Effect of the insect growth regulators, N-tert-butyl-N, N'-dibenzoylhydrazines, on neural activity of the American cockroach

N-tert-Butyl-N,N'-dibenzoylhydrazines, agonists of 20-hydroxyecdysone, decelerated the rising and falling phases of an action potential, which had been electrically induced in the cockroach giant axon, at moderately high concentrations. 4-Aminopyridine, a blocker of potassium channels of nerve, selectively decelerated the falling phase of the action potential. This class of compounds caused convulsions in American cockroaches when injected. The convulsive activity seemed to be positively related to the activity to decelerate the falling phase of the action potential.

Phylogeny of Epidermophyton floccosum and other dermatophytes

Eleven strains of Epidermophyton floccosum were compared with 5 Microsporum and 5 Trichophyton species with respect to the restriction fragment length polymorphism (RFLP) of the mitochondrial DNA to reveal their phylogenetic relationships. The phylogeny of 11 species showed that the three dermatophyte genera could not be separated from each other and could be considered to be congeneric. This result is not inconsistent with the results from ribosomal RNA sequences.

A transcription factor with a leucine-zipper motif involved in light-dependent inhibition of expression of the puf operon in the photosynthetic bacterium Rhodobacter sphaeroides

In the purple nonsulfur photosynthetic bacterium Rhodobacter sphaeroides the synthesis of components of the photosystem is regulated in response to oxygen tension and light intensity. We have purified and cloned a trans-acting protein (SPB) that binds to the promoter region of the puf operon, which encodes the apoproteins of light-harvesting complex I and the reaction center. The SPB was composed of a single polypeptide with an apparent molecular mass of 15.0 kDa. The nucleotide sequence of the spb gene was determined. The gene encoded 104 amino acid residues, which correspond to a molecular mass of 11.5 kDa. SPB exhibited 53% homology to HvrA in Rhodobacter capsulatus. The deduced amino acid sequence indicated that SPB contained a region with homology to the leucine-zipper motif of c-JUN, a transcription factor in eukaryotes, and SPB also had a DNA-binding domain on the amino-terminal side of the leucine-zipper motif. The leucine-zipper motif of SPB might contribute to the formation of a dimer. Northern analysis indicated that spb was constitutively and monocistronically transcribed in R. sphaeroides, irrespective of growth conditions. Structural and functional differences between SPB and HvrA are discussed.

Point mutation in the alpha-galactosidase A gene of atypical Fabry disease with only nephropathy

A point mutation in exon 6 of the alpha-galactosidase A gene (alpha-GAL A) was found in a Japanese hemizygous male without typical manifestations of Fabry disease other than renal involvement. This 45-year-old man developed moderate proteinuria and was diagnosed with Fabry disease on the basis of renal histologic findings and prominent decreases in alpha-GAL A activity in his plasma, urine, leukocytes, and skin fibroblasts. Determination of the cDNA sequence of his alpha-GAL A gene revealed substitution of a G to A in codon 301, resulting in a glutamine rather than an arginine residue. Our case is unique in that this patient only demonstrated renal manifestations while all other reported patients with atypical Fabry disease, including a case with the identical point mutation, present with a cardiomyopathy. Direct DNA sequencing of exon 6 and measurement of alpha-GAL A activity among the patient's family confirmed that the mutation was transmitted from his mother.

Analysis of right ventricular function during bypass of the left side of the heart by afterload alterations in both normal and failing hearts

