Growth, hemorrhage, and regression of multiple intracerebral vasoformative tumors: report of an unusual case

A rare case of multiple hemorrhagic vascular tumors of the cerebrum and cerebellum is reported. Computed tomographic scans in a 16-year-old girl revealed multifocal brain lesions with "jewel ring"-like areas of contrast enhancement. An old hematoma cavity was found inside the surgical specimen. Histologically, it was a vascular tumor composed of anastomosing vascular channels with proliferating endothelial cells and hemorrhages at different stages. Upon further histopathological study, this lesion could not be classified as any known vascular tumor entity, although it resembled some vascular tumors, such as cavernous hemangioma and hemangioendothelioma. The patient received steroid and alpha interferon treatment. The lesions initially increased in number once, then resolved 10 months after onset. The neuroradiological and histopathological features in the present case were characteristic, and the clinical course was unusual.

Location of focal silver staining at endothelial gaps in inflamed venules examined by scanning electron microscopy

The century-old histological technique of silver nitrate staining has proven to be extremely useful for visualizing endothelial cell borders and localizing endothelial gaps, but the significance of the staining is still not fully understood. To gain some insight into what silver nitrate stains, we developed a method that enabled us to use scanning electron microscopy with backscattered and secondary electron imaging to examine silver staining at endothelial cell borders of venules of the rat tracheal mucosa. We found that in normal venules, silver lines followed the smooth contour of cell borders. However, 1 min after endothelial permeability was increased by substance P, cell borders were irregular and displaced from the silver lines by as much as 4.3 microns, and the lines were accompanied by three types of silver deposits. Most common (46% of total) were annulus-shaped silver deposits that surrounded endothelial gaps. These deposits averaged 1.5 microns in width, were positioned symmetrically across cell borders, and were located at a depth of 0.3 micron beneath the luminal surface. Many endothelial gaps were partitioned into multiple pores (mean, 2.4) by fingerlike processes of endothelial cells. Surprisingly, the gaps occupied only 5.4% of the total area of the silver deposits and constituted 0.15% of the luminal surface of the leaky postcapillary venules. A second type of silver deposit (19% of total) was positioned asymmetrically with respect to the cell border and marked sites where endothelial cell margins still overlapped but appeared to be vertically separated by obliquely oriented gaps. A third type marked gaps at three-cell junctions; these were no more abundant than deposits elsewhere around the cell perimeter, suggesting that three-cell junctions were not unusually leaky sites. We conclude that silver nitrate marks endothelial cell borders and outlines endothelial cell gaps by staining an element of intercellular junctions. The annular shape of many silver deposits around gaps suggests that junctional elements in the apposing cells are separated during gap formation but are still present at the gap perimeter.

Augmented responses to 5-HT2-receptor-mediated vasoconstrictions in atherosclerotic rabbit common carotid arteries

The vascular responses of isolated and perfused atherosclerotic rabbit common carotid arteries to 5-HT were investigated. Atherosclerotic lesions were produced by positioning a hollow silicone collar around the common carotid arteries of rabbits fed with an atherogenic diet for 4 weeks. After the period, we removed the vessels from operated and sham-operated rabbits fed with either the atherogenic diet or a normal diet for 4 weeks. The removed vessels were divided into four groups: a control group, a cuffed normal-diet-fed group, a sham-operated, cholesterol fed group, and a cuffed cholesterol-fed group. Vascular effects of 5-HT and its analogs (5-CT, a 5-HT1-like receptor agonist; alpha-methyl-5-HT, a 5-HT2 agonist; 8-OH-DPAT and TFMPP, 5-HT1 agonists) were investigated in each group. The vasoconstrictor responses to 5-HT, 5-CT and alpha-methyl-5-HT were enhanced in atherosclerotic vessels. Removal of the endothelium did not affect the vascular responses to 5-HT and its analogs. Because the responses were not enhanced in vessel from a cuffed normal-diet-fed group, we did not show the data of this group in figures and did not examine antagonism studies. Vasoconstrictor responses to these agonists were markedly inhibited in other three groups by ketanserin and spiperone (5-HT2 receptor antagonists), and methysergide (a 5-HT1 and 5-HT2 receptor antagonist). 5-HT and its analogs did not show any vasodilatory action on phenylephrine-preconstricted preparations, which suggested that there were few functional 5-HT1 receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhalin gene mutations in patients with autosomal recessive childhood onset muscular dystrophy with adhalin deficiency

