Systemic lupus erythematosus with obstructive uropathy. Case report and review

We report a case of patient with documented SLE who displayed dysuria, gastrointestinal (GI) symptoms and renal insufficiency associated with the unusual occurrence of bilateral hydroureteronephrosis due to urterovesical junction stricture (obstructive uropathy). Pathologic investigations disclosed chronic interstitial cystitis (IC) with evidence of focal immune complex deposition in the blood vessel walls of the bladder. The GI symptoms and dysuria regressed with initial therapy for SLE with steroids. However, the persistent obstructive uropathy (OU) and renal insufficiency required bilateral nephrostomy followed by steroids plus intravenous pulse injection of cyclophosphamide. The obstructive uropathy was relieved even after removing the nephrostomy tube and renal function remained stable. Including this case, nineteen SLE patients associated with clinical and radiographic findings of OU were found in the world literature and reviewed to find any consistent pattern of clinical features. Most of the patients with OU in SLE were female (mean age, 31.7 yr) and orientals (63%), and had interstitial cystitis (89%) as a common underlying cause with concomitant involvement of the GI tract (89%) and WHO class IV or V advanced glomerulonephritis (67%). Despite the remarkable response (68%) to steroids in majority of OU patients associated with SLE, certain patients still required surgical correction (32%) and some even died (32%). OU, potentially reversible, was not an exception in patients with SLE, which might be overshadowed by other major organ involvement of SLE.

Induction of liver cytochrome P450 2B1 by beta-ionone in Sprague Dawley rats

Induction of liver cytochrome P450 2B1 by beta-ionone was investigated in male and female Sprague Dawley rats. Administration of beta-ionone subcutaneously 72 and 48 hr before sacrificing the animals not only significantly induced the liver microsomal activity of pentoxyresorufin O-dealkylase, but also clearly increased in the level of cytochrome P450 2B1 protein. The induction of cytochrome P450 2B1 by beta-ionone was much greater in male rats than in female rats. A slot blot analysis showed that the mRNA level was increased from 6 hr after treatment with beta-ionone in male rats and from 12 hr after treatment in female rats. Taken together, the present results indicate for the first time that the induction of cytochrome P450 2B1 by beta-ionone might be regulated by the accumulation of mRNAs.

Depletion of hepatic 3'-phosphoadenosine 5'-phosphosulfate (PAPS) and sulfate in rats by xenobiotics that are sulfated

Sulfation is considered a high-affinity but low-capacity conjugation mechanism that is limited by the availability of 3'-phosphoadenosine 5'-phosphosulfate (PAPS), the cosubstrate for sulfation. Salicylamide, phenol and 1-naphthol are all known substrates for the sulfation reaction. This study was conducted to determine whether the xenobiotics that are sulfated when administered to rats will lower hepatic PAPS and its precursor, sulfate. Urinary sulfate excretion was reduced 85% to 95% by these compounds. Hepatic PAPS was reduced 73%, 39%, and 87% by salicylamide, phenol and naphthol, respectively, 2 hr after administration of 2 mmol/kg. These compounds also decreased serum sulfate concentrations by 45% to 86% and lowered hepatic sulfate concentrations. In summary, these studies demonstrate that salicylamide, phenol and 1-naphthol lower hepatic PAPS and sulfate concentrations, as well as serum sulfate concentrations. These findings imply that increased sulfation, as a result of the sulfation of xenobiotics, results in depletion of hepatic PAPS concentrations, possibly because the utilization of PAPS by the sulfotransferases exceeds its generation via sulfate activation. Thus the capacity-limited sulfation of high dosages of xenobiotics appears to be due to the reduced availability of hepatic PAPS, which in turn is limited by the availability of sulfate.

Okadaic acid inhibits alkaline phosphatase activity in MC3T3-E1 cells

Alkaline phosphatase activity is regulated by various hormones and growth factors at least in part through the phosphorylation of target proteins during the bone cell differentiation. To investigate the role of protein phosphorylation in alkaline phosphatase activity in MC3T3-E1 osteoblast, we used okadaic acid which is a potent specific inhibitor of serine/threonine protein phosphatases to type 1 and 2A. Alkaline phosphatase activity in cellular layer was measured by spectrophotometer using p-nitrophenyl phosphate as substrate and data were expressed as p-nitrophenyl of nmol/min/mg of protein. Okadaic acid (1-50 ng/ml) caused the inhibition of alkaline phosphatase activity in MC3TC-E1 cells. At 50 ng/ml of okadaic acid showed the maximal inhibitory effect on alkaline phosphatase activity. Okadaic acid (50 ng/ml) also inhibited alkaline phosphatase activity in all differentiation stages. These results indicate that okadaic acid inhibits alkaline phosphatase activity in MC3T3-E1 cells.

Homogeneous assays for riboflavin mediated by the interaction between enzyme-biotin and avidin-riboflavin conjugates

Homogeneous-type enzyme-linked competitive binding assays utilizing the synthetic enzyme-biotin and avidin-riboflavin conjugates are developed for the detection of riboflavin as well as its binder protein. The activity of the enzyme-biotin conjugate is inhibited in the presence of the avidin-riboflavin conjugate, and the observed inhibition is reversed in an amount dependent on the concentration of riboflavin binding protein (RBP) added. Upon additions of free riboflavin to the mixture, activity is reinhibited in an amount proportional to the riboflavin concentration. Three different enzymes are examined as the labels: glucose-6-phosphate dehydrogenase, adenosine deaminase, and alkaline phosphatase. The catalytic activity of these enzymes, when conjugated with biotin, is shown to be inhibited to a significant degree (> 90%) by the binding of the avidin-riboflavin conjugate, and reversed upon additions of RBP.

