Pathological specimens of rat temporal bone--comparison between different fixative solution

We investigated the difference in temporal bone specimens fixated by three sorts of fixative solution (10% formalin fixative, Wittmaack's fixative and Heidenhein-SuSa fixative). 1. 10% Formalin's fixative solution We found many pinkish precipitates, which are stained by hematoxy-eosin, in the scala media of the cochlea. Same substance is found in the perilymphatic space and endolymphatic space in the vestibulum. The fusion of the cells is indicated in the tectorial membrane, inner sulucus cell, outer sulucus cell especially in the apical turn of the cochlea. 2. Wittmaack's fixative solution The detachment of inner and outer sulucus cells are found from basilar membrane at the basal turn of the cochlea. The tendency in convex and concave form of the Reissner's membrane is most remarkable in these three fixative solution. 3. Heidenhein-SuSa fixative solution In this solution, no precipitates, no fusion of cells are found. No detachment of the inner or outer sulucus cells is also found. This study indicates that Heidenhein-SuSa fixation is most excellent fixative method.

Parapsoriasis en plaques: its potential for progression to malignant lymphoma

BACKGROUND

Parapsoriasis en plaques (large-plaque type) is a premalignant condition capable of developing into cutaneous T-cell lymphoma (CTCL). However, it is not known whether the early stage of CTCL can be distinguished from parapsoriasis en plaques.

OBJECTIVE

Our purpose was to determine whether parapsoriasis en plaques can develop into CTCL.

METHODS

The clinical appearance, histopathologic features, immunophenotype, DNA rearrangements, and clinical course were analyzed in 20 cases.

RESULTS

T-cell receptor beta-chain gene rearrangement was detected in four of the 20 cases. No clinical, histopathologic, or immunohistochemical differences were found between patients with and without gene rearrangement.

CONCLUSION

The early stage of CTCL cannot be differentiated from parapsoriasis en plaques by clinical features, histopathologic characteristics, or immunophenotype. Patients with parapsoriasis en plaques exhibit heterogeneous findings, which may include monoclonal proliferation. Patients with long-standing parapsoriasis-like lesions resistant to conventional treatment require careful monitoring for the possible development of cutaneous lymphoma.

Superoxide anion generation from peripheral blood neutrophils stimulated by N-formyl-methionyl-leucyl-phenylalanine in oromaxillary cancer patients

Superoxide anion (O2-) generation levels in peripheral blood neutrophils stimulated by N-formyl-methionyl-leucyl-phenylalanine were evaluated in patients with oromaxillary cancer. The levels in patients with benign tumors were nearly equal to those of normal controls. Patients with squamous cell carcinoma in stage I and II had levels that were widely distributed. On the other hand, O2- generation levels in the advanced stages (III and IV) of squamous cell carcinoma showed lower levels than those of controls (P < .01). All cases of oromaxillary carcinoma showed low levels of O2- generation within 1 month before death compared with controls (P < .01). The generation levels of O2- in the posttreatment period were lower than those before combination cancer treatments. Among cancer treatments such as chemotherapy, surgery, and irradiation, the latter had the strongest effects on O2- generation. These results suggest that low levels of O2- generation by peripheral blood neutrophils may reflect a worsening status of oromaxillary cancer patients.

Malignant epithelioid schwannoma of the skin showing partial HMB-45 positivity

A malignant epithelioid schwannoma occurred on the right second toe of a 30-year-old Japanese man. It was a firm, flesh-colored, benign-appearing nodule and measured 13 x 9 mm in diameter and 6 mm in height. To our knowledge, this is the first case of malignant epithelioid schwannoma occurring on the toe. Histopathology was characterized by a circumscribed nodule in the dermis that predominantly consisted of atypical large epithelioid cells with some spindle cells whose proliferation was similar to that of the Verocay bodies seen in ordinary schwannoma. Fontana-Masson staining demonstrated no melanin pigment in the tumor at the light microscopic level. The eosinophilic cytoplasm contained abundant glycogen and was positive for S-100 protein and HMB-45, as usually seen in melanomas. Electron microscopy revealed that there was an abundance of long-spacing collagen in the extracellular matrix, and the cells contained numerous dense-cored granules. But no definite melanosomes were observed in any stage. As far as we are aware, this is the first case of a malignant epithelioid schwannoma showing HMB-45 positivity.

