Determination of 8-methyl ether of xanthurenic acid in human urine by high-performance liquid chromatography

We developed a simple and sensitive assay for the urinary 8-methyl ether of xanthurenic acid (XA-OMe) by high-performance liquid chromatography with fluorescence detection (excitation at 340 nm; emission at 450 nm). Urine samples were diluted with 0.03 M potassium phosphate buffer (pH 6.0) and applied to an octadecylsilane-bonded column (Nucleosil 5C18, 150 x 4 mm I.D.). The mobile phase used was a mixture of this same buffer and acetonitrile (1000:140, v/v). Both direct injection of urine and solvent extraction prior to HPLC were tested and showed a good correlation and sensitivity, although the peak of XA-OMe was occasionally less distinguishable from close peaks in urine from normal controls by the direct injection method. The quantification limit was 5 x 10(-14) mol which was sensitive enough to detect XA-OMe in urine from normal subjects. The method was applied to samples from patients with a deficiency in tryptophan catabolism, xanthurenic acid/3-hydroxykynurenine-uria and showed a striking elevation in urinary XA-OMe excretion.

Hypometabolism and dipole localization in hemimegalencephaly: a case report

A case of hemimegalencephaly was studied by means of neuroimaging (CT, MRI and PET) and magnetoencephalography (MEG). Hemimegalencephaly (HM) is a neuronal migration disorder. This is the first report of evaluation of HM with the use of PET and MEG from not only the morphological but also the functional point of view. PET with 11C-glucose showed a low radioactive concentration in the affected hemisphere, which suggested a metabolic deficit. MEG proved the epileptic foci existed mainly in the affected hemisphere, especially around a heterotopia and the pachygyric cortex, which was disclosed on MRI.

[A cooperative study on the incidence of bacteriuria in patients with benign prostatic hypertrophy]

The incidence of bacteriuria in patients with benign prostatic hypertrophy was studied at 8 National Hospitals. Among 1,542 patients, urinary infection was the reason of visit in 63 patients (4.1%). After open and transurethral prostatectomy, one-third of patients developed bacteriuria (30 of 59 subcapsular enucleations, and 252 of 776 transurethral resections). When a catheter is placed without prophylactic antimicrobial, all patients developed bacteriuria within 10 days, and within 30 days even if they received antimicrobials. The incidence of bacteriuria increased with age.

[Coincident renal cell carcinoma and renal angiomyolipoma in tuberous sclerosis: a case report]

The coincidence of renal cell carcinoma and renal angiomyolipoma in tuberous sclerosis is extremely rare, although the coexistence of tuberous sclerosis and renal angiomyolipoma is well recognized. A case of bilateral renal angiomyolipomas and left renal cell carcinoma in a patient with tuberous sclerosis is reported. A 40-year-old male was referred to our hospital for further evaluation and treatment of left flank masses. Tuberous sclerosis was diagnosed on the basis of adenoma sebaceum, seizures, mental retardation and periventricular calcification. Contrast enhanced CT scan demonstrated irregularly enhanced masses in the upper pole and the middle portion of the left kidney, and multiple small low density nodules in the bilateral kidneys. Selective left renal angiography showed hypervascular areas in the upper pole and the middle portion of the left kidney. From the findings obtained, a clinical diagnosis of left renal cell carcinoma associated with bilateral renal angiomyolipomas was made. Left radical nephrectomy was performed. The histopathological examination revealed renal cell carcinoma and multiple renal angiomyolipoma nodules. The diagnostic considerations, particularly differential diagnosis between renal angiomyolipoma and renal cell carcinoma by imaging features, are discussed.