Effect of route and pattern of exposure on the pharmacokinetics and acute hepatotoxicity of carbon tetrachloride

The objectives of this study were to evaluate the influence of both route and pattern of exposure on the pharmacokinetics (PK) and target organ toxicity of a common volatile organic chemical, carbon tetrachloride (CCl4). Male Sprague-Dawley rats, 325-375 g, inhaled 100 or 1000 ppm CCl4 for 2 hr through a one-way breathing valve. The total amount of CCl4 retained by each rat (i.e., the systemically absorbed dose) during the 2-hr period was determined to be 17.5 and 179 mg CCl4/kg body wt, respectively. CCl4, in doses of 17.5 and 179 mg/kg body wt, was administered in an aqueous emulsion by bolus gavage or by constant gastric infusion over 2 hr. Serial micro blood samples from the animals were analyzed for CCl4, in order to delineate blood concentration-versus-time profiles. Serum enzyme activities and total liver microsomal cytochrome P450 level and glucose 6-phosphatase activity were measured 24 hr postdosing as indices of CCl4 hepatotoxicity. The pattern of oral exposure, or dosage regimen, had a significant effect on the PK and acute the hepatotoxicity of CCl4. Arterial blood levels in the gastric infusion group were much lower than in the oral bolus group with both doses. Since CCl4 is quickly and extensively absorbed from the GI tract, large amounts of CCl4 in the portal blood following the oral bolus apparently exceeded the capacity of the liver to metabolize the chemical. Thus, substantially higher Cmax and AUC0 integral of infinity values were manifest. Hepatotoxicity was also significantly greater in these animals. The route of exposure also had a significant effect on the PK of CCl4. Levels of CCl4 in the arterial blood were much higher during inhalation than during gastric infusion. However, AUC0 integral of infinity vales for the two groups were not significantly different, due to relatively slow elimination after gastric infusion. There was little difference between the two groups in hepatotoxicity indices 24 hr postdosing.

Study on the Korean adult cranial capacity

Cranial capacity was measured in Korean adult skulls. The cavity was filled with rice seeds and the volume of the seeds were measured in a graduated cylinder. The results were 1470 +/- 107 (mean +/- standard deviation) in male and 1317 +/- 117 cc in female skulls. These values were in good accordance with those previously reported. In addition, regression formulae were obtained with the product of the length, breadth, and height of the skull as an independent parameter and the measured capacity as a dependent one. With known external measurements, the expected cranial capacity was as follows: when using baso-bregmatic height, male: capacity = 307.5 + 333 x 10(-6) x (length.breadth.baso-bregmatic height) female: capacity = -12.0 + 435 x 10(-6) x (length.breadth.baso-bregmatic height) and, when using auriculo-bregmatic height, male: capacity = 214.6 + 429 x 10(-6) x (length.breadth.auriculo-bregmatic height) female: capacity = 131.6 + 461 x 10(-6) x (length.breadth.auriculo-bregmatic height).

Morphometric study of the lumbar spinal canal in the Korean population

STUDY DESIGN

The anatomic dimensions of the vertebral body and spinal canal of the lumbar spine were analyzed in Koreans.

OBJECTIVES

To determine the normal dimension of the lumbar spinal canal in Koreans, to determine whether there are any racial differences in the morphometry of the lumbar spinal canal, and to provide criteria for diagnosing spinal stenosis in the Far Eastern Asian.

SUMMARY OF BACKGROUND DATA

Some radiologic and anatomic studies have been conducted regarding the size of the lumbar spinal canal of whites and blacks in western and African countries.

METHODS

One-thousand-eight-hundred measurements were performed on the transverse and sagittal diameters of vertebral bodies and spinal canals using complete sets of 90 lumbar vertebrae.

RESULTS

The mean mid-sagittal diameter of the lumbar spinal canal in the Korean population was less than that measured in white and African populations, but there was no significant differences between the Korean, white, and African populations regarding the transverse diameter of the lumbar spinal canal.

CONCLUSION

The mid-sagittal diameter of the lumbar spinal canal is narrowest in the Far Eastern Asian population; the radiologic criteria of spinal stenosis should be reconsidered for these people.

In vivo modification of 3'-phosphoadenosine 5'-phosphosulfate and sulfate by infusion of sodium sulfate, cysteine, and methionine

The importance of tissue sulfate concentrations in regulating 3'-phosphoadenosine 5'-phosphosulfate (PAPS) synthesis is not known. Therefore, this study was conducted to determine the influence of increased availability of inorganic sulfate on steady-state PAPS concentrations in various tissues. To increase tissue sulfate concentrations, 2-16 mmol/kg of sodium sulfate and sulfur-containing amino acids (cysteine or methionine) were infused intravenously for 2 hr into pentobarbital-anesthetized rats. Serial blood samples were taken during the infusion and analyzed for sulfate concentrations. After 2 hr of infusion, liver, kidney, and brain were removed for quantification of tissue PAPS and sulfate concentrations. Infusion of sodium sulfate, cysteine, and methionine increased serum and tissue sulfate concentrations in a dose- and time-dependent manner. Serum sulfate concentrations increased from 0.8 to 14 mM during the infusion of sodium sulfate, whereas infusions of cysteine and methionine increased serum sulfate concentrations to 4.8 and 2.0 mM, respectively. Tissue sulfate concentrations also increased during sulfate infusion. Liver sulfate concentration increased from 0.8 to 4.8 mM, kidney concentration increased from 0.6 to 31 mM, and brain concentration increased from 0.1 to 0.6 mM. Similar to the serum sulfate concentrations, sulfate infusion was the most effective in increasing tissue sulfate concentrations, cysteine was intermediate, and methionine the least effective. Although sulfate concentrations in liver, kidney, and brain increased 6-, 50-, and 6-fold by infusing sulfate, respectively; tissue PAPS levels were not altered markedly. Hepatic PAPS concentrations increased significantly (30-35%) only when infused with the higher doses (8 or 16 mmol/kg/2 hr) of sodium sulfate.(ABSTRACT TRUNCATED AT 250 WORDS)

Dosimetry of a D2/D3 dopamine receptor antagonist that can be used with PET or SPECT

FIDA-2 (R-(+)-2,3-dimethoxy-5-iodo-N-[(1-4'-fluorobenzyl)-2-pyrrolidinyl) methyl] benzamide) is a simultaneously fluorinated and iodinated D2/D3 dopamine receptor antagonist. The purpose of this study was to measure its biodistribution and radiation dosimetry in humans.

METHODS

Whole-body emission scans were sequentially acquired in eight healthy volunteers 24-43 hr after the intravenous administration of 101-150 MBq 123I FIDA-2. Regions of interest (ROIs) were placed on the initial set of conjugate emission images and transposed as a single set onto all the other scans without manipulating any of the regions for solid organs independently. The counts in each ROI were corrected for attenuation with transmission scans and compared to the net counts in images of the injection syringe containing the administered dose. The radiation doses were estimated with the MIRD formalism from the residence times for both the 18F- and 123I-labeled ligands.

RESULTS

There were no subjective or objective pharmacological effects of the tracer on any of the subjects. The findings showed that the dose-limiting organ for the 123I-labeled product was the thyroid gland in this sample. If the 18F-labeled product had been used, then the urinary bladder would have received 0.086 mGy/MBq (0.32 rads/mCi) and become the dose-limiting organ. The effective dose equivalents were 0.025 mSv/MBq (0.092 rem/mCi) for both the 123I- and the 18F-labeled versions of the tracer.