[Bone changes in Parkinson's disease]

Parkinson's disease (PD) is a movement disorder and tends to occur in elderly people, who sometimes develop age-related osteoporosis. Pathological bone changes seem to affect the outcome and prognosis of PD. We studied the relationship between bone changes and PD. Bone examination was conducted by multiple scanning X-ray photodensitometry in 70 patients with PD and 46 age-matched controls. We then compared the results with the clinical characteristics of PD. Of the 70 patients, 44 were women and 26 were men; the mean ages were 65.5 +/- 7.9 (mean +/- SD) and 63.4 +/- 9.9 years, respectively. Of the 46 controls, 25 were women and 21 were men, with mean ages of 61.4 +/- 10.2 and 60.3 +/- 9.3 years, respectively. Osteopenia was detected in 26 (59%) of the 44 female, and 5 (19%) of the 26 male patients, and in 6 (24%) of the 25 female and 2 (9%) of the 21 male controls. The frequency of osteopenia was significantly greater in the female patients than in the male patients or the female controls. The mean Hoehn & Yahr stage of female patients with osteopenia was more severe than that of those without osteopenia, with a significant difference between the two groups. Osteopenia in men was related to the duration of PD, but this was not so in the women. The female patients without osteopenia tended to have earlier onset of PD and longer duration of the disease and treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Transarterial immuno-chemotherapy including adoptive transfer of autologous cultured lymphocytes for stage IV breast cancer patients with locally-advanced tumor]

Immuno-chemotherapy via a catheter in the subclavian artery using sequential treatment with OK-432, chemotherapeutic agents (ADM, 5-FU), and cultured autologous lymphocytes, was performed for 9 Stage IV breast cancer patients with locally-advanced primary tumor. Tumor reduction of more than 50% was observed in 8 patients including 4 whose breast tumors had disappeared. Among 11 evaluable distant metastatic lesions, 7 (1 pleural effusion, 2 lung, 2 liver, 2 bone metastases) regressed after local immunotherapy of breast or additional regional immunotherapy (1 lung, 1 liver, 1 pleural effusion). Median survival time to date is 56 months. Five patients are currently alive, although 3 of them did not undergo mastectomy. Local immuno-chemotherapy may be useful because (a) toxicity is limited, (b) low doses of anti-cancer agents during the therapy (median dose of ADM, 60 mg) do not limit subsequent systemic chemotherapy, and (c) distant metastases often regress concomitantly with the primary lesions.

Possible pathogenic role of cationic anti-DNA autoantibodies in the development of nephritis in patients with systemic lupus erythematosus

Extensive studies in murine models of lupus nephritis have shown that cationic anti-DNA autoantibodies have nephritogenic potential. We have investigated whether cationic anti-DNA antibodies of IgG class are also produced in vivo in patients with active lupus nephritis. Antibodies against DNA in the sera from patients with SLE were purified by affinity chromatography on DNA-cellulose, followed by nonequilibrium pH gradient electrophoresis and SDS-PAGE. The highly cationic anti-DNA antibodies of IgG class were prominent in the nonequilibrium pH gradient electrophoresis-immunoblots of the antibodies from the patients with active lupus nephritis. Decreased proteinuria after successful treatment with prednisolone was associated with disappearance of the cationic anti-DNA antibodies in the circulation. The cationic anti-DNA antibodies did bind to heparan sulfate, which is a major glycosaminoglycan in glomerular basement membrane, much better than did neutral anti-DNA antibodies. The results suggest that the cationic anti-DNA autoantibodies may play a certain role in the development of lupus nephritis. Our study demonstrates the strong association between the presence of cationic anti-DNA antibody and the development of lupus nephritis in humans.

Possible pathogenic role of cationic anti-DNA autoantibodies in the development of nephritis in patients with systemic lupus erythematosus

Extensive studies in murine models of lupus nephritis have shown that cationic anti-DNA autoantibodies have nephritogenic potential. We have investigated whether cationic anti-DNA antibodies of IgG class are also produced in vivo in patients with active lupus nephritis. Antibodies against DNA in the sera from patients with SLE were purified by affinity chromatography on DNA-cellulose, followed by nonequilibrium pH gradient electrophoresis and SDS-PAGE. The highly cationic anti-DNA antibodies of IgG class were prominent in the nonequilibrium pH gradient electrophoresis-immunoblots of the antibodies from the patients with active lupus nephritis. Decreased proteinuria after successful treatment with prednisolone was associated with disappearance of the cationic anti-DNA antibodies in the circulation. The cationic anti-DNA antibodies did bind to heparan sulfate, which is a major glycosaminoglycan in glomerular basement membrane, much better than did neutral anti-DNA antibodies. The results suggest that the cationic anti-DNA autoantibodies may play a certain role in the development of lupus nephritis. Our study demonstrates the strong association between the presence of cationic anti-DNA antibody and the development of lupus nephritis in humans.