Homozygous adhalin gene mutations were found in three patients from two consanguineous families with autosomal recessive childhood onset muscular dystrophy. Muscle biopsies from patients in each family showed complete absence of adhalin. Sequencing of adhalin cDNA prepared from skeletal muscle by reverse transcription PCR demonstrated a cytosine to thymidine substitution at nt 229 in the patient in family 1 and an adenine to guanine substitution at nt 410 and a 15-base insertion between nt 408 and 409 in the two patients in family 2. Sequencing of genomic DNA prepared from peripheral blood leukocytes by PCR confirmed these mutations. The parents in each family were found to be heterozygous for the respective mutations. These adhalin gene mutations are presumed to be responsible for the absence of adhalin in the skeletal muscle. Adhalin deficiency likely causes disruption of the muscle cell membrane, resulting in dystrophic changes in the skeletal muscle similar to dystrophin deficiency in Duchenne muscular dystrophy.

JTP-4819: a novel prolyl endopeptidase inhibitor with potential as a cognitive enhancer

JTP-4819 ((S)-2-[[(S)-2-(hydroxyacetyl)-1-pyrrolidinyl]carbonyl]-N- phenylmethyl)-1-pyrrolidinecarboxamide) is a potent (IC50: 0.83 +/- 0.09 nM in rat brain supernatant; 5.43 +/- 0.81 nM in Flavobacterium meningosepticum) and specific inhibitor of prolyl endopeptidase (PEP). JTP-4819 (3 mg/kg p.o.) exhibited a strong and durable ex vivo inhibitory effect on PEP in various regions of the rat brain. In addition, JTP-4819 inhibited the degradation of substance P, arginine-vasopressin, thyrotropin-releasing hormone, neurotensin, oxytocin, bradykinin, and angiotensin II by purified PEP with IC50 values of 9.6, 13.9, 10.7, 14.0, 4.5, 7.6 and 10.6 nM, respectively. In the one-trial passive avoidance test in rats with scopolamine-induced amnesia, JTP-4819 significantly prolonged the retention time when administered orally at doses of 1 and 3 mg/kg 1 hr before acquisition or at 3 and 10 mg/kg 1 hr before retention. In addition, coadministration of JTP-4819 and substance P, arginine-vasopressin or thyrotropin-releasing hormone (at doses at which each drug alone did not prolong the retention time) improved the retention time of rats with scopolamine-induced amnesia. Microdialysis studies demonstrated that JTP-4819 caused a significant increase in ACh release in the frontal cortex and hippocampus of young rats at oral doses of 1 and 3 mg/kg, as well as in both brain regions of aged rats at a dose of 3 mg/kg. These results indicate that JTP-4819 potentiates neuropeptide functions inhibiting PEP, that it activates cholinergic transmission and that it enhances learning and memory.

Molecular miscibility of phosphatidylcholine and phosphatidylethanolamine in binary mixed bilayers with acidic phospholipids studied by 2H- and 31P-NMR

The intermolecular interactions and microscopic miscibility of the lipid bilayers of single component and binary mixtures with high content of saturated fatty acids were investigated by 2H- and 31P-NMR for phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylglycerol (PG) and cardiolipin (CL). Their glycerol backbones were selectively deuterated by biosynthesis and chemical synthesis. Deuterium quadrupole splittings and phosphorus chemical shift anisotropies provided the consistent information for the molecular miscibility of each phospholipids. PE was found to be completely miscible with PG and CL. Since deuterium quadrupole splittings and phosphorus chemical shift anisotropy are identical for two components in the mixed bilayer, the dynamic structure from the glycerol backbone to phosphate group should be uniform in the binary mixture of these phospholipids. In contrast to PE, PC was not fully miscible with PG and CL at molecular resolution. The dynamic structure from the glycerol backbone to phosphate group is different for two components in the binary mixed bilayers. In the case of the mixed bilayers of PC and PE, both phospholipids are microscopically immiscible with each other. Thus, while PE, PG and CL can adapt to a new situation to form a uniform dynamic structure in mixed bilayers, PC has no ability for adaptation. The molecular miscibility in lipid bilayers was shown to depend on the molecular species and the nature of the molecular interactions. The biological significance of this result was discussed.

