[Intrathoracic giant tumor accompanied by hypoglycemia]

Some non-islet tumors can induce hypoglycemia. We report a case of an intrathoracic giant tumor accompanied by hypoglycemia. The patient was a 53-year-old woman who was found to have hypoglycemia. Chest X-ray film showed a giant tumor in the left hemithorax and rightward shift to the mediastinum. CT and MRI revealed that the tumor's border was clear. The tumor was removed by sternotomy with third and seventh inter-costal incisions. The tumor was lobulated but its border was clear. It seemed to have grown from the posterolateral thoracic wall. After the tumor was removed, re-expansion pulmonary edema occurred but was relieved by diuretics and respiratory management. Histologic findings indicated that it was probably a thymoma or a localised mesothelioma, but it could not be identified even with special stains. Solitary fibrous mesotheliomas are sometimes complicated by hypoglycemia, and some of them produce insulin-like growth factor (IGF). In this case, the pre-operative level of immuno-reactive insulin was low, so the tumor may have produced IGF.

[Experimental studies on evaluation of rat testicular function by 31P magnetic resonance spectroscopy]

To evaluate the efficacy of 31P magnetic resonance spectroscopy (31P MRS) as a diagnostic method for abnormal testicular function, we examined three conditions using rat testes, ischemia, irradiation, and hormone manipulation. 1) Ischemia: Immediately after clamping of the feeding vessels, ATP signals began to fall and disappeared within 60 minutes. With the release of blood supply after 3 hours of ischemia, ATP appeared within 2 hours. However, after more than 4 hours of ischemia, ATP did not recover within 2 hours and the testis became necrotic after 1 week. 2) Irradiation: 31P MRS of the testis 2 weeks after irradiation with 10 Gy., 9 MeV showed a significant decrease (P < 0.05) in the PME/beta-ATP ratio from 1.30 +/- 0.11 (control level) to 1.11 +/- 0.12 and a decrease in PME/PDE ratio from 1.43 +/- 0.17 to 1.13 +/- 0.20. However 3 weeks later, the PME/beta-ATP ratio recovered to a control level. 3) Hormone manipulation: In the testes 5 weeks after weekly intramuscular injections of estradiol benzoate and testosterone enanthate, PDE/beta-ATP ratio significantly increased (P < 0.01) from 0.83 +/- 0.09 (control level) to 1.03 +/- 0.19. 31P MRS is a non-invasive method for evaluation of various testicular abnormalities, and ATP signals may be useful to evaluate an acute ischemic change for example testicular torstion and the changes of PME, PDE signals may be useful parameters in the assessment of the status of spermatogenesis.

MR of pituitary metastasis in a patient with diabetes insipidus

We present a case of acute-onset diabetes insipidus in a 69-year-old man who had been treated for lung cancer. T1-weighted MR images showed a thickened pituitary stalk and absence of the normal high intensity of the posterior pituitary lobe. Dynamic imaging demonstrated poor enhancement in the posterior lobe, whereas the anterior lobe was strongly enhanced. Autopsy revealed that metastatic tumor from lung cancer had infiltrated the posterior lobe as well as the pituitary stalk.

Selective imaging with a frequency-modulated laser-diode interferometer

It is shown that selective extraction of an image from multiple interferograms can be performed by electronic processing of interference beat signals. The frequencies of beat signals generated by ramping the laser-diode (LD) current are proportional to the optical path differences between the reference and the object arms in a LD interferometer. A beat signal with a frequency corresponding to an object-assigned interferometric arm can be extracted by electronic tuning. An interference pattern detected by a dissector camera is sampled in synchronism with the beat signal, which permits two-dimensional selective imaging.