Arachidonic acid metabolism by isolated and cultured middle ear epithelial cells from the chinchilla

Thin-layer chromatography was used to examine the metabolism of arachidonic acid and prostaglandins (PGs) in freshly isolated and cultured middle ear epithelial cells from the chinchilla. The freshly isolated cells converted arachidonic acid predominantly to PGE2, while those cells grown in culture for 10 days acquired the ability to convert arachidonic acid to 6-keto-PGF1 alpha, PGD2, and PGE2. Incubation of the isolated cells and primary cultures with acetylsalicylic acid and indomethacin inhibited the formation of these PGs. These findings suggest that studies on the factors regulating arachidonic acid metabolism in middle ear epithelium may help to explain the role of eicosanoids in middle ear secretions, particularly in relation to the pathophysiology of otitis media.

Microsurgical scalp and skull reconstruction using a serratus anterior myo-osseous flap

In reconstruction of large scalp and skull defects, the usefulness of microvascular free tissue transfer is manifest. We have performed 4 scalp and skull reconstructions by free serratus anterior osteomuscle flap transfer. The usefulness of serratus anterior osteomuscle flap for reconstruction of combined, extensive scalp and skull defects is emphasized.

Congenital cholesteatoma of the petrous pyramid

A congenital cholesteatoma arising from the petrous pyramid is rarely encountered, and we report a case of such a cholesteatoma in a 23-year-old male. This cholesteatoma was successfully removed by a middle cranial fossa approach. The cholesteatoma showed a unique mode of spread, that is, it originated from the pyramidal apex and extended in two directions: through the facial canal to the tympanic sinus, and along the tympanic tegmen to the mastoid antrum. We discuss the importance of CT and MRI for achieving a diagnosis, as well as the merits of using a middle cranial fossa approach for the surgical excision of this cholesteatoma.

Local control of prostate cancer with transurethral intracavitary radiation therapy

As of January 1986, 13 patients with adenocarcinoma of the prostate had been treated in our clinic by remote after-loading transurethral high dose rate radiotherapy using a 60Co source. Of these patients, four were at stage B2, three at stage C, three at stage D1, and three at stage D2. The mean total dose of transurethral radiotherapy was 35.2 Gy to the most distant prostatic capsule from the source. Three patients with stage D1 disease and one patient with stage C disease received additional external radiation with a total dose of 20 Gy to the prostate and 40 Gy to the pelvis. Local tumor response proved rapid and satisfactory as verified by rectal examination, ultrasonography, and needle biopsy. Serious complications such as proctitis, cystitis, incontinence, and urethral stricture were not evident during the average follow-up term of 34.9 months.

[Clinical significance of dystrophin test for patients with various neuromuscular diseases--immunofluorescence and immunoblot analyses of dystrophin abnormalities]

The dystrophin test was performed on skeletal muscle specimens from 81 cases with various neuromuscular diseases by using two new monoclonal antibodies. The results were compared with those obtained by using four polyclonal antibodies. These monoclonal and polyclonal antibodies were raised against various portions of the dystrophin molecule. On immunohistochemical analysis, the two new monoclonal antibodies showed the same staining pattern as the four polyclonal antibodies. Non-specific immunostaining of the cytoplasm, often seen with polyclonal antibodies, was not observed with monoclonal antibodies. With the application of monoclonal antibodies, the connective tissue sometimes showed non-specific immunostaining which originated from the second fluorescent antibody. On immunoblot analysis, one of the two monoclonal antibodies, antibody 4-4 C 5, showed weak immunoreactivity, and the 400 kDa dystrophin band was not detected. Three cases out of 15 with Duchenne muscular dystrophy (DMD), and one case out of 3 with limb-girdle type muscular dystrophy which had previously been diagnosed on the basis of clinical data, were found to have non-dystrophin-related muscular dystrophy, and Becker muscular dystrophy (BMD), respectively. Three and two of five cases were diagnosed as DMD and BMD, respectively, though clinical diagnosis had not been possible because they were too young. Clinical diagnosis of congenital muscular dystrophy was confirmed in 9 patients by the dystrophin test. Only one of three certain DMD carriers had a so-called mosaic staining pattern. We conclude that all six antibodies are useful tools for the diagnosis of neuromuscular diseases, because of their high specificity for dystrophin.