CONCLUSION

The data suggest that FIDA-2 can be used to produce relatively high contrast images of the D2/D3 dopaminergic system with substantially less than the maximum allowable radiation dose for research volunteers.

In vitro generation of immune effector cells from tumor-associated lymphocytes of human gastric cancer

Despite recent advances in cellular immunotherapy of cancer, the effectiveness of this type of treatment is limited only to some types of cancer. This study was performed to generate tumor-specific cytotoxic T lymphocytes (CTL) for the treatment of gastric cancer and to find the optimal culture conditions for this CTL, because most immune effector cells used in the previous trials were non-specific killers. Lymphocytes were isolated from tumors, tumor-draining lymph nodes, malignant ascites and peripheral blood of 29 patients with gastric cancer. Lymphocytes from each source were then cultured for three weeks under one or more of the following conditions: 1) 50 U/ml of rIL-2; 2) 50 U/ml of rIL-2 + irradiated (6,000 rad) fresh autologous tumor cells (in vitro sensitization - IVS); 3) 1,000 U/ml of rIL-2; 4) 1,000 U/ml of rIL-2 + IVS. The study found that 1,000 U/ml of rIL-2 generated higher cytotoxicity against allogeneic tumor targets than 50 U/ml of rIL-2 (p < 0.05). However, neither the concentration of rIL-2, lymphocyte source, nor IVS produced any significant differences in cytotoxicity against fresh autologous tumor cell targets. The data suggested that immune effector cells for gastric cancer could be generated efficiently, but it was difficult to produce CTL specific for autologous tumor cells of gastric cancer using a low concentration of rIL-2 and/or in vitro sensitization with autologous irradiated tumor cells.

Central ANG II-receptor antagonists impair cardiovascular and vasopressin response to hemorrhage in rats

The role of brain angiotensin II (ANG II) in mediating cardiovascular, vasopressin, and renin responses to hemorrhage was assessed in conscious spontaneously hypertensive rats (SHR) and in normotensive Wistar-Kyoto (WKY) and Wistar rats. Intracerebroventricular administration of losartan (10 micrograms) and saralasin (1 microgram.microliter-1.min-1) produced a markedly greater fall in blood pressure and a reduced tachycardia during and after hemorrhage (15 ml/kg) compared with the artificial cerebrospinal fluid control in SHR and Wistar rats but not in WKY rats. Vasopressin release after hemorrhage was also impaired, but renin release was enhanced by intracerebroventricular ANG II antagonists in SHR and Wistar rats but not in WKY rats. Losartan and saralasin produced remarkably similar effects on the cardiovascular, vasopressin, and renin responses to hemorrhage. These data suggest that brain ANG II acting through AT1 receptors plays an important physiological role in mediating rapid cardiovascular regulation and vasopressin release in response to hemorrhage. The relative importance of brain angiotensin system may vary in different strains of rate.

Pulmonary toxicity of continuous infusion 5-fluoro-2'-deoxyuridine

This report describes a patient who developed pulmonary toxicity, manifest by dyspnea on exertion, a low pO2, a normal FEV1 and FVC, and a low DLCO while receiving 5-fluoro-2'-deoxyuridine (FUDR) by intermittent continuous i.v. infusion. No other cause of his low DLCO could be identified. The dyspnea on exertion and DLCO improved gradually after the FUDR was discontinued. This case was felt to represent a previously undescribed toxicity of the continuous i.v. infusion of FUDR.

Bone erosion caused by sinonasal cavernous hemangioma: CT findings in two patients

We report two cases of cavernous hemangioma originating in the sinonasal cavity. Although CT showed some enhancing areas within both tumors, the substantial bone destruction caused by these tumors made it difficult to differentiate them from the more common malignant epithelial tumors. Angiography was performed in one patient and showed characteristic pooling of contrast material.

Tetracycline repressor-regulated gene repression in recombinant human cytomegalovirus

The tetracycline repressor (TetR)-regulated gene expression system from Escherichia coli was used to control gene expression in recombinant human cytomegalovirus (HCMV). To adapt the TetR system in HCMV, derivatives of the viral US11 (early) gene promoter, which controls the beta-glucuronidase reporter gene, were constructed by systematic insertion of the tetracycline operator (tetO) sequences. Gene expression from constructs containing two or three appropriately placed tetO sequences adjacent to the TATA box were efficiently repressed by a TetR-VP16 fusion protein (tTA) in a transient expression system. Efficient repression (50- to 120-fold) also occurred in tTA-expressing stably transfected human cells which were infected with recombinant HCMV containing a US11 promoter surrounded by three tetO sequences. The tTA-mediated gene repression was relieved in the presence of 1 microgram of tetracycline per ml. The results of this study are significant in three respects. (i) This is the first demonstration that a TetR-derived protein can be used to efficiently repress gene expression in a mammalian system. (ii) Efficient repression was dependent on the presence of the transcriptional activation domain from the herpes simplex virus type 1 VP16 protein. (iii) The ability to regulate gene expression in a controlled fashion in order to elucidate viral gene function is an important development in the HCMV field. The tTA-mediated gene repression system may be extremely useful for creating host-range mutants in essential genes in order to study their role in the HCMV replicative cycle, a system that is otherwise exceedingly difficult to genetically dissect.

Bilateral renal cortical necrosis with the changes in clinical features over the past 15 years (1980-1995)

A rare case of bilateral renal cortical necrosis (BRCN) diagnosed only by the characteristic and specific findings of a contrast-enhanced CT scan during the acute initial phase of the disease is presented in this paper. Furthermore, twenty-eight patients of BRCN in the world literatures in English after 1980 were analyzed to investigate the changes in its clinical features over the past 15 years in comparison with the reported data before 1980 from two large centers in France (F) and India (I). Obstetric causes decreased from 68% (F) and 71% (I) before 1980 to 28% after 1980, whereas nonobstetric causes increased from 32% (F) and 29% (I) to 72% after 1980. Among the nonobstetric causes of BRCN, the leading causes were sepsis in 4 out of 12 patients (F) and snake bite in 6 out of 14 patients (I) before 1980, but, in contrast, drugs in 4 out of 21 patients after 1980. As a definite diagnostic procedure for BRCN, 95 to 100% before 1980 but 86% after 1980 performed renal biopsy, of which renal biopsy while living was done in only 42% (F) and 16% (I) before 1980 and 67% after 1980. None showed renal calcification in abdominal X-ray, and only 25% (3/12) had nonspecific echo findings in renal ultrasonography, whereas the high sensitivity for BRCN was noted in renal arteriography in 100% (6/6) and contrast-enhanced CT scan in 88% (7/8). The mortality of BRCN decreased from 55% (F) and 86% (I) before 1980 to 36% after 1980. This review of BRCN, in conclusion, revealed the distinctive changes over the past 15 years in the etiology with a higher incidence of non-obstetric causes than obstetric ones, diagnostic procedures with less dependence on renal biopsy but new trials of non-invasive radioimagings including CT scan and even MRI, and a further declining mortality rate.