Push-pull model of the primate photopic electroretinogram: a role for hyperpolarizing neurons in shaping the b-wave

Existing models of the primate photopic electroretinogram (ERG) attribute the light-adapted b-wave to activity of depolarizing bipolar cells (DBCs), mediated through a release of potassium that is monitored by Müller cells. However, possible ERG contributions from OFF-bipolar cells (HBCs) and horizontal cells (HzCs) have not been explored. We examined the contribution of these hyperpolarizing second-order retinal cells to the photopic ERG of monkey by applying glutamate analogs to suppress photoreceptor transmission selectively to HBC/HzCs vs. DBCs. ERGs of Macaca monkeys were recorded at the cornea before and after intravitreal injection of drugs. Photopic responses were elicited by bright 200-220 ms flashes on a steady background of 3.3 log scotopic troland to suppress rod ERG components. 2-amino-4-phosphonobutyric acid (APB), which blocks DBC light responses, abolished the photopic b-wave and indicated that DBC activity is requisite for photopic b-wave production. However, applying cis-2,3-piperidine dicarboxylic acid (PDA) and kynurenic acid (KYN), to suppress HBCs/HzCs and third-order neurons, revealed a novel ERG response that was entirely positive and was sustained for the duration of the flash. The normally phasic b-wave was subsumed into this new response. Applying n-methyl-dl-aspartate (NMA) did not replicate the PDA+KYN effect, indicating that third-order retinal cells are not involved. This suggests that HBC/HzC activity is critical for shaping the phasic b-wave. Components attributable to depolarizing vs. hyperpolarizing cells were separated by subtracting waveforms after each drug from responses immediately before. This analysis indicated that DBCs and HBC/HzCs each can produce large but opposing field potentials that nearly cancel and that normally leave only the residual phasic b-wave response in the photopic ERG. Latency of the DBC component was 5-9 ms slower than the HBC/HzC component. However, once activated, the DBC component had a steeper slope. This resembles properties known for the two types of cone synapses in lower species, in which the sign-preserving HBC/HzC synapse has faster kinetics but probably lower gain than the slower sign-inverting G-protein coupled DBC synapse. A human patient with "unilateral cone dystrophy" was found to have a positive and sustained ERG that mimicked the monkey ERG after PDA+KYN, indicating that these novel positive photopic responses can occur naturally even without drug application. These results demonstrate that hyperpolarizing second-order neurons are important for the primate photopic ERG.(ABSTRACT TRUNCATED AT 400 WORDS)

[Effect of combination therapy with sulbactam/cefoperazone and amikacin in the treatment of infectious diseases accompanied by hematological disorders]

We studied the efficacy and safety of a combination therapy with sulbactam/cefoperazone (SBT/CPZ) and amikacin (AMK) on severe infections in the patients with hematological disorders. We administered SBT/CPZ and AMK to 65 patients and analyzed the result of 57 patients, except for 8 drop outs, for evaluation. The overall clinical efficacy of this combination therapy was 64.9% (excellent in 15 patients, good in 22 patients). Thirty seven patients had sepsis and suspected sepsis. The efficacy was 67.6% in these patients. The rate of improvement in the cases (18 patients) with neutrophil counts under 500/mm3 during the administration among 28 patients who had not responded to prior antibiotic treatment was 67.9%. Diarrhea was found in 1 patient as an apparent side effect likely related to this drug regimen. It appears that combination therapy of SBT/CPZ and AMK was a useful regimen in the treatment of infectious diseases complicated with hematological disorders.

Monomelic muscle atrophy

Two patients with slowly progressive muscle atrophy limited to only one leg are reported. They had pes equinovarus deformity and muscle weakness in the affected leg but no symptom in the other limbs. Muscle biopsies from the affected leg showed dystrophic changes consisting of variation in muscle fiber size, endomysial fibrosis, and necrotic and regenerating fibers. Dystrophin was normally expressed at the surface membrane of the muscle fibers. These two patients possibly had a variant of distal muscular dystrophy, though a neural influence could not be completely excluded.