This study investigated the mechanism of right ventricular failure during bypass of the left side of the heart by precisely assessing right ventricular function with use of a conductance catheter. Bypass of the left side of the heart was established with a centrifugal pump in 10 mongrel dogs weighing 11 to 19 kg. Right ventricular function during left heart bypass was evaluated by two parameters that were both derived from measurement of relative change in right ventricular volume by the conductance catheter technique. One parameter was the right ventricular end-systolic pressure-volume relationship as a load-independent index, and the other was the peak right ventricular pressure-right ventricular stroke volume relationship as a "force-velocity relationship." These parameters were measured in both normal and failing hearts while afterload was increased by bilateral intrapulmonary balloon inflation. Moreover, changes in these relationships were observed by varying assist ratios of left heart bypass from 0% to 100%. Failing heart models were induced by normothermic aortic clamping for 20 minutes. The right ventricular end-systolic pressure-volume relationship in normal hearts did not change, irrespective of the assist ratio of left heart bypass, whereas that in failing hearts decreased from 4.25 +/- 1.41 mm Hg/ml without bypass of the left side of the heart to 3.53 +/- 1.30 mm Hg/ml after 100% assist of left heart bypass (p < 0.05). In the peak right ventricular pressure-right ventricular stroke volume relationship, right ventricular stroke volume was almost constant in normal hearts when afterload was increased regardless of the assist ratio of left heart bypass. Moreover, right ventricular stroke volume was maintained at a higher level during bypass of the left side of the heart compared with that without left heart bypass. However, that slope of the relationship in failing hearts was inversely linear and became significantly steeper after 100% assist of bypass of the left side of the heart compared with that without left heart bypass (-0.131 +/- 0.042 versus -0.051 +/- 0.038, p < 0.005). Therefore ++these two slopes of the relationship intersected at a point that was considered the critical point of afterload during bypass of the left side of the heart. In other words, right ventricular stroke volume was decreased by 100% left heart bypass above the critical point of afterload. In conclusion, this study demonstrates not only that bypass of the left side of the heart results in an increase in right ventricular stroke volume in both normal and failing hearts at the physiologic range of afterload, but also that right ventricular function against higher afterload is impaired by 100% assist of bypass of the left side of the heart in failing hearts.

[Successful electroconvulsive therapy of Cotard syndrome with bitemporal hypoperfusion]

A case study is presented to illustrate a rare condition described by Cotard as "délire de négation". The central symptom is a nihilistic delusion with denial of one's own existence of oneself and that of the external world. In the present case, the syndrome became manifest as an escalation of a recurrent depressive disorder late in life. After initial resistance to therapy, the syndrome was successfully treated with electroconvulsive therapy. For the first time, we report the regional cerebral blood flow measured by 99mTc-HMPAO-SPECT before and after therapy. Before treatment, significant bitemporal hypoperfusion relative to the cerebellum was found, which was no longer demonstrable on remission.

99mTc-MIBI accumulation in the parathyroid autograft in a patient with recurrent hyperparathyroidism

A case with recurrent hyperparathyroidism secondary to chronic renal insufficiency is reported. The patient had undergone total parathyroidectomy and autotransplantation of parathyroid tissue five years ago. Bone scintigraphy clearly demonstrated skeletal involvement of secondary hyperparathyroidism and 99mTc-methoxyisobutylisonitrile scintigraphy clearly demonstrated a hyperfunctioning parathyroid autograft.

Continuous monitoring of short-latency somatosensory evoked potentials during cardiac and aortic surgery

The effectiveness of monitoring somatosensory evoked potentials (SEPs) intraoperatively to detect brain damage early remains controversial. To assess the diagnostic accuracy of this modality, a study was conducted between 1991 and 1994, recording SEPs in 287 consecutive patients undergoing cardiac and aortic surgery using cardiopulmonary bypass (CPB) with moderate hypothermia or deep hypothermic circulatory arrest. From P1 to N2 of the SEPs occurring within 50 ms latency in response to electrical stimulation of the median nerve were recorded over the contralateral postcentral cortex at 5-min intervals using a Neuropack-2 (Nihon Koden, Tokyo, Japan). Normal SEPs were recovered in 247 patients postoperatively; however, 2 of these patients had suffered a cerebral infarction and 1, a transient stroke intraoperatively, demonstrating a false-negative incidence of 1.2%. On the other hand, three different types of abnormal SEPs were recorded postoperatively. P1 and N1 absence, probably caused by a subcortical lesion, was observed in 4 patients; P2 and N2 absence, probably caused by a cortical lesion, was observed in 8 patients; and a flat SEP, representing diffuse damage, was observed in 2 patients. Among these 14 patients with abnormal SEPs, 7 showed no neurologic disturbance at all, demonstrating a false-positive incidence of 50%. Thus, we concluded that when normal SEPs are recovered during weaning from CPB, the incidence of brain damage could be predicted at below 5%. Conversely, when abnormal SEPs are demonstrated, the incidence of brain dysfunction impeding a return to active life is estimated to be about 70%.