Auditory brain stem response changes after application of endotoxin to the round window membrane in experimental otitis media

The effects of endotoxin (purified Escherichia coli lipopolysaccharide 0111:B4) on cochlear function in normal and otitis media animals were evaluated. Two types of experimental otitis media models were developed in guinea pigs: eustachian tube obstruction and intratympanic injection of endotoxin. In normal animals, three different concentrations (0.01, 0.1, or 1.0 mg/ml) of endotoxin were applied onto the round window membrane, and auditory brain stem responses were recorded at 1, 3, 6, and 12 hours and 1, 2, 3, and 14 days after the application of endotoxin. Concentrations of 0.01 and 0.1 mg/ml of endotoxin did not affect the auditory brain stem response thresholds, whereas a concentration of 1.0 mg/ml resulted in elevation of the auditory brain stem response thresholds. Alteration of the auditory brain stem response threshold began at 3 hours, reached a peak at 24 or 48 hours, and returned to a normal level 2 weeks after the application of endotoxin. However, when the same concentration (1.0 mg/ml) of endotoxin was applied to the round window membranes of animals that underwent eustachian tube obstruction or intratympanic injection of endotoxin, the endotoxin did not cause any alteration of the auditory brain stem response threshold compared with normal animals.

Effect of oral dosing vehicles on the subchronic hepatotoxicity of carbon tetrachloride in the rat

Previous studies in this laboratory have shown that corn oil delayed and prolonged the gastrointestinal absorption of carbon tetrachloride (CCl4) and reduced its acute hepatotoxicity in rats. The objective of the present study was to extend the duration of ingestion of CCl4 to assess vehicle effects on the subchronic oral toxicity of CCl4. Male Harlan Sprague-Dawley rats were given doses of 0, 25, or 100 mg CCl4/kg body weight by gavage in either corn oil or a 1% Emulphor aqueous emulsion 5 times a week for 13 wk. Blood was collected at 4, 8, and 13 wk for measurement of serum enzymes. Liver samples were also taken at 13 wk for measurement of triglyceride and microsomal enzyme levels, as well as for histopathological examination. Serum enzyme levels peaked at 8 wk in the high-dose groups, but not until 13 wk in the low-dose animals. Effects of CCl4 on serum and microsomal enzymes were of similar magnitude in the two vehicle groups. A comprehensive histopathological examination revealed no qualitative or quantitative differences between the corn oil and aqueous vehicle groups in hepatic lesions. Although CCl4 and chloroform have been reported by other investigators to be more hepatotoxic to mice when given for 90 d in corn oil, current findings indicate that corn oil does not significantly alter the subchronic hepatotoxicity of CCl4 in rats from that when the halocarbon is given in an aqueous medium.

Hemiazygos continuation of a left inferior vena cava draining into the right atrium via persistent left superior vena cava: demonstration by helical computed tomography

We report an unusual case of hemiazygos continuation of a left inferior vena cava draining into the right atrium via the persistent superior vena cava. Spiral computed tomography (CT) showed the course and the flow direction of this vena caval anomaly in a real-time manner, obviating conventional venography.

Locational relationship of the supraorbital notch or foramen and infraorbital and mental foramina in Koreans

The morphology and locational relationship of the supraorbital notch/foramen, infraorbital foramen, and mental foramen were studied from photographs of 124 Korean skulls (male 35, female 18, unknown sex 71). The infraorbital foramen was on the sagittal plane passing through the supraorbital notch/foramen (36.4%), or lateral to the plane (63.6%). The mental foramen was either on the plane (69.3%), lateral to the plane (21.8%), or medial to the plane (9.0%). The supraorbital notch/foramen, infraorbital foramen, and mental foramen were on the same sagittal plane in 38.1% of the cases. The supraorbital notch (69.9%) was found more frequently than the supraorbital foramen (28.9%). The average distance from the median plane to the center of the supraorbital notch/foramen, infraorbital foramen, and mental foramen was 22.7, 27.2 and 24.4 mm, respectively. The average length of the line from the center of the supraorbital notch/foramen to the center of the infraorbital foramen was 45.6 mm, and the angle of this line to the sagittal plane was 5.8 degrees. The average distance from the infraorbital margin to the center of the infraorbital foramen was 8.6 mm, and that from the inferior margin of mandible to the center of the mental foramen was 15.5 mm in males and 14.0 mm in females. The average horizontal width of the supraorbital notch/foramen, infraorbital foramen, and mental foramen was 4.7, 4.8 and 2.4 mm, respectively. Most commonly, the infraorbital foramen was lateral to the sagittal plane of the supraorbital notch/foramen, and the mental foramen was on that plane. This locational relationship would be helpful clinically to determine the location of the infraorbital and mental foramina, by palpation of the supraorbital notch.

Pharmacological effects of metronidazole+tetracycline+bismuth subcitrate versus omeprazole+amoxycillin+bismuth subcitrate in Helicobacter pylori-related gastritis and peptic ulcer disease

PURPOSE

Two 4-week triple-therapy treatment regimens, metronidazole+tetracycline+bismuth subcitrate and omeprazole+amoxycillin+bismuth subcitrate, were compared in a randomly allocated double-blind trial for their efficacy in eradicating Helicobacter pylori from the gastric mucosa of patients with gastritis and/or peptic ulcer disease.

PATIENTS AND METHODS

The presence of gastritis and/or peptic ulcers was confirmed by endoscopy in all patients included in the study. To evaluate drug effects, we used the urease test on gastric mucosa, and haematoxylin-eosin and specific Giemsa stains on biopsy tissues obtained by endoscopic procedures; we also evaluated the improvement in clinical symptoms before and after the 4-week treatments.