Simultaneous measurement of monoamines, metabolites and amino acids in brain tissue and microdialysis perfusates

A high-performance liquid chromatographic method with coulometric array electrochemical detection is described for the simultaneous analysis of monoamines, their metabolites and o-phthalaldehyde (OPA)-derivatized amino acids. This method has been used to examine metabolite levels in both striatal tissue homogenates and striatal microdialysis perfusates. An aliquot of sample was initially analyzed for monoamines and metabolites by isocratic elution and electrochemical detection on a serial electrode array of eight coulometric flow-through graphite electrodes (0 to 490 mV; 70-mV increment). The remaining sample was derivatized pre-column with OPA-beta-mercaptoethanol and after column switching was analyzed for amino acids on a second isocratic system with electrochemical detection on four electrodes. Metabolites were then identified based on their retention time as well as electrochemical behavior across the arrays. The analysis, derivatization procedure, column switching, data reduction and peak identification were fully automated. The limit of detection for striatal tissue homogenates was approximately 1.38 ng/g wet weight for the monoamines and 8.25 ng/g wet weight for amino acids. The limit of detection for striatal perfusates was approximately 2.5 pg per 20-microliters sample for the monoamines and 15 pg per 20-microliters sample for the amino acids with analysis completed within 25 min making it ideal for microdialysis samples.

Change of paraprotein from IgG lambda to lambda chain in myeloma

We describe a unique case of IgG lambda myeloma in which a plasma cell leukemia developed and the paraprotein changed from IgG lambda to lambda chain, the latter inducing fatal renal failure. In addition, J-chain was detected in the cytoplasm of the plasma cell leukemia cells.

Change in the northward movement of the pollen front of Cryptomeria japonica in Japan, during 1986-1991

A map of pollen fronts of Cryptomeria japonica was compiled from pollen counts taken at 28 airborne sampling sites in Japan in 1986. Thereafter, the number of sites was increased, reaching 80 in 1991. In this way an accurate and complete map of the C. japonica pollen fronts was compiled annually. We used the results obtained from mapping the pollen fronts to draw up a map of the average locations of the front, from which the beginning of the pollen season can be predicted. A close correlation was found between the latitude of the airborne sampling sites and the mean interval between January 1 and the day pollen release began during these 6 years.

Three rhamnose-binding lectins from Osmerus eperlanus mordax (olive rainbow smelt) roe

Three rhamnose-binding lectins were purified from the roe of Osmerus eperlanus mordax (olive rainbow smelt) by affinity chromatography and ion-exchange chromatography. The apparent molecular weights of Osmerus eperlanus mordax lectin (OML) -1, -2 and -3 were 25000, 32000 and 26000, respectively, on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) under reducing conditions. On native PAGE, these three lectins showed different migration patterns (Rm value; 0.37, 0.53 and 0.66, respectively). OMLs agglutinated rabbit and human type B erythrocytes and sarcoma 180 cells, but not human type A and O erythrocytes and AH109A cells. The most effective monosaccharide inhibitor was L-rhamnose. L-Mannose and D-galactose were also good inhibitors. Furthermore, OML-induced hemagglutination was inhibited more strongly by melibiose or raffinose rather than lactose or lactulose. Therefore, OMLs are L-rhamnose/alpha-D-galactosyl type lectins. OMLs did not require a detergent, when extracted from crude material, and Ca2+, Mg2+, EDTA and dithiothreitol were not necessary for the OML-induced hemagglutination activities. The OMLs had similar N-terminal amino acid sequences.

Developmental expression of vasopressin in the human hypothalamus: double-labeling with in situ hybridization and immunocytochemistry

