Abnormal coronary flow dynamics at rest and during tachycardia associated with impaired left ventricular relaxation in humans: implication for tachycardia-induced myocardial ischemia

OBJECTIVES

This study attempted to clarify the effect of ventricular relaxation abnormalities on coronary flow dynamics at rest and during tachycardia in humans.

BACKGROUND

Ventricular relaxation abnormality has been demonstrated in animals to have an adverse impact on early diastolic coronary flow dynamics. However, this relation has not been established in humans. Even if the adverse effect were latent at rest, it might become evident during tachycardia because tachycardia reduces coronary flow reserve and facilitates the production of myocardial ischemia.

METHODS

Doppler phasic left coronary flow velocity pattern was obtained at rest and during tachycardia in 23 patients without coronary stenosis. The time constant of left ventricular isovolumic pressure (tau) was used to assess ventricular relaxation.

RESULTS

The time to peak flow velocity of the diastolic coronary flow wave was longer, and the fraction of the first third of diastolic coronary flow was smaller, in patients with a longer tau (r = 0.58, p < 0.01; r = -0.44, p < 0.05), indicating a close relation between early diastolic coronary flow dynamics and ventricular relaxation. Although rapid atrial pacing yielded an increase in the coronary flow velocity integral per minute in all patients, diastolic coronary flow velocity integral per minute increased in 9 patients with a normal (< or = 40 ms) tau at rest but decreased in 14 patients with a longer (> 40 ms) tau at rest.

CONCLUSIONS

Impaired left ventricular relaxation was associated with decreased coronary flow in early diastole at rest and decreased coronary flow throughout diastole during tachycardia in patients without coronary stenosis. These findings may provide more insight into the mechanism of tachycardia-induced subendocardial ischemia in patients with impaired ventricular relaxation but without concomitant coronary stenosis.

Expression of transforming growth factor-alpha in the human ovary during follicular growth, regression and atresia

The cytologic localization and cellular levels of TGF alpha in the human ovary during follicular growth and regression were examined by avidin/biotin immunoperoxidase techniques with a monoclonal antibody to TGF alpha. In primordial follicles, only the oocyte showed intense immunostaining for TGF alpha, whereas the flattened pregranulosa cells were negative for the immunostaining. The earliest stage of follicular growth at which immunostaining for TGF alpha in granulosa cells and theca interna cells became apparent was the preantral stage. With the increase in the size of follicles, the intensity of TGF alpha immunostaining in the oocyte decreased, whereas the staining intensity of the granulosa and theca cells increased. The immunostaining for TGF alpha in granulosa and theca interna cells persisted in the corpus luteum, and further intensified during the midluteal phase. In the regressing corpus luteum, the immunostaining was present only in the peripheral theca lutein cells adjacent to the central scar tissue. The corpus albicans was negative for the immunostaining. Stromal cells exhibited weak staining for TGF alpha. In atretic follicles, the theca interna cells exhibited intense staining for TGF alpha without appreciable staining in the scattered granulosa cells. This is the first report to demonstrate that TGF alpha expression in the oocyte is maximal in primordial follicles, whereas TGF alpha expression in granulosa and theca cells increases with the progress of follicles and reaches its maximum in the lutein cells during the mid luteal phase.(ABSTRACT TRUNCATED AT 250 WORDS)

Cutaneous vasculitis in a patient with dermatomyositis without muscle involvement

A 74-year-old female patient with cutaneous ulcerations and typical dermatomyositis (DM) skin rash had no muscle disease for a 1-year and 5 months period. Histological examination of the skin ulceration indicated vascular occlusion without cellular infiltration. Cutaneous ulceration is a very rare manifestation of adult-onset DM patients without inflammatory myopathy.

Localization of mRNAs for three novel members (beta 3, beta 4 and gamma 2) of phospholipase C family in mature rat brain

In mature rat brain, PLC beta 3 mRNA was detected weakly only in the pituitary gland and the cerebellar Purkinje and granule cells whereas PLC beta 4 mRNA was expressed intensely in the olfactory mitral cells, thalamic nuclei, medial habenula, pituitary gland and cerebellar Purkinje and granule cells. The beta 4 mRNA was also detected discretely in large neurons of presumably cholinergic nature, scattered rather evenly throughout the caudate putamen and diagonal band, although no significant expression was seen in the medium spiny neurons in the caudate putamen, and the hippocampal pyramidal cells and dentate granule cells. PLC gamma 2 mRNA was localized only in the Purkinje and granule cells in the vermal portions of lobules IX and X of the cerebellum, and in the adenohypophysis.