Purification and characterization of a newly identified isoform of cytochrome P450 responsible for 3-hydroxylation of 2,5,2',5'-tetrachlorobiphenyl in hamster liver

In the hamster liver, 2,5,2',5'-tetrachlorobiphenyl (TCB) is metabolized to 3-hydroxy- and 4-hydroxy-2,5,2',5'-TCB to a similar extent, and formation of the former metabolite is stimulated by phenobarbital pretreatment of the animals, while that of the latter metabolite is stimulated by 3-methylcholanthrene pretreatment. In the present study, we identified a new isoform (designated P450HPB-1) of cytochrome P450 which proved to be phenobarbital-inducible and responsible for 3-hydroxylation of this TCB isomer. This isoform was purified from liver microsomes of phenobarbital-treated hamsters and characterized. P450HPB-1 has a molecular mass of 50 kDa, determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the absorption maxima of the oxidized form at 417 nm and of the reduced CO-complex form at 450 nm. The sequence of 28 amino acids of P450HPB-1 at the amino-terminal has a 68% similarity with those of rat P450 2B1 and mouse P450 2b10, 57% similarity with that of guinea pig P450GP-1, and 54% similarity with that of guinea pig P450GP-1, and 54% similarity with those of rabbit P450 2B4 and dog P450 2B11. P450HPB-1 in the reconstituted system catalyzed the 3- but not 4-hydroxylation of 2,5,2',5'-TCB, at a rate of 19.0 pmol/min/nmol P450. The isoform also has high catalytic activity for 17-oxidation of testosterone but low activity for the N-demethylation of benzphetamine and 16 alpha- and 16 beta-hydroxylations of testosterone. In microsomal metabolism of 2,5,2',5'-TCB, rabbit antiserum against P450HPB-1 almost completely inhibited 3- but not 4-hydroxylation. Immunoblot analysis of hamster liver microsomes revealed that P450HPB-1 was constitutive and phenobarbital-inducible but was decreased by pretreatment with 3-methylcholanthrene or 3,4,5,3',4'-pentachlorobiphenyl. These results suggest that P450HPB-1 belongs in the P450 2B subfamily and apparently plays a major role in the 3-hydroxylation of 2,5,2',5'-TCB, in hamster liver.

[A clinical study on superior sulcus tumors]

Twenty nine patients with superior sulcus tumors (26 men and 3 women) were studied. The incidence was 2.1% of 1350 patients with lung cancer. The mean age was 66.2 years, and 27 patients (93.1%) had a history of smoking (B.I. = 1193.7). There were 10 adenocarcinomas, 9 squamous cell carcinomas, 5 large cell carcinomas 4 small cell carcinomas, and 1 that could not be classified. Fifteen patients (51.7%) had Stage IV disease on admission. Eight patients (27.6%) presented with symptoms outside the chest. Pancoast syndrome was recognized in 9 patients (31.0%). In 15 patients (51.7%) the diagnosis was made by transbronchial biopsy and in 10 patients (34.5%) it was made by echoguided needle biopsy. Tumors were located in a posterior lesion in 13 patients (44.8%). Twenty patients were given radiation therapy. Clinical staging, irradiation, and surgical treatment were related to the length of survival. The median survival time was 7 months.

[Expression and subtype analysis of vascular endothelial growth factor (VEGF) and its receptor (flt-1) in human ovarian tumors]

Angiogenesis is very important not only for embryogenesis and wound healing but also for tumor growth in vivo because vessels supply oxygen and nutrition to the tumor mass. In this study, we focused on Vascular Endothelial Growth Factor (VEGF), a newly characterized endothel-specific growth factor and investigated the expression of VEGF in 13 ovarian tumors and 3 normal ovaries by using polymerase chain reaction (PCR) analysis and Northern blot analysis. Further, we examined the expression pattern of 4 alternatively spliced forms of VEGF in these tissues. The level of VEGF mRNA was higher in 77% of ovarian tumors when compared with that in normal ovaries. Among subtypes of VEGF, 121-, 165- and 189-amino acid types were detected but 206-amino acid type was not observed in ovarian tumors. The most abundant form of VEGF was 121-amino acid type and the relative amounts of the various forms of VEGF were 121-amino acid type > 165-amino acid type >> 189-amino acid type. Expression of flt-1, a receptor for VEGF was detectable by PCR but not by Northern blot analysis. These results suggest that like other epithelial cell-derived carcinomas, ovarian tumors use the VEGF/flt-1 system for tumor angiogenesis.