The developmental expression of arginine vasopressin (VP) and VP mRNA in human hypothalamus was studied using combined immunocytochemistry (ICC) for VP-neurophysin II and in situ hybridization (ISH) for VP mRNA. Routine formalin-fixed autopsy material was used from 22 cases ranging in age from 18 wk of gestation to 21 yr. VP-neurophysin II immunoreactive cells were detected in the supraoptic, accessory supraoptic, and paraventricular nuclei of all brains examined. The average size of the immunocytochemically labeled cells increased until birth and remained constant thereafter. VP mRNA was first detected in cells at 21 wk gestation; 3 wk after the first detectable VP by ICC. After 27 wk of gestation, consistent and strong signals were obtained from the specimens that were double-labeled for both immunoreactive VP-neurophysin II and VP mRNA. Three populations of double-labeled cells were identified: type 1, intensely positive for both ISH and ICC (most magnocellular neurons); type 2, positive for ISH and weak or negative for ICC (rare and generally found in younger fetuses), and type 3, positive for ICC and weak or negative for ISH (mostly scattered in accessory nuclei). Thus, double-labeling techniques can be routinely used on frozen or paraffin sections of human autopsy material for the simultaneous assessment of both message and peptide. In the human fetus, the relatively late appearance of adult-like levels of VP mRNA in the magnocellular neuroendocrine cells suggests an association with the development of functional synaptic interactions in this system.

Purification and characterization of Silurus asotus (catfish) roe lectin

A rhamnose-binding lectin isolated from Silurus asotus (catfish) roe by DEAE-cellulose ion exchange and galactose-Sepharose affinity chromatographies predominantly agglutinated human type B and rabbit erythrocytes. S. asotus lectin (SAL) also agglutinated sarcoma 180 ascites carcinoma cells, but not AH109A cells. The most effective saccharide in hemagglutination inhibition assay was L-rhamnose. The monosaccharides possessing steric similarity to the hydroxyl group orientation at C2 and C4 of the pyranose ring structure of L-rhamnose, such as L-mannose and L-lyxose, were also effective. The molecular weight of SAL was determined to be 38000 by size exclusion chromatography on TSK gel G3000SW and 33000 by SDS-polyacrylamide gel electrophoresis under reducing conditions. SAL did not require a Ca2+ ion or free thiol group for its agglutination activity. The N-terminal 29 amino acid sequence was determined by a gas-phase sequencer as follows, ANMITCYGDVQKLHXETGLIIVKSXLYGR (X: not determined). It has no homology to the sequences of well known vertebrate lectins.

[A study of bladder function in benign prostatic hyperplasia]

A study of bladder function was performed on 106 patients with benign prostatic hyperplasia (BPH), 21 of whom had cerebrovascular disease (CVD). The incidence of overactive bladder in 21 patients with CVD was 57% and was significantly higher than the 25% in 86 patients without CVD. The incidence of cases having residual urine of over 100 ml, was in the order of low compliance bladder, overactive bladder and normal bladder. The mean value of maximum voiding pressure in overactive bladder was higher than that in normal bladder. The high pressure was improved after the operation for BPH. Improvement of overactive bladder after the operation was seen in 9 of 13 patients without CVD while in 2 of 6 patients with CVD.

[The relationship between pathological spreading factors and tumor size in 45 patients with renal cell carcinoma]

The relationship between pathological spreading factors (T3,4 V+, N+, M+) and tumor size was studied in 45 patients with renal cell carcinoma during the past 10 years from 1982. The incidence of having one or more factors was 0% for the 17 tumors smaller than 5 cm, but 75% for the 28 tumors over 5 cm. The mean diameter of the tumors having a T, V, N or M factor was significantly larger than that of tumors having no factor (T1,2V0N0M0). These findings suggest that they have a higher tendency of having spreading factors once the tumors have exceeded a certain size.

[Clinical effects of distigmine bromide (Ubretid), a cholinesterase inhibitor, on micturition disturbance by benign prostatic hypertrophy--comparative study of distigmine bromide and the combination of distigmine bromide and adrenergic blocker]