[A case of accessory nerve neurinoma presenting an intracisternal tumor]

A case of neurinoma from the spinal accessory nerve which is located in the cisterna magna is reported. A 54-year-old woman was admitted to the institute in 1990 with complaints of headache, nausea and ataxic gait for several months. Plain CT showed dilation of the lateral ventricles and a mass of lower density in the cisterna magna. The capsule and septa of the mass were enhanced with contrast medium. MRI showed the mass was low intense on T1-weighted images and high intense on T2-weighted images. Gadolinium visualized the mass multicystic. V-P shunt was performed before tumor resection. Through suboccipital craniectomy and C1 laminectomy the tumor was removed. The tumor had a long neck attached to the right spinal accessory nerve and extended to the cisterna magna.

Nonphotosensitive video game-induced partial seizures

We report a 9-year-old boy with a ring 20 chromosome anomaly whose complex partial seizures (CPS), presumably of frontal lobe origin, were often induced by playing video games. Neither photosensitivity nor pattern sensitivity was observed. An intensive video-EEG investigation showed that video games as well as mental calculation elicited rhythmic runs of bilateral high-voltage slow waves, which eventually evolved into ictal discharges. This case suggests that higher brain functions can be involved in seizure induction.

A comparison of intraarterial carboplatin and ACNU for the treatment of gliomas

BACKGROUND

Intraarterial chemotherapy with carboplatin for malignant gliomas has been tried recently, but its therapeutic efficacy and toxicity have not yet been elucidated.

METHODS

We treated patients with malignant glioma by intraarterial chemotherapy using carboplatin, and compared the efficacy as well as the side effects with intraarterial ACNU.

RESULTS

Twenty patients were treated with carboplatin (300 mg/m2) and 22 patients were treated with ACNU (80-200 mg/m2). Response (complete remission+partial response) rate for carboplatin was 12.5% compared to 45% for ACNU. Despite higher response rate for ACNU, the difference in the survival curves of the two groups was not significant. Three patients who were treated with high dose (150-200 mg/m2) of ACNU developed hemiparesis and aphasia. Seven patients treated with carboplatin developed 10 incidences of neurotoxicities; two hemiparesis, one aphasia, one blindness, one visual field disturbance, three convulsions, and two developed incidences of disturbances of consciousness.

CONCLUSIONS

Intraarterial carboplatin was not superior to intraarterial ACNU in achieving remissions, and showed much greater tendency to produce neurotoxicities.

Tyrosine protein phosphorylation in murine B lymphocytes by stimulation with lipopolysaccharide from Porphyromonas gingivalis

The molecular effect of lipopolysaccharides (LPS) from porphyromonas gingivalis as well as Escherichia coli on the tyrosine protein phosphorylation in the splenic B lymphocytes from LPS-responsive C3H/HeN and LPS-hyporesponsive C3H/HeJ mice was examined. P. gingivalis LPS induced tyrosine phosphorylation of selected membrane proteins that included the phosphoproteins with apparent molecular masses of 24.8 kDa and 26.0 kDa (p24.8 and p26.) in the B lymphocytes from both strains of mice, while E. coli LPS induced p24.8 and p26.0 in C3H/HeN B Lymphocytes only. These findings suggest that through the same tyrosine phosphorylation pathway as observed in C3H/HeN B lymphocytes, P. gingivalis LPS induced the activation of C3H/HeJ B lymphocytes in which a trigger signal by E. coli LPS could not be transduced to initiate tyrosine protein phosphorylation.