[Scintigraphic comparison of graft patency between the left internal thoracic artery and saphenous vein graft after coronary bypass surgery]

Graft patency after coronary bypass surgery (CABG) was evaluated with stress 201-thallium scintigraphy (stress 201Tl) in 26 cases, including 13 cases using the left internal thoracic artery (LITA group) in situ and 13 cases with saphenous vein graft (SVG group). All of them had effort or unstable angina caused by LAD lesion without apparent infarction. Stress 201Tl using a symptom-limited, graded bicycle exercise test was performed before CABG and 1 month, 6 months to 1 year, 1 year to 1.5 years after surgery. Five tomographic images including the apical side of the area fed by the bypass anastomosed to LAD in short axial sections were picked out and piled up. Fan-shaped ROI was made on this area and % Tl uptake was calculated using the following formula. 201Tl counts in ROI--Background counts/Maximum counts--Background counts x 100 (%) The normal % Tl uptake calculated in the control group (n = 11) in this ROI was 68.2 +/- 4.8%. Preoperative % Tl uptake showed 49.3 +/- 0.2% in the LITA group and 54.3 +/- 13.2% in the SVG group. % Tl uptake of the SVG group 1 month after CABG was slightly higher than that of the LITA group, (62.0 +/- 7.0% vs. 56.3 +/- 7.6%). However 6 months to 1 year after, % Tl uptake of the LITA group increased to 60.8 +/- 6.4%, inspite of a tendency on the decrease of that in the SVG group, (59.0 +/- 8.5%), and further more, 1 year to 1.5 years after CABG, increased to 62.3 +/- 5.1% near the normal % Tl uptake of the control group and the SVG group decreased to 58.8 +/- 6.8%. This result suggested that arterial in situ bypass graft might have an auto-regulation and "growing property" corresponding to flow demand, and this helps the excellent long-term patency of arterial bypass grafts.

[Pregnancy obtained by in vitro fertilization (IVF) with epididymal spermatozoa in obstructive azoospermia: report of two cases]

Epididymal spermatozoa aspiration was performed in two cases of obstructive azoospermia. After the procedure, in both cases, the patient's wives obtained twin pregnancies by this method in conjunction with in vitro fertilization (IVF) and embryo transfer (ET). The patient's wife in one case had a normal delivery. The patient's wife in the other case, however, aborted artificially because she had cerebral infarction. Epididymal spermatozoa aspiration proved efficacious for male sterility in cases of obstructive azoospermia.

The lumbar spine in spastic diplegia. A radiographic study

Some radiological features of the lumbar spine of 84 patients with spastic diplegia were compared with 50 control subjects. The average age of the patients was 20.1 years (3 to 39). Spondylolysis of the fifth lumbar vertebra was found in 21%, four times more frequently than in normal subjects. No patient under nine years of age had spondylolysis and the frequency increased with age. The average angle of lumbar lordosis in spastic patients in the standing position was greater than in normal subjects, and increased with age. The patients had a decreased sacrofemoral angle which caused an increase in Ferguson's angle and explained the increased angle of lumbar lordosis.

Feedback regulation mechanisms for the control of GTP cyclohydrolase I activity

Guanosine triphosphate (GTP) cyclohydrolase I, the rate-limiting enzyme in the biosynthesis of tetrahydrobiopterin (BH4), is subject to feedback inhibition by BH4, a cofactor for phenylalanine hydroxylase. Inhibition was found to depend specifically on BH4 and the presence of another protein (p35). The inhibition occurred through BH4-dependent complex formation between p35 protein and GTP cyclohydrolase I. Furthermore, the inhibition was specifically reversed by phenylalanine, and, in conjunction with p35, phenylalanine reduced the cooperativity of GTP cyclohydrolase I. These findings also provide a molecular basis for high plasma BH4 concentrations observed in patients with hyperphenylalaninemia caused by phenylalanine hydroxylase deficiency.

Biochemical characterization of mucous glycoproteins secreted by in vitro chinchilla middle ear epithelial cells

A method for middle ear epithelial (CMEE) cell culture with active mucus secretory function has been successfully developed, using the chinchilla as an animal model. CMEE cells were dissociated by protease digestion from the middle ear mucosa. The CMEE cells grown in primary culture incorporated [3H]glucosamine into a glycoconjugate after its release into medium. This substance was characterized biochemically as mucin, although the production of mucin by the cells required growth on a substratum of collagen gel. These cultures provide an excellent model for studying factors that regulate synthesis and secretion of glycoproteins in CMEE cells.