Computed tomography-guided coil injection and thoracoscopic pulmonary resection under roentgenographic fluoroscopy

To remove a small, chest roentgenogram-negative, computed tomogram-positive nodule, we developed a novel technique of thoracoscopic pulmonary resection. This technique consists of the computed tomography-guided coil injection of a metallic coil and subsequent thoracoscopic resection under roentgenographic fluoroscopy. During the thoracoscopic resection, the fluoroscopic image was a valuable aid in determining the location of the nodule and in ensuring that the stapler was applied with a sufficient distance from the coil. Because this technique helps to determine the exact location of the nodule regardless of its depth from the pleural surface, even a minithoracotomy for direct palpation can be avoided.

Figo clinical stage IIb carcinoma of the uterine cervix and surgical staging

Postsurgical precise correlation was examined in 48 patients with an invasive carcinoma of the cervix in International Federation of Gynecology and Obstetrics (FIGO) clinical stage IIb. Of the 48 cases, 18 cases were overestimated; in which inflammatory parametrial changes and endophytic tumor growth were seen. Six lesions clinically underestimated were associated with superficial invasion into the rectal or bladder muscle. Resultant precise correlation was available in the remainder (24 cases).

Abnormal cytoskeletal pathology peculiar to corticobasal degeneration is different from that of Alzheimer's disease or progressive supranuclear palsy

An autopsy case of clinically diagnosed "corticobasal degeneration (CBD)" was investigated. In addition to status spongiosus and neuronal achormasia around the central sulcus, cortical pyramidal neurons and thread-like structures were densely stained by Gallyas stain and tau immunohistochemistry, but apparent fibrillary structures like Alzheimer's disease neurofibrillary tangle were absent. Bodian, methenamine-Bodian, Congo red, thioflavin S, or Bielshowsky stains failed to visualize these structures. They were not stained by immunohistochemical stain with anti-ubiquitin antibody. The widespread cytoskeletal pathology, which is distinct from that in Alzheimer's disease or progressive supranuclear palsy, is suggestive of CBD.

Preliminary evaluation of the new tumor marker, CYFRA 21-1, in lung cancer patients

Serum samples from 137 lung cancer patients were examined by RIA to evaluate the clinical efficacy of the new tumor marker, CYFRA 21-1, which could identify the soluble fragment of cytokeratin 19. The cut-off value was determined to be 2.2 ng/ml according to the receiver operating characteristic curve. The sensitivity, specificity and accuracy of the RIA for CYFRA 21-1 were 57.7, 91.9 and 64.9%, respectively. The serum concentration of CYFRA 21-1 and the sensitivity of the assay increased as the disease progressed. Histologically, the sensitivity was highest for squamous cell carcinomas (SQ) (76.5%) in comparison with adenocarcinomas (47.8%) and small cell lung cancers (42.1%) (P < 0.01, P < 0.05, respectively). The sensitivities for SQ were 60.0, 83.3, 80.0 and 100% at stages I, II, III and IV, respectively. When compared with CEA (45.3%) and squamous cell carcinoma related antigen (SCC) (22.6%) in all lung carcinomas, CYFRA 21-1 showed the highest sensitivity (57.7%), (P < 0.05, P < 0.01, respectively). In SQ, the sensitivity of the CYFRA 21-1 RIA was significantly higher than that of the assay for SCC (47.1%) (P < 0.05). In patients with adenocarcinomas, the sensitivity of the CYFRA 21-1 assay was almost the same as that for CEA (49.3%). In a combination of CYFRA 21-1 and CEA for non-small cell lung cancers (NSCLC), the sensitivity and accuracy increased to 75.4 and 78.1%, respectively, although the specificity decreased to 86.5%. It is concluded that CYFRA 21-1 could replace SCC, a less satisfactory tumor marker, for SQ of the lung. The potentiality of the combination of CYFRA 21-1 and CEA for NSCLC should be estimated using larger samples in the near future.