Syntaxin 1 (HPC-1) is associated with chromaffin granules

Syntaxin 1 (HPC-1), a component of the receptor for SNAPs (soluble N-ethylmaleimide-sensitive factor attachment proteins), has been implicated in the docking and fusion of synaptic vesicles with the plasma membrane. It was reported that syntaxin 1 in rat brain and chromaffin cells (PC12) is exclusively located on the plasma membrane (Bennett, M. K., Calakos, N., and Scheller, R. H. (1992) Science 257, 255-259; Söllner, T., Bennett, M. K., Whiteheart, S. W., Scheller, R. H., and Rothman, J. E. (1993) Cell 75, 409-418). By means of biochemical and morphological analyses, we now show that syntaxin 1 is associated with chromaffin granules in the adrenal medulla. This finding raises the possibility that syntaxin 1 in chromaffin cells is a component of vesicle-SNAP receptor as well as one of target-SNAP receptor on the plasma membrane.

Involvement of HPC-1/syntaxin-1A antigen in transmitter release from PC12h cells

We examined the effect of antiserum against HPC-1/Syntaxin-1A on the norepinephrine release from digitonin-permeabilized PC12h cells. PC12h cells were permeabilized with digitonin and preincubated with nonimmunized serum or antiserum against HPC-1. The release of norepinephrine was measured in the presence or absence of calcium. The calcium-dependent norepinephrine release was increased in the cells preincubated with anti HPC-1 antiserum. However, with a higher concentration of anti HPC-1 antiserum, the calcium-dependent norepinephrine release was decreased, possibly because of a nonspecific effect. In the case of purified IgG, the same results were obtained. These findings suggested that HPC-1 plays an important role in the exocytosis of transmitter presumably by suppressing the membrane fusion process between the synaptic vesicle and presynaptic membrane.

A bolster suture technique for ear reconstruction for microtia without skin necrosis

A new bolster suture technique to prevent skin necrosis in microtia ear reconstruction is presented. An outer series of bolsters is placed distant from the ear framework in a zigzag fashion, the temporal skin being gathered on the framework. In this way, the skin flap overlying the framework is relaxed and has sufficient blood flow. Therefore the skin flap can be thinned with little risk of necrosis. Furthermore, the contour of the reconstructed auricle is accentuated because of the thin relaxed overlying skin. Seven ears with microtia were reconstructed using this method. The results were satisfactory, except for one auricle which became slightly congested at the conchal portion due to excessive thinning. There were no haematomas or skin necrosis.

Maternal placenta-like endometrial hyperplasia in a beagle dog (Canine deciduoma)

Three thumb-sized segmental swellings were found in both uterine horns of a 15 month-old, non-pregnant and non-pseudopregnant female beagle dog. Histopathological examination of the uterus revealed a marked proliferation of the endometrium that was characterized by two distinct parts, an inner tightly-folded banded layer and an outer dilated spongy layer, quite similar to the maternal placenta except for the fetus and chorion in the lumen. Because the plasma level of progesterone was unusually high at autopsy, this hormonal disorder might be related to the pathogenesis of the endometrial hyperplasia in the present case.

Interleukin-8 and monocyte chemotactic activating factor responses to cardiopulmonary bypass

Cardiac operations with cardiopulmonary bypass cause a systemic inflammatory response. Neutrophils and monocytes-macrophages play an important role in triggering the initiation of the inflammatory response. Recently, some kinds of cytokines that are powerful leukocyte chemotactic factors have been characterized concerning an inflammatory response: interleukin-8 has a potent chemoattractant activity for neutrophils, and monocyte chemoattractant factor has monocyte-macrophage chemotactic activity. To investigate the possible roles of the cytokines in the inflammatory response in cardiopulmonary bypass, 12 adult patients undergoing cardiopulmonary bypass were studied for measurement of interleukin-8 and monocyte chemoattractant factor. Systemic blood was collected before cardiopulmonary bypass, at the end of cardiopulmonary bypass, and at 3, 12, 24, and 48 hours after cardiopulmonary bypass from the patients' radial arteries. Significant increases in levels of interleukin-8 and monocyte chemoattractant factor were detected with a peak level at 3 hours after bypass compared with levels before cardiopulmonary bypass (p < 0.05). This study demonstrated that interleukin-8 and monocyte chemoattractant factor are released into the circulation after adult hypothermic cardiopulmonary bypass and reach a maximum level 3 hours after bypass.