We report the results of a comparative study on the clinical efficacy of the single use of distigmine bromide and its combined use with prazosin hydrochloride in the treatment of benign prostatic hypertrophy. The single use and combined use groups were administered 10 mg/day of distigmine bromide and the same with 1 mg/day of prazosin hydrochloride for a period of 8 weeks respectively. In the single administration group, marked improvement was found in one patient (9%), moderate improvement in 4 patients (36.3%), slight improvement in 3 patients (27.2%) and aggravation in 3 patients. In the combined use group, marked improvement was found in one patient (11.0%), moderate improvement in 5 patients (55.5%), and slight improvement in 3 patients (33.3%). No significant differences were found in the improvement rate between the two groups. However, significant improvements were found in both groups for the subjective symptoms of urinary disturbance, diurnal and nocturnal frequency. As a result of the examination of objective findings, a significant decrease in residual urine ratio was also shown in both groups, while significant improvement for average flow and maximum flow rates were found in only the combined use group. In conclusion, distigmine bromide and distigmine bromide+prazosin hydrochloride are considered very useful for the treatment of miturition disturbance due to benign prostatic hypertrophy.

Schedule-dependent synergistic action of tiazofurin and dipyridamole on hepatoma 3924A cells

Tiazofurin is an oncolytic nucleoside analog that has shown therapeutic activity in end-stage acute non-lymphocytic leukemia and in chronic granulocytic leukemia in blast crisis. Tiazofurin is anabolized to the active metabolite, TAD, which inhibits IMP dehydrogenase activity, leading to a reduction in guanylate pools and to the cessation of neoplastic cell proliferation. The drug exhibits potent cytostatic and cytotoxic activity against hepatoma 3924A cells in culture. In growth-inhibition and clonogenic assays, the 50% inhibitory concentration of tiazofurin was 3.8 and 4.2 microM, respectively. Dipyridamole, an inhibitor of nucleoside transport, curtails the salvage of nucleosides and bases for nucleotide biosynthesis. Dipyridamole exhibited cytotoxicity against hepatoma 3924A cells, with an LC50 of 24 microM and an IC50 of 29 microM being recorded. A combination of tiazofurin and dipyridamole provided synergistic cytotoxicity in hepatoma 3924A cells in culture. This synergistic activity was dependent on the order of addition of the drugs. Simultaneous addition of the two drugs produced antagonism, whereas preincubation of cells with tiazofurin or dipyridamole followed by addition of the second drug resulted in synergy. TAD concentrations were significantly higher (129% and 135%) in cells that had been pretreated with tiazofurin or dipyridamole before the addition of the second agent as compared with cells that had been treated simultaneously (113%). These studies indicate the importance of the order of the addition of drugs to obtain a synergistic response in combination chemotherapy and suggest the need for a careful selection of drug modulation in clinical trials of tiazofurin and dipyridamole.

[Clinical studies of terodiline hydrochloride and clenbuterol hydrochloride for urinary frequency and incontinence]

The clinical effectiveness and safety of terodiline hydrochloride and clenbuterol hydrochloride were studied on 51 patients with neurogenic bladder, stress incontinence, unstable bladder and others, the chief complaints of which were urinary frequency or urinary incontinence. Overall improvement was graded as marked in 6 patients (11.8%), moderate in 20 patients (39.2%), slight in 11 patients (21.6%), unchanged in 13 patients (25.5%) and aggravated in one. The patients impression was "good" or better in 56.9%. There were a total of 13 cases (25.5%) of adverse reactions, namely, 7 cases of finger tremor, 3 cases of dry mouth and others. These reactions disappeared rapidly after the discontinuance of drug administration. The clinical efficacy in the treatment of subjective symptoms was 71.4% for urinary incontinence, 56.4% for diurnal pollakisuria. The examination of lower urethral functions demonstrated a significant (p less than 0.01) increase in bladder capacity at first desire and maximum desire to void. However, we found no significant increase in urethral clossure pressure. The findings of this study suggest that terodiline hydrochloride and clenbuterol hydrochloride are very useful for the treatment of urinary frequency and incontinence.