A new type of growth exhibited by Trimmatostroma abietis

Trimmatostroma abietis initially grew as hyphae when grown in various media containing yeast extract or bactopeptone. It grew as segmented elements (lumbricoid elements) characterized by bidirectional growth, when grown in Czapek-Dox broth or yeast nitrogen base supplemented with 1% glucose. A lumbricoid element usually was 10-70 microns in length, with transverse septation only and contained 3 to 15 cells. Growth and propagation, as revealed by time-lapse photomicrography occurred as follows. Elements usually grew by apical elongation without widening; after simple apical elongation adjacent parts of two central cells eventually started to grow, resulting in the separation of the element into two.

[Clinical analysis of embolism with left atrial myxomas]

We conducted a retrospective analysis examining the relationship between the tumor quality and the occurrence of systemic embolization in 16 patients who underwent surgical excision of the left atrial myxoma. Systemic embolization occured in 10 patients (63%) before surgery, in 5 of whom embolic episodes were the first manifestation of the tumor. Cerebral infarction had developed in 7 patients, TIA in 2, myocardial infarction in 2, limb ischemia in 2, and multiple infarctions in the kidney, adrenal gland, spleen and bone marrow in one. A permanent deficit remained in 6 patients (60%). Myxoma was a lobulated and gelatinous type in 9 (90%) of these patients with embolization and a solid type only in one case. When the dignosis of the left atrial myxoma with soft and fragile quality is made by echocardiography, surgical excision should be performed without delay to prevent systemic embolization.

[Temporal modulation transfer function in normal-tension glaucoma patients]

In an attempt to detect patients in an early stage of glaucoma, a new screening test, the Flicker System, by which temporal modulation transfer function is evaluated, was performed in 64 normal-tension glaucoma patients and 65 normal eyes. The early stage of glaucoma, i.e., stage 0-1 of Aulhorn-Greve's classification, showed a significant decrease of the modulation in the range from 20 to 45 Hz in comparison with normal eyes (p value < 0.05). The moderate stage of glaucoma of stages 2-3 also revealed significantly decreased values of the modulation in the range from 14 to 55 Hz. In the range from 25 to 45 Hz, the reduction of modulation in the glaucoma with diffuse visual defect was more profound than in glaucoma with localized or mixed defects. The results seem to be compatible with the presence of diffuse visual function deficit in glaucoma.

[Symptoms, FEV1/FVC, and peak flow as indices of the control of asthma]

In a cross-sectional study, we evaluated success in the control of asthma as defined by criteria for symptoms, for FEV1/FVC, and for peak flow rates. One hundred and three patients with chronic asthma who had been treated with inhaled steroids were studied. Chest tightness, dyspnea, wheezing, sputum production, and coughing were each scored from 1 (worst) to 5 (best). Symptoms were said to have been controlled if the symptoms scores for the preceding 4 weeks were greater than or equal to 20; FEV1/FVC was said to be under control if it was greater than or equal to 70% when measured in the clinic; peak flow was said to have been controlled if the lowest peak flow in the preceding 4 weeks was greater than or equal to 80% of the highest measured value. Symptoms were controlled in 72% of the patients, FEV/FVC was under control in 83%, and peak flow was controlled in 66%. The patients were grouped by severity of disease into four classes, and these percentages did not differ significantly among the classes. In 22 out of 74 (30%) patients in whom symptoms were controlled, peak flow was not controlled. Furthermore, in 18 out of 64 (28%) patients in whom symptoms and FEV/FVC were controlled, peak flow was not controlled. We concluded that in treating asthma, not should symptoms be controlled, but peak flow should also be measured each day to avoid undertreatment.