Metabolic alterations in the neonate and infant brain during development: evaluation with proton MR spectroscopy

PURPOSE

To evaluate the usefulness of hydrogen-1 magnetic resonance (MR) spectroscopy in the evaluation of the developing brain.

MATERIALS AND METHODS

Localized MR spectra were obtained with an echo time of 272 msec from the brain of 78 neonates and infants aged 1 week to 100 months. All patients were retrospectively classified into three groups on the basis of neurologic development: abnormal (group 2, n = 21), normal despite minor neurologic signs (group 1, n = 23), and normal (group 0, n = 34).

RESULTS

Seventeen patients in group 2 and eight patients in group 1 revealed abnormally low N-acetylaspartate (NAA)/choline or NAA/creatine ratios compared with those obtained in group 0. MR spectroscopy was slightly more useful in the differentiation of patients in groups 2 and 1 (chi 2 test, P < .005) than MR imaging (P < .01).

CONCLUSION

H-1 MR spectroscopy provides prognostic information about the brain in healthy and neurologically damaged infants and augments the value of MR imaging.

MR imaging of hepatosplenic sarcoidosis

We present a case of hepatosplenic sarcoidosis. Splenic lesions were detectable by both MRI and dynamic CT. They were demonstrated as multiple low signal intensity lesions on T2-weighted images obtained by MRI and as low density lesions by dynamic enhanced CT. Hepatic focal lesions were not apparent on CT or MRI. After steroid therapy, both dynamic enhanced CT and MRI showed disappearance of the splenic lesions. These are valuable modalities for detecting focal splenic sarcoidosis and evaluating the effect of steroid therapy.

Bone mineral status in preterm-born children: assessment by dual-energy X-ray absorptiometry

To elucidate the long-term consequences of osteopenia of prematurity, lumbar spinal bone mass was measured in 21 preterm-born children aged 3-4 years by dual-energy X-ray absorptiometry. Their mineral intake remained low during early life, and all 11 infants previously studied were osteopenic at term postconception. At the age of 3-4 years, however, all 21 children were found to have normal bone mineral content and density with slightly elevated serum osteocalcin levels. Our results show that in preterm-born children spontaneous resolution of lumbar spinal osteopenia occurs during early childhood.

Serial proton magnetic resonance spectroscopy in a patient with the interval form of carbon monoxide poisoning

Serial proton magnetic resonance spectroscopy (1H-MRS) studies were performed from immediately after the appearance of sequelae in a patient with the interval form of carbon monoxide (CO) poisoning. The volume of interest was set over the frontal lobe white matter. In the early period a persistent increase in choline was found, which was thought to reflect the course of progressive demyelination. The appearance of lactate and decrease in N-acetylaspartate reflected the point at which neuron injury became irreversible. These were followed later by the finding of irreversible changes on MRI and single photon emission computed tomography. The findings suggest that 1H-MRS may be a useful modality to determine neuron viability and prognosis early in the course of the interval form of CO poisoning.