[Clinical study of voiding disorders in patients with cerebrovascular accidents]

Cystometry and urethral pressure profile were determined in 41 patients (29 males and 12 females) with voiding disorders resulting from cerebrovascular accidents within one year after the episode. By clinical symptoms, they were classified into 3 groups, urge incontinence (14 patients, 34%), pollakisuria (10 patients, 24%) and dysuria (17 patients, 41%). Cystometrogram were classified into 3 types, hyperactive bladder (31 patients, 76%), normal bladder (5 patients, 12%) and hypoactive bladder (5 patients, 12%). All patients in both groups of incontinence and pollakisuria showed hyperactive bladder except one normal bladder, while in the group of dysuria 3 types of cystometrograms were observed. Bladder capacity in incontinence group showed tendency to be smaller than that in dysuria group who had hyperactive bladder. Maximum urethral pressure in incontinence group was significantly lower than that in pollakisuria group and dysuria group who had hyperactive bladder. Ten patients with cerebral cortical lesions (80%) showed hyperactive bladder and 60% of them showed incontinence. In patients with cerebral lesions who had hyperactive bladder, the maximum urethral pressure of patients with incontinence showed tendency to be lower than that of patients with pollakisuria and dysuria. The majority of 7 patients with thalamic lesions showed hyperactive bladder and normal urethral pressure, and had dysuria. Two patients with pontine lesions showed hypoactive bladder. These findings suggested that urge incontinence resulting from cerebrovascular accidents was due not only to hyperactive bladder but also to lower urethral pressure.

Phylogenetic affiliation of ancient and contemporary humans inferred from mitochondrial DNA

Nucleotide sequence analysis of the major non-coding region of human mitochondrial DNA (mtDNA) from three major races was extended with data from 27 contemporary Mongoloids (20 from southeast Asia, seven from America) and 11 Ancient Japanese bones (five from Jomon Age; 3000-6000 years BP, six from the early modern Ainu; 200-300 years BP). In both cases, the sequence was determined directly from the polymerase chain reaction products. Based on a comparison of the 482 base pair sequences from a total of 128 contemporary humans, the nucleotide diversity is estimated to be 1.46%, which is three times higher than the corresponding value estimated from restriction-enzyme analysis of the whole mtDNA genome. The phylogenetic tree revealed that all lineages are classified into at least five clusters designated as C1-C5. C1 consists exclusively of Africans, and most Asians and Europeans formed C2, C3, C5 and C4, respectively. Phylogenetic analysis also indicated that part of the Asians, including the Japanese, subsequently diverged from the majority of Africans, and that Asians can therefore be separated into two distinct groups. Native Americans, however, appeared only in C3 and C5, suggesting that the size of the founder population was not so large during the peopling of American. Nucleotide sequences derived from ancient bones in a highly polymorphic region were also compared with those of contemporary humans. The nucleotide diversity among the 139 sequences in the region was estimated to be 2.26%. A group of ancient Japanese, including both Jomon peoples and the Ainu, showed a close phylogenetic affiliation with one group of contemporary Japanese and southeast Asians.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurological aspects of del(1q) syndrome

We have studied three children with de novo terminal deletion of the long arm of chromosome 1 (46,XX,del(1)(q43)). They all have minor anomalies and neurological signs (severe psychomotor developmental delay, generalized hypotonia, and seizures) that have been described previously. In addition, all of these three patients have autistic-like behavior. They avoid eye contact, show no interest in people, express little emotion, and repeat stereotypic movements such as head nodding and purposeless finger manipulation. They also spend excessive time in making unusual sounds consisting of a high-pitched shrill cry with little intonation in infancy and a harsh, strained, and glottal stridency in later life. They make no labial, lingual, or nasal sounds. We suggest that these observations may be unique clinical manifestations of certain terminal 1q deletions.