Bladder cancer producing granulocyte colony-stimulating factor: a case report

A rare case of bladder cancer producing granulocyte colony-stimulating factor (G-CSF) is reported. A 63-year-old man with a progressive, grade 3 transitional cell bladder carcinoma, showed marked leukocytosis (maximum 181,800/mm3) and an elevated serum G-CSF to 131.7 pg/mL. After radical cystectomy and neoadjuvant chemotherapy, the tumor recurred locally. Immunohistochemical examination with monoclonal antibody specific for G-CSF revealed positive staining in the local recurrent tumor. To our knowledge, there have been only seven cases reported of bladder cancer producing G-CSF.

Dysfunction of cholinergic and dopaminergic neuronal systems in beta-amyloid protein--infused rats

Accumulations of beta-amyloid protein are characteristic and diagnostic features of the brain of Alzheimer's disease patients; however, the physiological role of this protein in CNS is unknown. We have previously reported that continuous infusion of beta-amyloid protein into rat cerebral ventricle impairs learning ability and decreases choline acetyltransferase activity, a marker enzyme of cholinergic neuron. In this study, the effects of beta-amyloid protein infusion on the release of neurotransmitters in cholinergic and dopaminergic neuronal systems were investigated by using an in vivo brain microdialysis method. Nicotine-stimulated release of acetylcholine and dopamine in these animals was significantly lower than that in vehicle-infused rats. Further, dopamine release induced by high-K stimulation was decreased in beta-amyloid protein-infused rats compared with vehicle-infused rats. These results suggest that the release of the two transmitters, acetylcholine and dopamine, was decreased by beta-amyloid protein and that learning deficits observed in the beta-amyloid protein-infused rats are partly due to the impairment of neurotransmitter release. Furthermore, continuous infusion of beta-amyloid protein may be a useful method to produce the animal model of Alzheimer's disease.

Expression of the puf operon in an aerobic photosynthetic bacterium, Roseobacter denitrificans

The effects of oxygen and light on the expression of the puf operon were investigated in Roseobacter denitrificans in a comparison with those in Rhodobacter sphaeroides. In darkness, the levels of the total puf mRNA in Ros. denitrificans were about 1.3 times those in Rb. sphaeroides at low concentrations of oxygen, reflecting the accumulation of bacteriochlorophyll and carotenoids. The oxygen tension, up to 94% saturation of dissolved oxygen, did not affect the levels of the total puf transcripts in Ros. denitrificans, whereas those in Rb. sphaeroides were reduced to 55% of the maximum level even at 50% saturation. Four puf-specific transcripts were detected: a 0.5-kb transcript was the most abundant; 1.2-kb and 1.9-kb transcripts accumulated at low levels; and a 3.5-kb transcript accumulated at very low levels under all conditions tested. The levels of the individual transcripts were barely affected by molecular oxygen. An S-1 nuclease protection assay revealed that the 0.5-kb transcript encoded the LHI-alpha and LHI-beta subunits (pufBA), the 1.2-kb transcript encoded puf-BA and part of pufL, and the 1.9-kb transcript encoded pufBAL and part of pufM. It was not clear whether the 3.5-kb transcript encoded the entire pufBALM and the gene for the polypeptide moiety of cytochrome c. The difference in levels between the 0.5-kb transcript and the other transcripts (1.2 kb, 1.9 kb, and 3.5 kb) was presumed to be due to the presence of several stem-loop structures at the 3' terminus of the 0.5-kb transcript which acted as terminators of transcription and, possibly, as protection against nucleolytic digestion. Light inhibited the expression of the puf operon in Ros. denitrificans more effectively than that in Rb. sphaeroides. The insensitivity to oxygen, as well as the sensitivity to light, of the expression of the puf operon in Ros. denitrificans, which was different from that in Rb. sphaeroides, seemed to represent a mode of adaptation that allowed the former cells to avoid photodynamic damage by light under highly aerobic conditions.