In vitro and in vivo effects of cisplatin and etoposide in combination on small cell lung cancer cell lines

The effects of cisplatin (CDDP) and etoposide (ETP) in combination were evaluated in vitro and in vivo using small cell lung cancer cell lines. The combination effects in vitro were investigated using isobologram analysis. Used together, CDDP and ETP showed a synergistic effect against cell growth on only 1 cell line (SBC-3), additive effects on 6 (SBC-2, SBC-5, Lu130, Lu134AH, Lu135T and H69) and an antagonistic effect on 1 (SBC-1). In the in vivo experiment, nude mice were inoculated with SBC-1, SBC-3 and SBC-5 cells. Two or 5 mg/kg CDDP and 10 or 30 mg/kg ETP were administered intraperitoneally alone and simultaneously in combination to nude mice. The in vivo effects of the combination were determined by comparing the observed growth ratio in mice treated with the combination with the expected value of this ratio calculated based on the assumption that the effects of the drugs were simply additive. According to this definition, synergistic effects were observed against all 3 tumors. Thus, the in vivo and in vitro effects differed. The toxicity of the combination therapy, which was analyzed by estimating the body weight change of mice, was no higher than that of CDDP or ETP alone. These results suggest that the excellent clinical effects of CDDP and ETP combination therapy may be attributable not to drug interaction at the cellular level but to the feasibility of combined use of them at full doses without overlapping side effects.

Cloning and nucleotide sequence of cDNA encoding Asp-hemolysin from Aspergillus fumigatus

The nucleotide sequence of a cDNA encoding Asp-hemolysin from Aspergillus fumigatus was clarified. The deduced amino acid sequence was shown to contain a set of negatively charged domains similar to portions of the cysteine-rich sequence in the ligand-binding domain of LDL-receptor. A potential signal sequence was also identified in the N-terminal domain of the deduced amino acid sequence.

Cloning of cDNAs for new subtypes of murine low-affinity Fc receptor for IgE (Fc epsilon RII/CD23)

In humans, two subtypes of the low-affinity Fc receptor for IgE, Fc epsilon RIIa and Fc epsilon RIIb, have been identified. The two forms differ only in a short stretch of amino acids at the cytoplasmic amino terminus. On the other hand, only one Fc epsilon RIIa-like receptor was reported in the mouse, although the existence of another subtype of transcript has been suggested. A new cDNA subtype for murine Fc epsilon RII that has amino acid homology to the human subtype b at the amino terminus was cloned by polymerase chain reaction. When expressed transiently in COS cells, the cDNA is capable of generating a functional cell surface protein that is recognized by an anti-Fc epsilon RII antibody and that has affinity to IgE. In the spleen, although the expression level is considerably lower than that of subtype a, the transcript appears in B cells and in non-B cells upon stimulation with IL-4 and LPS, in contrast to the constitutive expression of the conventional Fc epsilon RII transcript. It is also detectable in several cell lines of B- or T-cell lineages. These results suggest that this gene may be the murine counterpart of human Fc epsilon RII subtype b. Another cDNA clone for the distinct Fc epsilon RII transcript has also been isolated. The cDNA also encodes a surface protein functional on COS cells, but its human counterpart has not been found.

Marked elevation of carcinoembryonic antigen and carbohydrate antigen 19-9 in the peripheral blood as an initial manifestation of meningeal carcinomatosis

Marked elevation of tumor markers in the peripheral blood was initially a sole manifestation of meningeal carcinomatosis in a man with gastric carcinoma. In addition to extensive meningeal carcinomatosis, no metastatic lesions were found at autopsy other than microscopic infiltration into a tiny paraaortic lymph node. Elevation of these markers in the peripheral blood is best explained by meningeal carcinomatosis. When elevation of these markers is otherwise unexplainable, meningeal carcinomatosis should be considered as a diagnostic possibility even in the absence of neurological symptoms.