Effects of diclofenac sodium and indomethacin on proliferation and collagen synthesis of lens epithelial cells in vitro

We investigated the effects of diclofenac sodium and indomethacin on the proliferation of and collagen synthesis by lens epithelial cells (LECs) of human cataracts in culture. The anterior capsule with attached LECs, obtained by anterior capsulotomy during cataract surgery, was cultured directly without cell dispersion. When the culture became almost confluent, diclofenac sodium or indomethacin at various concentrations was added to the incubation medium. The incorporation of 3H-thymidine and 3H-proline into the LECs was measured after the cells were labeled with these radioactive materials. Both drugs greatly suppressed the incorporation of 3H-thymidine and of 3H-proline, indicating that they inhibit cell division and collagen synthesis by LECs. Both drugs may help prevent posterior capsule opacification.

The amino acid sequence of Nitrosomonas europaea cytochrome c-552

The complete amino acid sequence of cytochrome c-552 derived from the chemoautotrophic ammonia-oxidizing bacterium Nitrosomonas europaea was determined. The cytochrome consisted of 81 amino acid residues, and its molecular weight was calculated to be 9098 including heme c. Although the sequence of cytochrome c-552 was highly homologous to those of cytochromes c-551, which were known as the electron-donating components to dissimilatory nitrite reductase in pseudomonads, cytochrome c-552 differed from cytochrome c-551 in two points: (1) the sequence of cytochrome c-552 was shorter by two amino acid residues than that of cytochrome c-551 at the N-terminus and (2) one amino acid insertion was present in cytochrome c-552.

[The usefulness of monitoring hepatic venous saturation during open heart surgery for a patient with severe liver dysfunction]

We report the usefulness of monitoring hepatic venous saturation (ShVO2) during open heart surgery for a patient with severe liver dysfunction. The patient was a 55-year-old man who had been suffering from acute aortic regurgitation due to bacterial endocarditis. Indocyanine green retention test at 15 min was 55%. Serum GOT, GPT and T bilirubin were 56 U.l-1, 35 U.l-1 and 1.5 mg.dl-1 respectively. Aortic valve replacement was scheduled in spite of severe liver dysfunction because amelioration of congestive heart failure after the operation was expected to improve liver dysfunction to the previous chronic state. Anesthesia was induced and maintained by intermittent administration of diazepam and low dose of fentanyl with 100% oxygen. After induction, we inserted a balloon tipped pulmonary catheter with ultra-red beam into hepatic vein by fluoroscopy guidance and monitored ShVO2 as an index of hepatic oxygen supply/demand balance. During re-insertion of a thoracic catheter, we could detect the continued decrease in hepatic vein saturation even after the improvement of systemic circulatory state. Postoperatively, liver function became slightly worse for a short period and improved thereafter. These results suggest that ShVO2 monitoring is clinically useful in detecting hepatic oxygen supply/demand imbalance which circulatory monitoring could not uncover during open heart surgery.

Self-induced photogenic seizures in a child with severe myoclonic epilepsy in infancy: optical investigations and treatments

In a 2-year-old patient with severe myoclonic epilepsy in infancy, we studied self-induced photogenic seizures using optical filters and blue-tinted contact lenses. The patient induced absences and/or myoclonic jerks by two kinds of behaviors: flickering hand movement (FHM) and forced eye closure (FEC). The placebo inhibitory effect on FHM by a blank goggle frame indicated that acquisition of learning affected the frequency of FHMs per se. Optical studies suggested that the degree of absorption from approximately 600-700 nm might determine the inhibitory effect of filters on FHM. Investigations using contact lenses showed that blue-tinted lenses gradually reduced photosensitivity and inhibited FHMs.