[A study on lipid peroxidation in neonates--(2). Perioperative changes in serum lipid peroxide and superoxide dismutase activity]

Pre-, intra-, and post-operative changes in serum lipid peroxide: malondialdehyde (MDA) level and superoxide dismutase (SOD) activity were studied in 10 neonates aged from 15 hours to 26 days. The results are summarized as follows: 1) Preoperative serum MDA levels were significantly lower than those of normal neonates. No significant difference was found between pre- and post-operative values, although much fluctuations were observed in neonates within 7 days of age. All the individual values returned to the normal range during the early postoperative period with different respiratory management. 2) Changes in serum SOD activity were similar to those in MDA values. The activity seemed to be higher and more sensitive to oxygen concentration in younger neonates, which may suggest the specific antioxidant properties of the neonates. 3) Postoperatively, serum MDA levels tended to increase following intravenous administration of lipid emulsion. 4) There was a positive correlation between the values of serum MDA and SOD activity, especially in neonates within 7 days of age.

[A study of lipid peroxidation in neonates--(1) Daily change of serum lipid peroxides in full term neonates]

Lipid peroxide has been highlighted as a possible marker of cell destruction by oxygen derived free radical reactions. We, therefore, examined serum lipid peroxides, malondialdehydes (MDA) in 106 healthy full term neonates (aged 0.5 to 317 hrs, averaged 79.3 +/- 69.9 hrs). Their lipid peroxides in capillary blood were determined by the luminescence method (Yagi method). Based on our data, we conclude as follows: 1) MDA concentrations were influenced by the serum bilirubin concentrations. We, therefore, adjusted our data according to the serum bilirubin concentrations. 2) We found significantly higher values of MDA (4.76 +/- 1.35 nmol.ml-1) than those in adult (3.12 +/- 0.35 nmol.ml-1). In fact, these values increased gradually on the second day, and the high values were maintained until the fifth day. 3) The values of MDA and total bilirubin concentrations in the vaginally delivered neonates were significantly higher than those delivered by Cesarean section (P less than 0.05). 4) There were no correlations between the values of MDA and values of other serum lipid and bilirubin.

Electroretinograms and pattern visually evoked cortical potentials in central areolar choroidal dystrophy

We describe three patients with central areolar choroidal dystrophy whose electroretinograms (ERGs) and pattern visually evoked cortical potentials (VECPs) confirmed their macular dysfunction. Visual fields measured by Goldmann perimetry showed central relative scotomata corresponding to a dystrophic lesion. Dark adaptation curves were slightly abnormal either in the first curve or in the second curve, depending on the visual acuity. Color vision was disturbed irregularly. Fluorescein angiography revealed a loss of the choriocapillaries, and a hyperfluorescent border outlined the dystrophic lesion. Single-flash dark-adapted ERGs and scotopic ERGs were almost normal, while photopic and flicker ERGs showed slightly attenuated amplitudes. Conversely, VECPs to pattern reversal stimulation were greatly affected for both transient and steady-state stimuli. We conclude that, in central areolar choroidal dystrophy, pattern VECPs can provide more information on macular dysfunction than does the ERG.

Identification of 17-hydroxyprogesterone and other steroid hormones in saliva from a normal child and patients with congenital adrenal hyperplasia by plasmaspray liquid chromatography/mass spectrometry

A very sensitive, selective and simultaneous method for the analysis of salivary steroid hormones was examined by discharge-assisted thermospray liquid chromatography mass spectrometry (plasmaspray LC/MS). Plasmaspray LC/MS gave [M + H]+ or [MH - H2O]+ as a predominant ion in most of the steroids in this work and in some cases fragment ions were also observed. Eight salivary steroid hormones, pregnenolone, 17-hydroxypregnenolone, progesterone, 17-hydroxyprogesterone, 11-deoxycortisol, cortisol, aldosterone, and testosterone were identified within 10 minutes using the selected ion monitoring technique in conjunction with plasmaspray LC/MS. Progesterone, 17-hydroxyprogesterone, cortisol, aldosterone and testosterone were detected in 1 mL of saliva from a normal child and two patients with congenital adrenal hyperplasia.