Molecular cloning of rat cDNA for cytosolic phospholipase A2 and the increased gene expression in the dentate gyrus following transient forebrain ischemia

Rat cytosolic phospholipase A2 (cPLA2) cDNA was cloned from rat brain. The cDNA showed a high homology of 90% in the nucleotide sequence of the coding region with the human counterpart. By in situ hybridization, the gene expression for cPLA2 was detected in the hippocampus, olfactory bulb, and cerebellar granular cells at very low level of normal rats. The expression was markedly increased in the dentate granule cells of postischemic rat brain. This alteration of the gene expression was discussed in relation to the free fatty acid-mediated neurotoxicity.

Expression of the chemokine superfamily in rheumatoid arthritis

The infiltration of leucocytes into the joint of rheumatoid arthritis (RA) is believed to be mediated by chemotactic factors released by activated cells. In this study, examination was made of the gene expression and production of the chemokine superfamily in RA patients by reverse transcriptase-polymerase chain reaction (RT-PCR) and immunoprecipitation. Cultured synovial fibroblasts were found capable of expressing and producing IL-8, GRO, monocyte chemotactic and activating factor (MCAF), macrophage inflammatory protein-1 alpha (MIP-1 alpha), MIP-1 beta and RANTES in response to IL-1 alpha. The expression of IL-8, GRO, MCAF, MIP-1 alpha, and MIP-1 beta was clearly shown to increase in freshly isolated synovial fluid mononuclear cells (SFMC) of RA patients, in contrast to peripheral blood mononuclear cells (PBMC) of RA patients and normal subjects. The gene expression of RANTES appeared to be the same for RA SFMC, RA PBMC, and normal PBMC. Thus, the over-expression of various chemokines may promote the recruitment of inflammatory cells into rheumatoid inflamed joints.

Transthoracic Doppler assessment of pattern of left ventricular dysfunction in hypertensive heart disease: combined analysis of mitral and pulmonary venous flow velocity patterns

Although mitral flow velocity pattern changes with the progression of left ventricular (LV) diastolic dysfunction, it lacks predictive value in individual patients because of pseudonormalization in the presence of congestive heart failure and many physiologic and pathologic contributors to the mitral flow velocity pattern. To determine whether analysis of pulmonary venous flow velocity patterns complements the information obtainable from the mitral flow velocity patterns in the evaluation of patterns of LV dysfunction of hypertensive heart disease in individual patients, the ratio of the peak early diastolic filling velocity/peak filling velocity at atrial contraction (E/A ratio) in the mitral flow velocity pattern and the ratio of the peak systolic forward flow velocity (S)/peak diastolic forward flow velocity (D) (S/D ratio) in the pulmonary venous flow velocity pattern by the transthoracic approach were determined in 107 hypertensive patients with and without congestive heart failure. Age-related normal values of the E/A and S/D ratios were determined in 61 normal subjects and used to judge the normality or abnormality of the patterns. Results of the study indicate that (1) although an increased mitral E/A ratio is strongly indicative of heart failure with normal LV systolic function, the mitral E/A ratio is frequently within the normal range in hypertensive patients with heart failure; (2) association of decreased pulmonary venous S/D ratios with a normal mitral flow velocity pattern indicates the presence of heart failure as a result of LV systolic dysfunction that is usually observed at the most advanced pattern of LV dysfunction; (3) mild LV diastolic dysfunction is likely to exist in patients with normal E/A ratios if the pulmonary venous S/D ratio is higher than normal value; (4) predictive accuracy in the detection of LV systolic and diastolic dysfunction would be improved if both mitral and pulmonary venous flow velocity patterns rather than the mitral flow velocity pattern alone were analyzed. In conclusion, analysis of pulmonary venous flow velocity recordings improves accuracy and reliability of the Doppler assessment of LV systolic and diastolic dysfunction, particularly in individual hypertensive patients with normal mitral flow velocity patterns.