RESULTS

Among 164 patients with gastritis and/or peptic ulcers, H. pylori infection was confirmed in 93.9% (154 patients) by the urease test and in 87.8% (144 patients) by haematoxylin-eosin stain. Following 4 weeks of treatment with both combination regimens, negative conversion rates by the urease test and haematoxylin-eosin staining and rates of recovery from clinical symptoms were similar in both regimens (metronidazole+tetracycline+bismuth subcitrate: 82.3, 72.9 and 73.9%; omeprazole+amoxycillin+bismuth subcitrate: 89.6, 83.4 and 76.1%, respectively). Also, the extent of inflammatory activity and the H. pylori score by the Giemsa method indicated high rates of recovery, with improvements to grade 0 (lowest grade) from higher grades with both combination regimens (60.4 and 66.7% of patients taking metronidazole+tetracycline+bismuth subcitrate and 64.6 and 83.3 of those taking omeprazole+amoxycillin+bismuth subcitrate). However, the prevalence of side effects during the 4 weeks of treatment was doubled in the former group compared to the latter (25.5 versus 12.5% of patients).

CONCLUSIONS

Significant improvements in biochemical and histopathological findings and in the clinical symptoms of gastritis and/or peptic ulcer disease in patients with a high rate of H. pylori infection were observed equally with both regimens. However, there were notably fewer side effects in patients treated with omeprazole+amoxycillin+bismuth subcitrate. We therefore recommended this regimen in preference to metronidazole+tetracycline+bismuth subcitrate for the treatment of H. pylori-related gastritis and peptic ulcer disease.

Mid-sagittal canal diameter and vertebral body/canal ratio of the cervical spine in Koreans

In order to ascertain the normal values of the mid-sagittal canal diameter and the canal/body ratio of the cervical spine in Korean adults, ninety sets of cervical vertebral columns were examined. The average mid-sagittal canal diameters from C3 through C7 in the normal Korean are 13.2 +/- 1.3 millimeters in male and 13.1 +/- 2.6 millimeters in female. The normal average canal/body ratio of the cervical spine is 0.93 +/- 0.10 in male and 1.02 +/- 0.09 in female. The mid-sagittal canal diameter is largest in the White population and smallest in Asian, but there is no racial differences in the canal/body ratio, and the lower limit of normal canal/body ratio is 0.8 in Korean. The authors conclude that measurement of the canal/body ratio is more reliable than direct measuring of the mid-sagittal diameter of the cervical spinal canal in the diagnosis of cervical spinal stenosis or predicting the prognosis of cervical spinal cord injury.

Anomalous left brachiocephalic vein: spiral CT and angiographic findings

OBJECTIVE

To alert the radiologist to CT findings that suggest the correct diagnosis of anomalous left brachiocephalic vein.

MATERIALS AND METHODS

The authors report two cases of anomalous left brachiocephalic vein diagnosed by spiral CT and CT angiography.

RESULTS

Spiral CT accurately depicted an anomalous left brachiocephalic vein, which ran between the ascending aorta and the trachea within the mediastinum to reach the right superior vena cava just below the entrance of the azygos vein.

CONCLUSION

Spiral CT combined with CT angiography is a very useful and minimally invasive technique in the diagnosis of this anomalous vein.

Preoperative diagnosis of angiomyolipoma of the liver

We experienced a case of surgically proven hepatic angiomyolipoma, a rare primary benign lipomatous tumor, which was preoperatively diagnosed by defining of its characteristic histologic components and benign radiologic nature with various imaging modalities. It was the first case that full radiologic evaluation was taken and internal vascular proliferation was defined by using dynamic bolus computed tomography (CT) prior to angiography.

The changes in electrolytes and acid-base balance after artificially induced acute diarrhea by laxatives

Following the acute diarrhea in patients (n = 24) overnight with commonly used laxatives for bowel preparation, the changes in electrolytes and acid-base balance in blood and urine were investigated. Though no alterations of serum sodium or potassium concentrations were noted, mild but significant reduction of mean values (+/- SEM) of plasma pH and HCO3 after diarrhea when compared to those before it developed (pH, from 7.42 +/- 0.01 to 7.39 +/- 0.01, p < 0.01; HCO3, from 25.8 +/- 0.6 to 23.7 +/- 0.6 mEq/L, p < 0.05). However, significant reduction of concentration in spot urine sodium from 150 +/- 12.3 to 93 +/- 14 mEq/g of crea. (p < 0.01) and increase in spot urine potassium from 33 +/- 3.2 to 51 +/- 6.0 mEq/g of crea. (p < 0.05) following diarrhea were seen with significant reduction of urine pH from 6.67 +/- 0.21 to 5.5 +/- 0.13 (p < 0.001). Also, with this effective urinary acidification following diarrhea, a significant reduction of urinary anion gap as well as significant increment of spot urine ammonium was accompanied (anion gap, from 80.4 +/- 11.1 to 44 +/- 8.5 mEq/g of crea. p < 0.001; ammonium, from 87 +/- 18.5 to 229 +/- 37 mg/g of crea. p < 0.001) in addition to the significant inverse correlation between these changes in spot urine from basal levels in 24 study subjects (y = -1.13 x +61, r = 0.7, p < 0.001). In conclusion, we observed that the acute diarrhea with laxatives used for bowel preparation caused a mild degree of metabolic acidosis with no changes in blood electrolytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Ectopic Hoxa-1 induces rhombomere transformation in mouse hindbrain

Homeobox genes are expressed with a specific spatial and temporal order, which is essential for pattern formation during the early development of both invertebrates and vertebrates. Here we show that widespread ectopic expression of the Hoxa-1 (Hox 1.6) gene directed by a human beta-actin promoter in transgenic mice is embryolethal and produces abnormal phenotypes in a subset of domains primarily located in anterior regions. Interestingly, this abnormal development in the Hoxa-1 transgenic mice is associated with ectopic expression of the Hoxb-1 (Hox 2.9) gene in select hindbrain regions. At gestation day 9.5, two domains of strong Hoxb-1 expression are found in the anterior region of the hindbrains of Hoxa-1 transgenic embryos. One region represents the normal pattern of Hoxb-1 expression in rhombomere 4 and its associated migrating neural crest cells, while another major domain of Hoxb-1 expression consistently appears in rhombomere 2. Similar ectopic domains of beta-galactosidase activity are detected in dual transgenic embryos containing both beta-actin/Hoxa-1 transgene and a Hoxb-1/lacZ reporter construct. Expression of another lacZ reporter gene that directs beta-galactosidase activity predominantly in rhombomere 2 is suppressed in the Hoxa-1 transgenic embryos. We have also detected weaker and variable ectopic Hoxb-1 expression in rhombomeres 1, 3 and 6. No ectopic Hoxb-1 expression is detected in rhombomere 5 and the expression of Hoxa-3 and Krox-20 in this region is unchanged in the Hoxa-1 transgenic embryos. While no obvious change in the morphology of the trigeminal or facial-acoustic ganglia is evident, phenotypic changes do occur in neurons that emanate from rhombomeres 2 and 3 in the Hoxa-1 transgenic embryos. Additionally, alterations in the pattern of Hoxa-2 and Hoxb-1 expression in a subpopulation of neural crest cells migrating from the rhombomere 2 region are detected in these transgenics. Taken together, these data suggest that ectopic Hoxa-1 expression can reorganize select regions of the developing hindbrain by inducing partial transformations of several rhombomeres into a rhombomere-4-like identity.