Localization of stem cell factor (SCF) and c-kit mRNA in human placental tissue and biological effects of SCF on DNA synthesis in primary cultured cytotrophoblasts

The supernatant of homogenized human placental tissues at early and late stages of pregnancy were found to contain 40-100 pg of stem cell factor (SCF)/mg of total protein by enzyme linked immunosorbent assay. When the SCF mRNA expression was examined by reverse transcriptase-polymerase chain reaction (RT-PCR), the secretory type and membrane-bound type SCF mRNA were detected in the human placental tissues in the early stages of pregnancy and in a human placental cell line;tPA30-1 cells. However, the secretory type SCF mRNA was predominant and membrane-bound type SCF mRNA was absent or very weak in the term placental tissues. When the distribution of SCF mRNA and c-kit mRNA in the placental tissues was examined by in situ hybridization, SCF mRNA was detected in the cytotrophoblast, the intermediate trophoblastic cell column and the stromal cells, while c-kit mRNA was detected in the cytotrophoblast and the intermediate trophoblastic cell column. Both c-kit and SCF mRNA were absent or very weak in the syncytiotrophoblasts. The supernatant of primary cultured cytotrophoblasts and tPA30-1 cells were found to contain SCF. In cytotrophoblasts in the early stage of pregnancy cultured in the presence of recombinant human secretory type SCF, DNA synthesis was increased depending on the SCF concentration. These findings indicate that SCF is a cytokine which promotes the growth of placental cells by the autocrine and paracrine mechanism.

Profiles of outer membrane proteins and lipopolysaccharide of Pseudomonas aeruginosa grown in the presence of sub-MICs of macrolide antibiotics and their relation to enhanced serum sensitivity

We have previously reported that erythromycin at sub-inhibitory concentrations enhanced the serum sensitivity of some Pseudomonas aeruginosa strains. To explore the mechanism of this effect, we have now examined the influence of macrolide antibiotics on outer membrane proteins and lipopolysaccharide (LPS) of P. aeruginosa. The strains S-6 and PAO-1 of P. aeruginosa were used as susceptible and resistant strains respectively to assess enhancement of serum sensitivity by erythromycin. The strain S-6 became more serum-sensitive when grown on agar with sub-MICs of erythromycin or azithromycin, but not of josamycin, whereas no change was observed in the serum sensitivity of the strain PAO-1 after growth with any of these antibiotics. The analysis of outer membrane proteins showed that erythromycin treatment resulted in a reduction in the amount of the 38 kDa protein (OprF) and in a prominent increase of 41 kDa protein band in the strain S-6, but not in the strain PAO-1. By an immunoblotting assay, this 41 kDa protein was shown to be highly reactive to the immune serum against untreated P. aeruginosa. LPS of the strain S-6 were examined by SDS acrylamide gel electrophoresis. The treatment with erythromycin or azithromycin, but not with josamycin, reduced the amounts of LPS species with lower molecular weights although the levels of LPS species with high molecular weights were similar to those of untreated bacteria. These results suggest that the enhanced serum sensitivity of P. aeruginosa by erythromycin is associated with changes in bacterial surface components, such as outer membrane proteins and LPS.

Mesenchymal regulation of epithelial gene expression in developing avian stomach: 5′-flanking region of pepsinogen gene can mediate mesenchymal influence on its expression

The expression of a gene encoding an embryonic chick pepsinogen was investigated in developing avian gut. Expression is restricted to the epithelial layer of the embryonic proventriculus (glandular stomach). We can therefore regard this gene as a marker gene for proventricular epithelial differentiation. There is some considerable evidence in favour of epithelial-mesenchymal interactions being important during the development of the gastrointestinal system; for example, pepsinogen expression is induced in proventricular and gizzard (muscular stomach) epithelial by the proventricular mesenchyme but is suppressed by the gizzard mesenchyme. In the present paper, we studied how the mesenchymes influence this gene expression pattern. For this we produced constructs containing various portions of the 5′-flanking region of the embryonic chick pepsinogen gene, driving reporter sequences (beta-galactocidase or luciferase), and these constructs were transfected into dissociated epithelial cells either from the proventriculus or gizzard. We then recombined these cells with mesenchymal cells and cultured them as cell aggregates. In this way, we were able to dissect the timing and other requirements of the epithelial-mesenchymal interactions for expression of embryonic chick pepsinogen gene. We also report that 1.1 kb of 5′-flanking sequence is sufficient to drive correct expression of embryonic chick pepsinogen gene, although further enhancement was seen if the constructs contained 3.2 kb of upstream sequence.