Transgenic mice overexpressing human vasoactive intestinal peptide (VIP) gene in pancreatic beta cells. Evidence for improved glucose tolerance and enhanced insulin secretion by VIP and PHM-27 in vivo

Vasoactive intestinal peptide (VIP), a 28-amino acid peptide hormone, plays many physiological roles in the peripheral and central nervous systems. It has been proposed that endogenous VIP released from VIP-containing nerves is involved in the regulation of the secretory function of the endocrine pancreas. To test this hypothesis in vivo, we produced transgenic mice carrying the human VIP/peptide histidine methionine 27 (PHM-27) gene under the control of insulin promoter. In immunohistochemical analyses of islets, all the islet beta cells of transgenic mice were intensely stained for both VIP and PHM-27, consistent with the fact that these two peptides are encoded in a single mRNA (Itoh, N., Obata, K., Yanaihara, N., and Okamoto, H. (1983) Nature 304, 547-549). VIP was efficiently secreted from isolated transgenic islets in vitro. The blood glucose assays in free-fed mice indicated that the transgene lowered the blood glucose levels of transgenic mice (128 +/- 4 mg/dl) by about 20% below control levels (155 +/- 6 mg/dl). In the glucose tolerance test, at 60 min after glucose administration, the transgenic blood glucose levels (129 +/- 12 mg/dl) were much lower than control levels (175 +/- 13 mg/dl). The transgenic serum insulin levels at 15 min after glucose administration were 2.5-3.0-fold higher than control levels. The transgene was also effective in ameliorating glucose intolerance of 70% depancreatized mice. These results indicate that VIP and PHM-27 produced from the transgenic beta cells efficiently enhance glucose-induced insulin secretion from beta cells by an autocrine mechanism. These results also suggest that genetic manipulation of islet beta cells by the human VIP/PHM-27 gene or delivery of VIP to beta cells may ultimately provide a valuable approach to enhancing insulin secretion in clinical diabetes.

Synthesis and antibacterial activity of thiazolopyrazine-incorporated tetracyclic quinolone antibacterial agents. 2

A novel series of 8-(2-substituted morpholino)-9,1-[(N-methylimino) methano]-7-fluoro-5-oxo-5H-thiazolo[3,2-a]quinoline-4-carboxylic acids, designated 8a-j, with a unique tetracyclic structure were synthesized, and the in vitro and in vivo antibacterial activities against Gram-positive strains, including methicillin-resistant Staphylococcus aureus isolates (MRSA), and Gram-negative strains were evaluated. These morpholino derivatives, 8a-j, showed excellent in vitro antibacterial activities against Gram-positive bacteria. The substitutions at the C-2 position of the 8-morpholino moiety of compound 8 play an important role in the enhancement of in vivo antibacterial activity. The unsubstituted morpholino derivative 8a, the 2,6-dimethyl derivative 8c, and the 2-ethylmorpholino derivative 8d showed poor in vivo antibacterial activity, while 8b, 8f-h, and 8j exhibited good activities. The 2-(methoxymethyl)morpholino derivative, 8h, showed the most potent activity in vivo. The therapeutic effects of 8h on systemic infection against S. aureus IID 803 were over 10-fold more potent than that of ofloxacin. Compound 8h, which showed superior oral bioavailability, has a chiral center. The enantiomers of 8h were synthesized, and the in vitro and in vivo antibacterial activities were evaluated. Both enantiomers, (S)-8h and (R)-8h, and the racemic compound 8 exhibited similar activities in vitro and in vivo. Compounds 8b and 8f-h also showed good levels of antibacterial activity against MRSA strains. The morpholino derivatives with unique tetracyclic structures are characterized by strong antibacterial activities against MRSA strains.

Re-examination of the ontogeny in the gene expression of DARPP-32 in the rat brain

By in situ hybridization histochemistry, we have re-examined the ontogeny of the gene expression of mRNA encoding the dopamine- and cyclic AMP-regulated phosphoprotein with a molecular weight of 32,000, termed DARPP-32. On E13 and E15, weak expression signals were detected in the mantle zones and ventricular germinal zones of the fore-, mid-, hind-brain, and spinal cord. In the caudate putamen, the expression signals were first visible at its lateral margin on E15. The ventrolateral region of the caudate putamen expressed the gene intensely, while its ventricular germinal zone expressed it weakly on E18-20. Thereafter, the mRNA for DARPP-32 were expressed over the entire caudate putamen in patchy patterns. After birth, the expression levels in the caudate putamen increased markedly, with the majority of the neurons in the caudate putamen expressing the gene intensely on P7 and thereafter. In addition to the caudate putamen, expression signals were detected, albeit faintly, in the olfactory bulb, cortical plate, hippocampal pyramidal cell layer, and their ventricular zones on E18-20. The olfactory tubercle and medial habenular nucleus expressed the gene at slightly higher levels. In the cerebellum, the Purkinje cells showed progressively increasing gene expression from E20 to P7, whereas the external granule cell layer expressed the gene weakly. The ontogeny of the gene expression is largely consistent with previous immunohistochemical findings by other authors. Furthermore, the present finding suggests that DARPP-32 is involved in the regulation of the mitosis-related dephosphorylation by protein phosphatase 1 in the neuroepithelium.