Sulfation of acetaminophen and acetaminophen-induced alterations in sulfate and 3'-phosphoadenosine 5'-phosphosulfate homeostasis in rats with deficient dietary intake of sulfur

Sulfation of drugs depends on the availability of 3'-phosphoadenosine 5'-phosphosulfate (PAPS), which requires inorganic sulfate for its synthesis. Therefore, decreased alimentary intake of inorganic sulfate or its precursor, cysteine, may compromise sulfation of xenobiotics. To test this hypothesis, separate groups of rats were maintained for 5 days on synthetic diets, which lacked sulfate, or cysteine, or both sulfate and cysteine. These dietary restrictions did not cause growth retardation or depletion of glutathione in liver. Under anesthesia, the animals were injected with acetaminophen (0.5 mmol/kg, i.v.) and elimination of acetaminophen from blood and excretion of acetaminophen metabolites in urine and bile was simultaneously quantified. Deficient intake of inorganic sulfate or cysteine alone did not significantly change elimination and biotransformation of acetaminophen. Combined nutritional deficiency of sulfate and cysteine, however, resulted in a 40% reduction in the excretion of acetaminophen-sulfate, quantitatively the most significant metabolite. Concomitantly, these animals eliminated acetaminophen from blood at a slower rate and converted more acetaminophen to its toxic intermediate, as indicated by increased excretion of acetaminophen-thioether conjugates. Serum and tissue sulfate concentrations were decreased to significantly lower levels in rats on sulfate and cysteine deficient diets, than in rats with a sufficient sulfur supply. Thus, reduced sulfation is apparently caused by diminished availability of inorganic sulfate for PAPS synthesis, even though hepatic and renal PAPS levels were not depleted more by acetaminophen in rats with deficient dietary supply of sulfate and cysteine than in rats with adequate sulfur intake.(ABSTRACT TRUNCATED AT 250 WORDS)

Unexpected gallbladder cancer with cutaneous seeding after laparoscopic cholecystectomy

We describe a case of gallbladder carcinoma involving full thickness of the gallbladder wall after laparoscopic cholecystectomy for cholecystitis. Laparotomy for removal of the gallbladder bed and excision of the umbilical cannula site revealed focal residual tumor in the liver bed and microscopic tumor implant in the cannula site. Postoperatively, the patient had radiotherapy of the tumor bed and umbilical scar. Eleven months later, the patient was alive without any evidence of relapse. Excision of the gallbladder bed and laparoscopic scar with or without complementary radiotherapy may be indicated for management of cases in which transmural extension of the unexpected gallbladder carcinoma occurs after laparoscopic cholecystectomy.

Chemical modification of implantable biologic tissue for anti-calcification

Biologic porcine tissue was modified by coupling sulfonated polyethyl-eneoxide (PEO-SO3) and the effect of modification on calcification was evaluated in vitro and in vivo. The modification process involves grafting PEO-SO3 to porcine valve leaflet either by carbodiimide (EDC) activation or by direct coupling using glutaraldehyde. Thermal property, measured by differential scanning calorimetry, showed that the shrinkage temperature of modified tissue increased compared with control tissue and fresh tissue, suggesting increased thermal stability. Resistance to collagenase digestion revealed that modified tissues have greater resistance to enzyme digestion than do control tissues. In vitro calcification showed that modified tissues have less calcium deposition than do control tissues. In vivo calcification, using a rat subcutaneous implantation model, also showed less calcification of modified tissue than that of control. The resistance of modified tissue to collagenase, higher shrinkage temperature, and reduced calcification, when compared with control tissue, attest to the usefulness of this chemical modification for implantable biologic tissue.

Morphometric study of the pedicles of thoracic and lumbar vertebrae in Koreans

STUDY DESIGN

The shape and size of the pedicles of the human spine differs within different races. The authors studied the diameters and angles of the spine pedicle from the T1 to L5 levels in Koreans. The following measurements were made 1) transverse diameter, 2) superoinferior diameter, 3) anteroposterior pedicle angle, 4) horizontal pedicle angle, and 5) pedicle axis angle.

OBJECTIVES

This study obtained indices of pedicle morphology in Koreans to use in transpedicular screw fixation and to explain the difference between other races and Koreans.

SUMMARY OF BACKGROUND DATA

Internal fixators for vertebrae fixation have been developed. Knowledge of pedicle morphology is essential for pedicle screw use. The use of pedicle screws in Asians is questionable. Few reports exist regarding pedicle morphology, and in those few reports, the pedicle isthmus diameter, pedicle angles, and the depth to the anterior cortex are emphasized.

METHODS

The following measurements of the diameter and length of the human cadaver pedicle were done with vernier and dial calipers: 1) transverse diameter of pedicles, 2) superoinferior diameter of pedicles, 3) anteroposterior pedicle angle, and 4) horizontal pedicle and pedicle axis angles.

RESULTS

The widest transverse diameter of the pedicle was seen at the L5 level and the narrowest was at the T4 level. The widest superoinferior diameter of the pedicle was seen at the T12 level, the narrowest was at the T1 level. In the transverse plane, the angles of the pedicles of T11 and T12 were faced laterally. The anteroposterior angle increased rapidly at the T4 level, with the T1 level having the greatest. In the sagittal plane, the horizontal angle of the lumbar vertebra was almost parallel to the horizontal plane. The pedicle axis was longest at the L3 level and shortest at the T1 level. In all areas, the transverse diameter of the pedicle in males was wider than the that in the female.

