstrated that Mn2+ can suppress TPST activity in PC12 cells in both a time and concentration-dependent manner at concentrations of Mn2+ (0.1 to 1 mM) that promote morphological changes in PC12 cells. Since uptake of Mn2+ may occur via the Ca2+ channel, LaCl3, an inhibitor of Ca2+ transport, was examined and found not to prevent the suppression of TPST activity induced by Mn2+, suggesting that Mn2+ may function at an extracellular site. Suppression of TPST activity occurred with cells plated in serum-free medium on a substrata consisting of either serum or polylysine, suggesting that attachment to extracellular matrix was not an absolute requirement for regulation of activity. Consistent with this is the fact that an RGD-containing pentapeptide did not prevent suppression of TPST activity. Results from the present study demonstrated that Mn2+ is capable of promoting the suppression of TPST activity in PC12 cells at concentrations that have been shown to induce cell spreading and neurite outgrowth. However, unlike the Mn(2+)-induced morphological changes, the presence of ECM proteins is not an absolute requirement for suppression of TPST activity.

[Epidemiological study of gestational diabetes mellitus in Taipei and factors effecting blood glucose]

The prevalence of non-insulin-dependent diabetes mellitus has increased significantly in the last decade. Meanwhile, it has been found that patients with gestational diabetes have a greater chance of developing diabetes than normal subjects. This study was designed to survey the prevalence of GDM in metropolitan Taipei. A screening test with 50 g of glucose was performed on pregnant patients between 24 and 28 weeks of gestation, and a blood sample was collected one hour after ingestion. The subjects with a plasma glucose level over 130 g/dL were scheduled for a standard 75 g oral glucose tolerance test for diagnosis. Altogether, 872 pregnant women participated in the study. According to the WHO criteria which were published in 1985, a total of 224 (25.7%) subjects had a positive screening test. Thirty-seven (4.2%) subjects had impaired glucose tolerance (IGT) and five (0.6%) subjects were found to have GDM after the 75 g OGTT. Comparisons of the glucose levels of women of different ages (< 30 and > or = 30), BMI (< or = 24 and > 24), and parity (0 and > or = 1) demonstrated that women over 30, with a BMI over 24, or a parity over 1 had a significantly higher plasma glucose level than their counterparts in the screening test. Even after BMI-adjustment, the difference was still significant for the age and parity comparisons.

[Effects of fasting and diet resupplementation on the variation of blood zinc, copper, calcium and magnesium levels in two laboratory rodents: DBA/2 mouse and SD rat]

The effects of fasting and diet resupplementation on the variation of certain blood metals were studied in DBA/2 mice and SD rats. Metal concentrations in serum and erythrocyte were determined by atomic absorption spectrometer. Blood zinc levels were decreased and varied within sampling time from 0800 to 1200 AM, and the other blood metals concentrations were no change when animals had no fasting. After overnight fasting, blood zinc levels both in serum and erythrocyte, and erythrocyte magnesium concentration were decreased significantly. Fasting did not alter the sampling time-related variation on serum zinc levels, but would increase the erythrocyte zinc levels in opposite when in comparison with non-fasting. When animals resupplied with diet after fasting, blood zinc increased smoothly, and blood copper, calcium and magnesium would exhibit a lower concentration at the sampling time of 1400 and 1600, respectively. The species and sex did not affect the variation of blood metals levels in this study. This study showed that food intake and absorptive equilibrium of body metals had effects on the variation of blood metals concentration. Endocrine and nutrient factors also might indirectly affect this variation. So, it is suggested that a standard and compatible concern on the sampling time, animals breeding and selection should be noticed when conducting the relevant metals studies with biological samples in order to prohibit any mistakes on the explanatory results.

Manganese induces spreading and process outgrowth in rat pheochromocytoma (PC12) cells