Evaluation of validity of five weight-height obesity indices

Validity of five weight-height obesity indices, Broca-Katsura index, weight/height ratio, BMI, Rohrer index and Benn index were evaluated as an obesity index in male medical students of Kyushu University. Validity of them was evaluated using the following three criteria: (1) it should be highly correlated with body weight and its distribution should be independent of height; (2) it should be highly correlated with obese rate to the standard body weight of Japanese young men; (3) it can accurately classify individuals as overweight or not overweight. BMI met all three criteria in this population. Benn index proved to be not only independent of body height but also highly correlated with body weight and obese rate, though we could not evaluate this obesity index using criterion (3) because there is no generally-accepted cut-off point of overweight of it. Broca-Katsura index, weight/height ratio and Rohrer index were not independent of body height. From these results, it is concluded that BMI is the best weight-height obesity index in this population.

Sequential immunotherapy using interleukin-1 followed by interleukin-2 of ascitic MOPC104E-bearing mice

This study shows that intraperitoneal injection of interleukin-1 (IL-1), followed by interleukin-2 (IL-2), can effectively eradicate murine ascitic tumor cells. This antitumor effect of IL-1 and IL-2 was abolished when administration of IL-2 preceded that of IL-1. Solid tumors inoculated subcutaneously (s.c.) into the back of mice were also sensitive to this combined i.p. therapy, indicating a systemically-operating antitumor mechanism. Splenocytes from tumor-bearing mice treated with IL-1 followed by IL-2 showed a strong tumor-neutralizing activity. The population responsible proved to be Lyt2.2 (CD8)-positive cells.

Three-dimensional reconstruction of the temporal bone from a case of E trisomy syndrome

Computer-assisted three-dimensional reconstruction was performed from histologic sections of the left temporal bone removed from a case of E trisomy syndrome. The reconstructions included structures such as the bony and membranous labyrinths, ossicles, ossicular muscles, tympanic membrane, and facial and eighth nerves. The structures could be observed individually or simultaneously in combination. Prominent abnormalities observed in these reconstructions included enlargement of the utricle, absence of the posterior semicircular canal, slight hypoplasia of the cochlea, anomaly of the stapes, abnormally shaped stapedius muscle, abnormal course of the facial nerve, and flattening of the tympanic membrane. The results were useful for the visual and stereoscopic understanding of abnormal configurations and the spatial orientations of these abnormalities.

The effect of spermine on the disaccharidase activities in suckling rats of different age

The influence of the age of the rat on the maturation of disaccharidase activities induced by spermine was studied. Three-day- and 9-day-old rats were used in the experiment. Spermine was administered orally or directly into the stomach using thin tubing daily for 3 days, and disaccharidase activities in the jejunum were measured. While spermine caused maturation of not only lactase activity but also maltase and sucrase activities in 9-day-old rats, it only caused maturation of lactase activity in 3-day-old rats. Histological studies showed no significant changes in the jejunum of 3-day-old rats treated with spermine.

Antioxidant protection against oxidant-induced damage in cultured gastric mucosal cells

Gastric epithelium is exposed not only to oxidants generated within the lumen, but also to those produced by ischemia/reperfusion. This study examined the mechanism(s) of oxidant-induced injury to cultured rat gastric mucosal cells, and characterized the antioxidant profile of these cells. Hydrogen peroxide (H2O2), generated by glucose oxidase, damaged cells dose-dependently, as assessed by increased leakage of labeled 51Cr. Glucose oxidase-induced damage was prevented by exogenous catalase (but not by exogenous superoxide dismutase). Chelation of cellular iron with desferrioxamine or phenanthroline specifically protected cells against H2O2, whereas binding of extracellular iron with apotransferrin failed to. Disruption of the glutathione redox cycle at three independent sites rendered cells less resistant to H2O2, whereas inhibition of cellular catalase did not result in sensitization of cells to H2O2. In conclusion, (1) oxidant injury induced by extracellular H2O2 is mediated by intracellular iron; (2) extracellular superoxide is not involved in the damaging process; and (3) the glutathione redox cycle plays a principal role in detoxifying H2O2 as a cellular antioxidant in cultured gastric mucosal cells.