Purification of a phenobarbital-inducible morphine UDP-glucuronyltransferase isoform, absent from Gunn rat liver

A morphine UDP-glucuronyltransferase (morphine UGTPB) was purified from liver microsomes of Sprague-Dawley rats treated with phenobarbital. UDP-glucuronyl-transferases in the liver microsomes were solubilized with Emulgen 911 and separated by omega-(beta-carboxypropionyl-amino)octyl Sepharose 4B column chromatography, which has been developed in our laboratory. Morphine UDP-glucuronyltransferases were eluted into two fractions, Peak I and Peak II, which have different substrate specificities. Morphine UGTPB was purified by two times of Chromato-focusing from Peak II which was more specific to morphine. The purified morphine UGTPB gave an apparent pI of 8.0 on chromatofocusing and displayed a subunit molecular weight of 55 kDa after sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The purified enzyme catalyzed the glucuronidation of 3-hydroxyl group of morphine and small extent of 4-hydroxybiphenyl, but not of androsterone, bilirubin, chloramphenicol, codeine, 4-methylumbelliferone, 4-nitrophenol, testosterone, and 6-hydroxyl group of morphine. The N-terminal amino acid sequences of morphine UGTPB were identical to those of UGT1*01P which is deficient to homozygous Gunn rat. Peak II was absent from the fraction of omega-(beta-carboxypropionylamino)octyl Sepharose 4B column chromatography of liver microsomes of Gunn rats treated with phenobarbital, whereas morphine UGT in Peak I was PB-inducible in Gunn rats. Present results suggest that an isoform of morphine UDP-glucuronyltransferase belongs to the UGT1 family and is phenobarbital-inducible.

Oral florid papillomatosis and leukoplakia of the esophagus associated with keratoderma and showing transepidermal elimination

A 37-year-old male presented with a cauliflower-like tumor in the right buccal mucosa, leukoplakia of the tongue and esophagus, and keratotic papules or plaques on the extremities including bilateral palms and soles, associated with borderline diabetes mellitus and a repeated history of infections. A multi-system keratinizing abnormality was suspected, although no distinct disease category has been found showing similar involvements.

Overproduction and purification of Lon protease from Escherichia coli using a maltose-binding protein fusion system

Lon protease, which plays a major role in degradation of abnormal proteins in Escherichia coli, was overproduced and efficiently purified using the maltose-binding protein (MBP) fusion vector. The MBP-Lon fusion protein was expressed in a soluble form in E. coli and purified to homogeneity by amylose resin in a single step. Lon protease was split from MBP by cleaving a fusion point between MBP and Lon with factor Xa and purified by amylose resin and subsequent gel filtration. In this simple method, Lon protease was purified to homogeneity. Purified MBP-Lon fusion protein and Lon protease showed similar breakdown activities with a peptide (succinyl-L-phenylalanyl-L-leucyl-phenylalanyl-beta-D-methoxynaphthyl amide) and protein (alpha-casein) in the presence of ATP. Therefore, the gene-fusion approach described in this study is useful for the production of functional Lon protease. MBP-Lon fusion protein, which both binds to the amylose resin and has ATP-dependent protease activity, should be especially valuable for its application in the degradation of abnormal proteins by immobilized enzymes.