CONCLUSIONS

The results suggest that using 6-mm screws can violate the cortex of the pedicles in a significant number of levels of the upper lumbar spine. Using a screw longer than 40 mm is dangerous in the lower thoracic spine of a Korean. A statistical difference exists between the transverse diameter of the pedicles of Westerners and Koreans.

Proteolytic activity of human cytomegalovirus UL80 protease cleavage site mutants

The human cytomegalovirus UL80 open reading frame encodes protease and assembly protein from its N- and C-terminal regions, respectively. We reported previously that a 30-kDa protease is derived by autoproteolytic processing of a polyprotein which is the translation product of the entire UL80 open reading frame (E. Z. Baum, G. A. Bebernitz, J. D. Hulmes, V. P. Muzithras, T. R. Jones, and Y. Gluzman, J. Virol. 67:497-506, 1993). Three autoproteolytic cleavage sites within the UL80 polyprotein were characterized; site 143 is within the protease domain and inactivates the protease. In this article, we report (i) expression analyses of UL80 in infected cells, including the processing kinetics of the UL80 polyprotein; (ii) the existence of an additional cleavage site (site 209) within the protease domain of the UL80 polyprotein; and (iii) the effect of mutagenesis at each of the cleavage sites upon proteolytic activity and steady-state levels of the UL80 processing products. During the course of infection, UL80 polyprotein processing begins at cleavage site 643 and follows at sites 256 and 143. Cleavage at site 643 and/or 256 within the polyprotein is not a prerequisite for efficient protease activity, since all three proteases (85-, 80-, and 30-kDa proteins) were equally active in cleaving the assembly protein precursor to its mature form. Inhibition of cleavage at site 143 resulted in a three- to sixfold increase in the steady-state level of the 30-kDa protease, supporting the hypothesis that cleavage at this site may represent a mechanism by which cytomegalovirus regulates the level of active protease.

Mechanisms of hyperkalemia associated with hyporeninemic hypoaldosteronism in streptozotocin-induced diabetic rats

This study was aimed at investigating the mechanisms of clinically important overt hyperkalemia in diabetes mellitus with underlying hyporeninemic hypoaldosteronism known as a classic model of the syndrome of hyporeninemic hypoaldosteronism (SHH). Rats (Sprague-Dawley, male) were streptozotocin-treated (60 mg/kg, ip) and used after 60 days. Rats with plasma glucose levels higher than 300 mg/dL (mean +/- SEM, 423 +/- 20 mg/dL, n = 8) were selected as the diabetic group. Age-matched normal rats served as control (mean plasma glucose, 88 +/- 2, mg/dL, n = 8). Serum potassium concentrations and osmolalities as well as serum creatinine levels were significantly higher in the diabetic than in the control group (5.07 +/- 0.09 vs. 4.68 +/- 0.11 mEq/L; 330 +/- 14 vs 290 +/- 3 mOsm/L; 0.40 +/- 0.03 vs 0.31 +/- 0.02 mg/dL, p < 0.05). Plasma renin activity (PRA) in the diabetic group was significantly lower than that in the control group (6.0 +/- 1.0 vs 12.1 +/- 1.1 ng Al/ml/h, p < 0.001). Plasma aldosterone concentration (PAC) was also significantly lower in the former than in the latter (368 +/- 30 vs 761 +/- 57 pg/ml, p < 0.001). Renomegaly, abnormal distal tubular cells with few organelles, and increased lipid droplets with pyknotic nucleus in zona glomerulosa of the adrenal glands were noted in the diabetic group. In conclusion, multifactorial causes including insulinopenia, hyperosmolality, elevated serum creatinine level and hypoaldosteronism with possible contribution of altered distal tubular response to aldosterone may have interacted to develop hyperkalemia in these diabetic rats.

Surgical treatment of stage III lung cancer after chemotherapy and radiotherapy

We have experienced eight patients with advanced bronchogenic carcinomas who underwent resectional surgery after receiving preoperative adjuvant chemotherapy and radiotherapy during the period March, 1990, to February, 1992. Four patients were in stage IIIA and four in stage IIIB, of which six had epidermoid carcinomas and two small cell carcinomas. All patients were male with ages ranging from 48 to 73 (mean 56.7) years. The induction chemotherapy for six patients consisted of cisplatin and VP-16 (Etoposide) only, and two patients were given fluorouracil/cyclophosphamide and cyclophosphamide/adriamycin/cisplatin in addition to cisplatin/VP-16, respectively. All patients also received four to six weeks of radiotherapy following chemotherapy and were re-evaluated for the possibility of surgery after four weeks of observation. All patients underwent pneumonectomies. Postoperative histological staging revealed complete responses in two patients, partial responses in three and no response in three. Patients were followed-up for seven to 33 (mean 21.5) months after the diagnosis of lung cancer. Six patients died 1, 2, 3, 10, 14 and 26 months postoperatively and two patients are alive, revealing no evidence of tumor recurrence 24 months postoperatively. Induction therapy may induce a better resectability by the conversion of the lung cancer to a lower clinical stage by the time of surgery.

Morphological study of surgically induced open neural tube defects in chick embryos--postoperative 24 hours

For the experimental study of neural tube defect (NTD), a surgical model has advantages over other models in a few aspects. It causes less functional derangement of cells and the NTDs can be made selectively by surgery. The authors planned to use the surgical model for the experimental study of NTD. As the first step for the studies, the chronological changes of morphology during the early postoperative period were investigated using postincubation 3-day chick embryos. The objectives of this study are (1) the morphological evaluation of the surgical model as a method for studies of open NTD, and (2) the observation of morphological changes for the first 24 hours after surgery which include 'overgrowth' appearance and the continuity between the surface ectoderm and the neuroectoderm. The morphological changes were observed by light microscope and scanning electron microscope. Immediately after surgery, typical open NTDs were observed. Morphologically they were very similar to the appearance of spontaneous (non-surgical) open NTDs. The opened neural tubes were everted progressively and they looked rather flat at 24 hours after surgery. Cellular hyperplasia ('overgrowth' appearance) was noted within 24 hours after surgery and became more prominent during the 24 hours. There was increasing continuity between the surface ectoderm and the neural tissue until 24 hours after surgery when the continuity looked almost complete. In conclusion, surgically induced NTDs are morphologically very similar to spontaneous NTDs.(ABSTRACT TRUNCATED AT 250 WORDS)

Differential effects of brefeldin A on hormonally regulated Na+ transport in a model renal epithelial cell line

Na+ transport in renal epithelia is regulated by a wide variety of endogenous and exogenous cellular factors. Although most natriferic agents have an action on the amiloride-sensitive Na+ channel, the biochemical pathways which precede activation of the channel remain incompletely defined. One approach to dissecting such intricate pathways is to perturb a specific cellular process and determine its importance in the postulated mechanism. The current studies examine the effect of brefeldin A (BFA), an inhibitor of the central vacuolar system, on basal as well as aldosterone-, insulin-, and forskolin-stimulated Na+ transport. In the A6 cell line, BFA had a time-dependent effect on basal transport. Aldosterone-induced Na+ transport was sensitive to BFA while insulin's action was only partially blocked and forskolin-stimulated Na+ transport was relatively resistant to the action of the inhibitor. These studies highlight differences as well as points of convergence in the natriferic pathways.