Renal thrombotic microangiopathy in a patient with rheumatoid arthritis and antiphospholipid syndrome: successful treatment with cyclophosphamide pulse therapy and anticoagulant

A female patient with a history of migraines and chorea developed polyarthralgia at age 24 and was diagnosed with rheumatoid arthritis. In 1991 she was hospitalized because of impaired renal function and hypertension. Examination revealed thrombocytopenia and the presence of lupus anticoagulant. Antinuclear antibody was weakly positive, but anti-DNA antibody was negative, and no decrease in leukocyte count or complement level was observed. Rheumatoid arthritis with antiphospholipid syndrome was diagnosed. Renal biopsy showed renal thrombotic microangiopathy. This renal lesion was considered to be associated with antiphospholipid syndrome. Cyclophosphamide pulse therapy and anticoagulation therapy decreased proteinuria and improved renal function.

Molecular cloning of rat cDNAs for the zeta and theta subtypes of 14-3-3 protein and differential distributions of their mRNAs in the brain

We isolated from the rat brain two cDNA clones encoding the zeta and theta subtypes of the 14-3-3 protein. Both clones encoded 245 amino acid sequences, which share a high sequence homology with each other and also with other subtypes of the 14-3-3 protein. The distribution of their mRNAs was determined in the developing brain, by in situ hybridization with subtype-specific oligonucleotide probes. At embryonic day 18, the zeta and theta subtype mRNAs were expressed at high levels throughout the brain and the spinal cord. Distribution patterns of the two mRNAs were distinct in the brain at postnatal day 21. The zeta subtype mRNA was distributed widely in the brain gray matter, and high levels of the transcripts were detected in various brain regions, including the neocortex, hippocampus, caudate-putamen, thalamus, cerebellar cortex, and several brainstem nuclei. On the other hand, high signal levels of the theta subtype mRNA in the gray matter were restricted to the cerebellar cortex and the hippocampus. In addition, significant signals for the theta subtype mRNA were found over the white matter, where cell bodies of glial cells are populated. The wide gene expression of the zeta and theta subtypes suggests their fundamental and essential role in the brain function, but the degrees of functional involvement by the respective subtypes would be heterogeneous between neuron and glia, and also among neuron types.

Hydroxyl radical generation in skeletal muscle atrophied by immobilization

Male Wistar rats (15 weeks old), the ankle joints of one hindlimb of which were immobilized in the extended position for 12 days, were injected with salicylate as a trapping agent for hydroxyl radicals before sacrifice. Atrophied and contralateral soleus, typical slow red muscles were collected and their levels of 2,3-dihydroxybenzoic acid (2,3-DHB), one of the main reaction products formed by the attack of hydroxyl radical on salicylate, were determined using high-performance liquid chromatography with an electrochemical detector. There was a significant increase in 2,3-DHB in the atrophied muscle. This result strongly suggests the enhanced generation in vivo of hydroxyl radicals in atrophied muscle.

Analysis of transmural trend of myocardial integrated ultrasound backscatter for differentiation of hypertrophic cardiomyopathy and ventricular hypertrophy due to hypertension

OBJECTIVES

This study was undertaken to differentiate hypertrophic cardiomyopathy from hypertensive hypertrophy using a newly developed M-mode format integrated backscatter imaging system capable of calibrating myocardial integrated backscatter with the power of Doppler signals from the blood.

BACKGROUND

Myocardial integrated ultrasound backscatter changes in patients with hypertrophic cardiomyopathy; however, it is unknown whether ultrasound myocardial tissue characterization may be useful in differentiating hypertrophic cardiomyopathy from hypertensive hypertrophy.