Proinflammatory cytokine levels in patients undergoing cardiopulmonary bypass. Does lung reperfusion influence the release of cytokines?

Proinflammatory cytokines have been implicated in mediating tissue injury after cardiopulmonary bypass. Causative factors of inflammatory response after cardiopulmonary bypass include contact of the blood with the extracorporeal circuit and heart-lung reperfusion injury when discontinuing bypass. To evaluate proinflammatory cytokine release during cardiopulmonary bypass, plasma levels of interleukin-6, 8, and monocyte chemoattractant factor were measured in the radial artery (for systemic blood) and left atrium before and after cardiopulmonary bypass. A total of 13 patients were studied, with no deaths or complications. In both radial artery and left atrium, interleukin-6, 8, and monocyte chemoattractant factor rose significantly after cardiopulmonary bypass (p < 0.05 versus before cardiopulmonary bypass). These changes may have been caused by removal of the aortic cross clamp and recommencement of artificial ventilation, which result in reperfusion of the pulmonary capillary beds. There were no differences in cytokine levels after cardiopulmonary bypass in the radial artery and left atrium. This result suggested that lung reperfusion injury after cardiopulmonary bypass may not be the major causative factor of the release of proinflammatory cytokines.

Cloning, sequencing and expression of a novel cDNA encoding human vacuolar ATPase (14-kDa subunit)

A cDNA encoding the 14-kDa subunit of vacuolar ATPase was cloned from human fetal brain. The sequence was composed of 680 nucleotides containing an open reading frame of 357 nucleotides. The deduced peptide sequence consisted of 119 amino acid residues with a calculated molecular weight of 13,369 Da and a pI of 5.19. Overall, this amino-acid sequence was respectively 69% and 70% identical to those of Manduca sexta and Drosophila melanogaster 14-kDa subunits, although the two representatives of Class Insecta were remarkably similar to one another (91% identity). Three regions in particular (the N-terminal, amino acids 5-36; the middle, residues 58-68; and the C-terminal, residues 88-118) were highly conserved. Hence, we think that the 14-kDa subunits have evolved from the same ancestral gene, and that the three conserved regions are important for the structure and function of vacuolar ATPase. A single 0.8-kb band was detected in various human tissues by Northern blot analysis. Since the human 14-kDa subunit is expressed ubiquitously, it might be a housekeeping protein. A separate transcript found in the cDNA library lacked a 6-bp segment in the 5' non-coding region (nucleotides -40 to -35) and also carried a 23C to T (8Thr to Ile) point mutation in the coding region; these minor differences likely reflected normal polymorphism.

Intracellular localization of 8-oxo-dGTPase in human cells, with special reference to the role of the enzyme in mitochondria

We examined the intracellular distribution of 8-oxo-dGTPase (8-oxo-7,8-dihydrodeoxyguanosine triphosphatase) encoded by the MTH1 gene, a human mutator homologue. The activity of 8-oxo-dGTPase mainly located in cytosolic and mitochondrial soluble fractions of Jurkat cells, a human T-cell leukemia line. Electron microscopic immunocytochemistry, using a specific antibody against MTH1 protein, showed localization of MTH1 protein in the mitochondrial matrix. Activity in the mitochondria accounted for about 4% of the total activity. The specific activity in the mitochondrial soluble fraction (8093 units/mg protein) was as high as that in the cytosolic fraction (8111 unit/mg protein). The 8-oxo-dGTPase activities in cytosolic and mitochondrial soluble fractions co-eluted with MTH1 protein by anion-exchange chromatography, and the molecular mass of the mitochondrial MTH1 protein was much the same as that of the cytosolic MTH1 protein (about 18 kDa). HeLa cells expressing MTH1 cDNA showed an increased cytoplasmic signal together with a weak signal in the nucleus in in situ immunostaining of MTH1 protein, and the overexpressed MTH1 protein was recovered from both cytosolic and mitochondrial fractions. Thus, the 8-oxo-dGTPase encoded by MTH1 gene is localized in mitochondrial and cytosol.