A short sequence upstream of the 5' major splice site is important for encapsidation of HIV-1 genomic RNA

A series of linker scanning and deletion mutations has been constructed in the 5' leader sequence of HIV-1. One virus with a 13-base-linker substitution upstream of the 5' major splice site was as impaired in its ability to replicate as a virus with a large deletion, which included these 13 bases, and was less efficient in packaging its genomic RNA than viruses carrying mutations between the 5' major splice site and the gag translation initiation site. These observations have led to the identification of a conserved pattern of repeated sequence elements associated with sequences experimentally defined as necessary for encapsidation of Moloney murine leukemia virus, spleen necrosis virus, avian leukosis-sarcoma viruses, and human immunodeficiency virus type 1.

Hyperkalemia due to hyporeninemic hypoaldosteronism with liver cirrhosis and hypertension

A 49-year-old man with liver cirrhosis and hypertension was found to have hyperkalemia out of a degree of renal insufficiency and metabolic acidosis with low to normal anion gap, aggravated by volume contraction with diarrhea and medications (captopril, spironolactone and atenolol) interfering with potassium homeostasis. Plasma renin activity and serum aldosterone levels of this patient on a regular diet after discontinuation of medications were very low compared to those of five other cirrhotic patients with normokalemia as controls. Also, the renin-aldosterone stimulation testing on this patient performed by sodium restricted diet and furosemide, upright position and by angiotensin converting enzyme inhibition (captopril, 50 mg) showed the blunted renin and aldosterone responses to each of these stimuli, almost no changes from baseline renin and aldosterone levels, it was concluded that the underlying defect responsible for hyperkalemia in this case was hyporeninemic hypoaldosteronism and this was aggravated by other factors or drugs affecting potassium homeostasis.

[Localization and isozyme patterns of phosphatase in Fibricola seoulensis]

The present study was carried out to investigate the localization and isozyme patterns of acid phosphatase and alkaline phosphatase in metacercariae and in adults of F. seoulensis by enzyme-histochemistry method and electrophoresis. Acid phosphatase showed a strong activity at pH 5 in the intestinal caecum of adults, but showed no reactions in the non-substrate control and in the inhibitor-treated control. Alkaline phosphatase showed a strong activity at pH 8 in the intestinal caecum and the tribocytic organ of adults, and in the intestinal caecum and in the genital anlagen of metacercariae. In non-denature PAGE, ten bands of protein fraction from the extracts of metacercariae and twenty-two bands from adults were detected. In denature PAGE, two protein bands having molecular weights of 192 kDa and 123 kDa were detected in the metacercariae, but absent from adult stage. In adults, protein fractions of 27.5 kDa, 24.5 kDa, 21.4 kDa, 18 kDa, 16 kDa and 15 kDa were detected. In non-denature PAGE, isozymes of acid phosphatase showed the most strong activity at pH 5, whereas no activity was shown at pH 2 and pH 7. One isozyme band (62 kDa) of AcPase was recognized in metacercariae and 4 isozyme bands (95 kDa, 85 kDa, 73 kDa and 62 kDa) in adults.

Increased span of oxido-reduction states between pyridine nucleotide and cytochrome c oxidase in the regenerating rabbit liver as measured by arterial ketone body ratio and near-infrared spectroscopy

Oxido-reduction states of intramitochondrial pyridine nucleotide and cytochrome c oxidase and oxygen saturation of hemoglobin in the regenerating rabbit liver were studied with arterial ketone body ratio and tissue near-infrared spectroscopy. Arterial ketone body ratio (acetoacetate/beta-hydroxybutyrate), which reflects the oxido-reduction states of the intramitochondrial pyridine nucleotide (NAD+/NADH), was reduced from the control value of 0.93 +/- 0.09 to 0.42 +/- 0.03 12 h after 70% hepatectomy, while the oxido-reduction states of cytochrome c oxidase and the oxygen saturation of hemoglobin did not change. The velocity of ATP synthesis, as measured by state 3 respiration and ADP/O ratio in isolated mitochondria, increased by 61.4% 24 h after hepatectomy. These results support the near-equilibrium theory that an increased span in oxido-reduction state between pyridine nucleotide and cytochrome c oxidase drives mitochondrial ATP synthesis.

Rapid identification of streptomycetes by artificial neural network analysis of pyrolysis mass spectra

An artificial neural network was trained to distinguish between three putatively novel species of Streptomyces using normalised, scaled prolysis mass spectra from three representative strains of each of the taxa, each sampled in triplicate. Once trained, the artificial neural network was challenged with spectral data from the original organisms, the 'training set', from additional members of the putative novel taxa and from over a hundred strains representing six other actinomycete genera. All of the streptomycetes were correctly identified but many of the other actinomycetes were mis-identified. A modified network topology was developed to recognise the mass spectral patterns of the non-streptomycete strains. The resultant neural network correctly identified the streptomycetes, whereas all of the remaining actinomycetes were recognised as unknown organisms. The improved artificial neural network provides a rapid, reliable and cost-effective method of identifying members of the three target streptomycete taxa.

Abnormalities of sympathetic innervation in the area of an injured peripheral nerve in a rat model of neuropathic pain

Using the rat model that we have developed, a potential underlying mechanism for sympathetically maintained neuropathic pain (SMP) was explored. In rats showing neuropathic pain behaviors after a tight ligation of the L5 spinal nerve, putative sympathetic postganglionic fibers were examined in the injured spinal nerve and the dorsal root ganglion (DRG), using immunohistochemical staining with antibody against tyrosine hydroxylase (TH). In the neuropathic rats, there was an increase in the number of TH-immunolabeled fibers in the spinal nerve, and some DRG cells were surrounded by the labeled fibers. These abnormalities of sympathetic postganglionic innervation of the injured spinal nerve or the DRG may be a part of the mechanisms underlying the development of SMP.