Assessment of local cerebral blood flow in neonates with N-isopropyl-P-[123I]iodoamphetamine and single photon emission computed tomography

Local cerebral blood flow was measured in 10 high-risk infants with neonatal episodic neurological events at 41-44 post-conceptional weeks using N-isopropyl-p-[123I]iodoamphetamine (IMP) and single photon emission computed tomography (SPECT). In 5 of the 7 infants with normal neurological outcome, prominent cerebral perfusion was found in the basal ganglia, brainstem, cerebellum, parietal white matter, and sensory motor cortex. The frontal lobes showed poor relative perfusion. In 3 infants with severe neurological deficits, SPECT demonstrated severe hypoperfusion of all parts of the brain except the basal ganglia, brainstem and sensorimotor cortex. However, MRI revealed non-specific changes, such as poor myelination and ventricular dilatation. SPECT, when performed in the first weeks of life, can be useful and may be more sensitive than MRI in predicting the occurrence of major neurological handicaps. However, because of the relatively invasive character and high cost of SPECT, SPECT should not necessarily be performed in all high-risk neonates.

Effect of NIK-247 on basal concentrations of extracellular acetylcholine in the cerebral cortex of conscious, freely moving rats

We studied the effect of orally administered NIK-247 (9-amino-2,3,5,6,7,8-hexahydro-1H-cyclopenta[b]quinoline monohydrochloride monohydrate) on basal extracellular acetylcholine (ACh) concentrations in the rat cerebral cortex using microdialysis without the addition of cholinesterase inhibitor to the perfusion fluid and radioimmunoassay for ACh. In addition, the effect of oral administration of NIK-247 on acetylcholinesterase (AChE) activity in rat cerebral cortex was determined. The mean basal ACh content in the perfusate from the cerebral cortex of freely moving rats was 123.2 +/- 21.8 fmol/30 min (n = 7). NIK-247 (2.5-10.0 mg/kg, p.o.) increased the ACh content of the perfusate in a dose-dependent manner. NIK-247 at 10 mg/kg significantly increased the ACh content in the perfusate from 0.5 to 2.5 hr after administration, and the maximum increase was attained at 1 hr after administration. 9-Amino-1,2,3,4-tetrahydroacridine (5 mg/kg, p.o.) and physostigmine (0.5 mg/kg, i.p.) significantly increased the ACh content in the perfusate from 1 to 2 hr and from 0.5 to 1.5 hr after administration, respectively. AChE activities in the cerebral cortex were about 32% and 12% below the control value at 1 hr and 3 hr after administration of NIK-247 at 10 mg/kg, respectively. These findings demonstrate that NIK-247 increases extracellular ACh concentration and inhibits AChE activity in the cerebral cortex after oral administration, and they suggest that NIK-247 facilitates central cholinergic transmission.

Corpus callosum in developmentally retarded infants

The development of the corpus callosum was examined by magnetic resonance imaging in developmentally retarded infants ranging in age from 1-13 months. Results were compared with those of normal infants. Eighteen magnetic resonance imaging studies were performed on 18 developmentally retarded infants. Fifty-four magnetic resonance imaging studies were performed on 38 normally developed infants. The thickness of the corpus callosum was measured at a point one-third of the length of the entire corpus callosum from the most anterior aspect of the genu. The development of the corpus callosum was related to aging in both groups. There was significant difference in the thickening of the corpus callosum between normal and developmentally retarded infants.

[A case of bilateral coronary-pulmonary artery fistula with multicystic saccular aneurysms]

A 71-year-old woman was admitted to our hospital for evaluation of a chest X-ray abnormality. Heart murmur was not heard. Chest X-ray showed a bulge with calcification at left third arch. Chest computed tomography revealed contrast enhancement of masses, which appeared to originate from the vascular system. Coronary angiography demonstrated multicystic aneurysmal dilatation of a coronary artery fistula originating from the proximal left descending and right coronary artery. Electrocardiography showed no remarkable findings and a treadmill exercise test showed no significant ST-T change. The size of the mass of 3 cm in diameter on chest X-ray remained the same for two years. We concluded that surgery was not necessary immediately. In Japan, nineteen cases of coronary-pulmonary artery fistula with multicystic saccular aneurysms have been reported in the literature, including our case. The majority of these cases are elderly women from fifty to sixty years old.