Mn2+ has been shown to promote cell-substrate adhesion and cell spreading in many cell culture systems. In this study, we present data demonstrating that Mn2+ not only promotes spreading, but also induces process outgrowth in rat pheochromocytoma (PC12) cells. In the presence of 1.0 mM MnCl2, cell spreading was apparent by 6 hr, and nearly 50% of the exposed cells extended neurite-like processes. These morphological effects of Mn2+ were both time- and dose-dependent. In the presence of cycloheximide, a protein synthesis inhibitor, both Mn(2+)-induced spreading and neurite outgrowth were prevented, indicating that de novo protein synthesis is required for the effects of Mn2+ to take place. Of the other divalent cations tested, Mg2+, Cd2+, Cu2+, Ni2+, and Zn2+ were ineffective, and only Co2+ partially mimicked the effects of Mn2+. Although Mn(2+)-induced cell adhesion and spreading have been extensively studied, this is the first report that this divalent cation can cause neurite outgrowth. The neurite outgrowth-promoting effects of Mn2+ were distinct from those of nerve growth factor in that the response to Mn2+ was considerably more rapid, but apparently lacked the ability to sustain continuous outgrowth and networking of neurites. Mn2+ also induced the levels of GAP-43 and peripherin, two proteins associated with neuronal differentiation of PC-12 cells. In cells grown in serum-free defined medium, Mn2+ was capable of promoting neurite outgrowth when the cells were plated on surfaces pretreated with normal growth medium, vitronectin, or fibronectin, while it failed to cause these morphological changes in cells plated on untreated or poly-D-lysine-coated substrata. Similarly, Mn2+ also promoted neurite outgrowth from rat sympathetic neurons attached to laminin-treated substrate, but had no effect on neurons maintained on substrate with polylysine only. The pentapeptide Gly-Arg-Gly-Asp-Ser nearly completely prevented the morphological effects of Mn2+ on PC12 cells. These findings are consistent with a hypothesis that Mn(2+)-mediated alteration of an RGD-dependent extracellular matrix-integrin interaction is responsible for the neuritogenic effects.

[The evaluation of blood perfusion of lower extremities in patients with NIDDM by 133Xe muscle clearance test: a preliminary report]

In this study, we collected twenty NIDDM patients with impaired sensation and clinically suspected angiopathy over both lower extremities. All the patients underwent testing by means of the ultrasonic Doppler technique and were separated into two groups, group 1 with impaired blood flow, and group 2 with no significant impairment of blood flow. Ten normal persons were also included in this study (group 3). The results of the 133Xe muscle clearance test showed that the Q value of group 1 was 0.85 +/- 0.24 [mean +/- SE, ml (100g tissue min-1)], 1.05 +/- 0.31 in group 2 and 1.78 +/- 0.23 in group 3 of normal controls. After statistical analysis, there were significant differences in groups 1 and 2 relative to group 3 (p < 0.05), respectively. This preliminary result indicates that the 133Xe muscle clearance test may be an effective and convenient method to evaluate angiopathy of lower extremities in patients with NIDDM.

[Studies on the chemical constituents of Croomia japonica Miq]

A new steroid alkaloid, namely croomionidine (II), together with four known compounds pachysamine A(I), croomine (III), didehydrocroomine (IV) and beta-sitosterol were isolated from the roots of Croomia japonica Miq. Their structures were identified by IR, MS, 1H NMR, 13C NMR and chemical conversion.

[Studies on the chemical constituents of Fritillaria taipaiensis L]

A new C-nor-D-homo-steroidal alkaloid named taipaienine, together with five known alkaloids namely chuanbeinone, imperialine, verticinone, perimissine and isoverticine were isolated from the bulbs of Fritillaria taipaiensis L. var. ningxiaensis Y. et W.. The unusual structure of taipaienine was a first sample with a hydroxyl group substituted at C-25 of (22)R-trans quinolizidine moiety with orientation of nitrogen lone pair. Their structures were determined by various spectral analyses.

[Alterations of zinc levels in patients with thyroid disorders]

It is known that patients with hyperthyroidism have a lower zinc content in their erythrocytes, and that this decrement returns to normal after treatment with anti-thyroid drugs. This study was designed to investigate the alteration of body zinc levels in thyroid disorder. Two groups of out-patients associated with hyperthyroidism or hypothyroidism, and a group of normal healthy controls were collected. Zinc contents in the blood, hair and 24-hour urine samples were determined by a flame atomic absorption spectrometer. The results showed that patients with hyperthyroidism had a lower erythrocyte zinc level and an increased urinary zinc excretion (p < 0.05). The hypothyroidism had a higher hair zinc content and a decrement in urinary zinc excretion (p < 0.05). Body zinc levels, excluding the plasma zinc, held a certain correlation to the plasma thyroid hormones levels. The urinary zinc levels showed a more parallel variation in the thyroid disorders (p < 0.05). This data indicates that the alteration of urinary zinc levels might be a useful index for thyroid disorder evaluation. Body zinc could also play a physiological role in the metabolic regulation(s) of a thyroid disorder.

Thyrotoxicosis accompanied with periodic seizure attacks a case report and review of literature

A 58-year-old female was admitted and discovered to be a victim of thyrotoxicosis. She had experience periodic seizure attacks for 14 months. These seizures disappeared when function of the thyroid returned to normal. We performed many studies to search for the cause of the seizures. No epileptic focus could be detected from an EEG or a MRI of the brain. There was no abnormal laboratory data such as: hypoglycemia, hypoxemia, serum electrolyte imbalance, or an acid-base imbalance. No evidence of CNS infection was noted. She had good response to antithyroid treatment. We therefore suggest, that the seizure attacks may be related to thyrotoxicosis. In reviewing the literature, we found that only 13 cases of thyrotoxicosis with seizures have been reported since 1956 [1-9].