A new magnetically suspended centrifugal pump: in vitro and preliminary in vivo assessment

To overcome problems derived from the shaft within the conventional centrifugal pump, we have been developing a new centrifugal pump, namely a magnetically suspended centrifugal pump (MSCP), which has no shaft and operates as a noncontacting and bearingless pump. The impeller is suspended magnetically between the magnetic bearing and the driving motor. Hemolysis tests were performed in comparison with the Biopump (BP80, BioMedicus). The index of hemolysis (IH) was significantly lower in the MSCP than in the Biopump. In addition, a smaller gap in the MSCP induced lower hemolysis. In preliminary studies using mongrel dogs, the layer of thrombus adherent to the impeller was observed in a few hours, which impaired the pumping efficiency. However, by using an impeller coated with silicone, no aggregations of platelets or fibrin on the impeller were observed in 24 h of continuous pumping. In conclusion, the MSCP had a gentler influence on blood cells than the Biopump, and the impeller coated with silicone may contribute to the long-term pumping of the MSCP.

Management of subarachnoid fluid collection in infants based on a long-term follow-up study

We report the natural history and management of subarachnoid fluid collections in infants and their management based on a longterm follow-up study in 20 cases. These subarachnoid fluid collections were resolved spontaneously in 17 of 20 patients and only 3 by surgical intervention at the age of 2. In our 20 patients the natural history of subarachnoid fluid collection in infants was benign unless the patients sustained head trauma. Surgical treatment was performed in the cases where a subarachnoid fluid collection developed into a subdural haematoma. Head trauma may precipitate subdural haematoma in patients with subarachnoid fluid collection. All patients except one who underwent the placement of subdural-peritoneal shunt, attained normal psychomotor development in time. During the follow-up period of 3 to 10 years after resolution of the fluid collection, no patient has had a recurrence once it resolved.

Captopril, an angiotensin-converting enzyme inhibitor, induced pulmonary infiltration with eosinophilia

In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied by productive cough and striking peripheral eosinophilia, these symptoms disappeared after termination of the administration of captopril, pronase and cephalexine. Furthermore, the results of the peripheral lymphocyte stimulation test, skin patch test and provocation test under informed consent showed a positive reaction only for captopril. Therefore, this patient was diagnosed as captopril-induced PIE syndrome.

[HLA antigens in patients with testicular germ cell tumors]

The role of HLA antigens in the etiology of testicular germ cell tumor has been suggested previously. Several attempts have been made to establish associations of HLA antigens in patients with testicular cancers, but have yielded inconsistent results. We studied the frequencies of HLA antigens by serological typing and DNA typing and examined the association between testicular germ cell tumors and HLA antigens. The serological expression of HLA-A, -B, -C, -DR and -DQ antigens was analyzed in 23 patients with germ cell cancers of the testis. The findings indicated a trend towards an increase in the antigen DQ4 (p < 0.05). The 13 patients were typed for HLA DRB1 and DQB1 allele by PCR-RFLP analysis. The findings revealed an increased frequency of DRB1 0405 (p < 0.01) and DQB1 0401 (p < 0.01).

Long-term followup of patients with tumor thrombi from renal cell carcinoma and total replacement of the inferior vena cava using an expanded polytetrafluoroethylene tubular graft

PURPOSE

Inferior vena caval resection and its reconstruction are sometimes necessary when the inferior vena cava is extensively involved by a large and fixed tumor thrombus from renal cell carcinoma or other malignancies. We successfully replaced the inferior vena cava using tubular expanded polytetrafluoroethylene (Teflon) vascular grafts after en bloc removal of the tumor thrombus and inferior vena cava. We followed the patients long term and observed inferior vena caval patency.

MATERIALS AND METHODS

The 3 men and 2 women ranged from 42 to 75 years old. The renal tumors were on the right side in 4 patients and asynchronously bilateral in 1. The suprarenal inferior vena cava was replaced in 3 patients and the infrarenal portion was replaced in 2. The expanded polytetrafluoroethylene tube grafts, 18 to 22 mm. in diameter and 5 to 12 cm. long, were externally stented in 3 patients and not stented in 2.

RESULTS

Followup ranged from 6 to 96 months (mean 58). Long-term patency of the graft was maintained in all patients. Of the patients 3 had no evidence of disease at 6 months and 2 died of recurrent tumor at 6 and 84 months.

CONCLUSIONS

Total replacement of the inferior vena cava using an expanded polytetrafluoroethylene tubular graft may offer a feasible method with good patency rates in the long term.