METHODS

Calibrated myocardial integrated backscatter and its transmural gradient were measured in the septum and posterior wall in 31 normal subjects, 13 patients with hypertensive hypertrophy and 22 patients with hypertrophic cardiomyopathy. The gradient in integrated backscatter was determined as the ratio of calibrated integrated backscatter in the endocardial half to that in the epicardial half of the myocardium.

RESULTS

Cyclic variation of integrated backscatter was smaller and calibrated myocardial integrated backscatter higher in patients with hypertrophied hearts than in normal subjects, but there were no significant differences in either integrated backscatter measure between patients with hypertensive hypertrophy and those with hypertrophic cardiomyopathy. Transmural gradient in myocardial integrated backscatter was present only in patients with hypertrophic cardiomyopathy (5.0 +/- 1.8 dB [mean +/- SD] for the septum; 1.2 +/- 1.6 dB for the posterior wall).

CONCLUSIONS

Hypertrophic cardiomyopathy and ventricular hypertrophy due to hypertension can be differentiated on the basis of quantitative analysis of the transmural gradient in integrated backscatter.

[Methylprednisolone pulse therapy for SLE patients with CNS disorder]

A clinical trial was conducted in 22 SLE patients with central nervous system (CNS) disorder in which the efficacy of pulse methylprednisolone suleptanate at the dose of 400 mg or 800 mg (as methylprednisolone) was assessed. The symptoms of CNS disorder disappeared within 40 days after pulse therapy in all of the 16 patients with organic brain syndrome (OBS). No improvement in the symptoms took place in any but one of the five patients who had cerebrovascular disorder. One SLE patient with depression showed improvement 55 days after pulse therapy. In the patients with OBS who had not received pulse therapy until 28 days or more after onset of CNS disorder, the symptoms disappeared in 20 days or more in both 400 mg and 800 mg dose groups. On the other hand, five of the six patients given the dose of 800 mg within 10 days of occurrence of the disease experienced a complete relief of the symptoms in 10 days after pulse therapy. However, at least 13 days were required for complete relief in all the four patients of the 400 mg group. The adverse reactions reported consisted of hyperlipemia, diabetes mellitus, and infections such as thrush or herpes zoster. The above results suggest that methylprednisolone pulse therapy is useful in the treatment of CNS disorder associated with SLE, particularly in patients with OBS who are given the dose of 800 mg early after onset of the disease.

Localization of phosphatase inhibitor-1 mRNA in the developing and adult rat brain in comparison with that of protein phosphatase-1 mRNAs

The localization and ontogenic changes in the gene expression for phosphatase inhibitor-1 (I-1) were analyzed by in situ hybridization histochemistry, and they were compared with those for three catalytic subunits of protein phosphatase type 1 (PP-1). At the adult stage, intense expression signals for I-1 were detected in the hippocampal formation, piriform cortex, claustrum, dorsal endopiriform cortex, suprachiasmatic nucleus, choroid plexus, arachnoid membrane, and pineal body. Moderate expression signals for I-1 were observed in the olfactory neuronal layers, caudate putamen, layers II-IV, and VI of the neocortex, and cerebellar granule cells, whereas the expression levels were low in the thalamus, cerebellar Purkinje cells, and brain stem nuclei. Although the expression levels for the three PP-1 mRNAs varied notably in various brain regions, a relatively high and parallel expression of I-1 and PP-1 mRNAs was found in most regions of the forebrain. However, the dissociation in the expression levels between I-1 and PP-1 mRNAs was found in several loci: the laminar expression of I-1 mRNA versus the homogeneous expression of PP-1 mRNAs in the cerebral cortex; low levels of expression of I-1 mRNA versus relatively high expression of PP-1 mRNAs in the brain stem nuclei; high expression of I-1 mRNA in the arachnoid membrane versus low expression of PP-1 mRNAs in it. The unparallel expression was also seen in embryonic brain: No significant expression of I-1 mRNA versus substantial expression of PP-1 mRNAs in the ventricular zone and cerebellar external granular layer; transiently high expression of I-1 mRNA in developing thalamus versus constantly moderate to low expression of PP-1 mRNAs there. These findings suggest that I-1 may play some discrete roles independent of the regulation of PP-1 in certain regions and developing stages of the brain.