[Primary malignant lymphoma of the urinary bladder: report of a case]

A case of primary malignant lymphoma of the bladder is presented. A 42-year-old woman was admitted to our clinic with the chief complaint of asymptomatic hematuria. Examination of cystoscopy, IVP, ultrasonography and CT scan suggested a non-epithelial tumor of the bladder, which was reported as malignant lymphoma, non-Hodgkin, by findings of transurethral biopsy. Subsequent systemic CT scan, Ga-scintigraphy and bone marrow puncture revealed no abnormalities. Therefore, this case was thought to be primary malignant lymphoma of the bladder. Partial cystectomy with pelvic lymph node resection was carried out. The tumor, 2 x 1 cm in diameter, invaded into the middle portion of muscularis. Histological diagnosis of the tumor was follicular lymphoma, medium-sized cell type according to LSG classification, and immunohistological findings also showed B-cell lymphoma. Resected lymph nodes had no signs of neoplasms. Postoperative adjuvant chemotherapy consisting of vincristine, cyclophosphamide and prednisolone was performed. She has been doing well without any clinical evidence of recurrence for 16 months after the operation.

Capillary gas chromatography/negative ion chemical ionization mass spectrometry for the quantification of bile acids including 1 beta-hydroxylated and unsaturated bile acids in serum and urine

12 bile acids, including 1 beta-hydroxylated and unsaturated bile acids, have been quantified by capillary gas chromatography/negative ion chemical ionization mass spectrometry, using the trimethylsilyl(TMS) ether derivatives of bile acid pentafluorobenzyl(PFB) esters. The analysis time is 12 min and the minimum measurable amount is 100 fg for each bile acid. Bile acids in 200 microL of serum and 50 microL of urine from healthy human adults were measured. These small sample sizes enhance the practicality of using this method as a screening test for bile acids in the serum and urine of human infants, where small sample size is a major problem.

[Dural arteriovenous malformation in the posterior fossa presenting with multiple intracerebral hematomas. Case report]

A 59-year-old female was hospitalized because of disturbance of consciousness and convulsive seizures. She had taken a hormonal drug for 15 months after breast cancer surgery. A computed tomography scan revealed multiple high-density areas in the left temporal and frontal and the right parietal lobes. Angiography showed a dural arteriovenous malformation (AVM) in the posterior fossa fed by the occipital and the middle meningeal arteries and draining into the transverse sinus. It also demonstrated occlusion of the left sigmoid sinus in the venous phase. She complained of headache in the occipital region and dizziness. On day 13, the left occipital artery was ligated and cut, and then abnormal arterial anastomoses around the lesion were coagulated. After surgery, clinical symptoms disappeared. The etiology of dural AVM is controversial, but in this case it is suspected that sinus thrombosis due to the drug caused the dural AVM. The authors discuss the etiology and treatment of dural AVM in the posterior fossa.

[The therapeutic effect of enoxacin on chronic prostatitis]

The clinical efficacy of enoxacin (ENX) was evaluated in 39 patients having chronic prostatitis. The overall clinical efficacy of ENX was determined by three factors, (1) the effect on bacteria, (2) white blood cells in the VB3 and (3) the subjective symptoms. The overall clinical effectiveness rate was 80%. ENX eliminated 66.7% of the bacteria in the VB3. As determined from white blood cells in the VB3, 56.4% of patients were relieved of the inflammation of prostate by ENX. The subjective symptoms were improved by ENX treatment in 77% of the patients.

[A case of non-functioning adrenal cortical carcinoma with pulmonary and bony metastases]

A 49-year-old woman was admitted to our hospital with complaints of edema and abnormal shadow in right pulmonary area. CT scan and abdominal aortography showed left adrenal mass. Moreover, the lung metastasis measured 60 x 65 mm and bony metastases were suspected in three areas on bone scanning. Under diagnosis of left non-functioning adrenal tumor with pulmonary and bony metastases, left adrenalectomy was performed. Histological diagnosis was left adrenal cortical carcinoma without lymph node metastasis. Treatment consisted of 3 g o,p-DDD and 400 mg carmofur per day after surgery. At present, pulmonary metastasis has decreased in size and bony metastases decreased in uptake on bone scan 12 months postoperatively.

[Clinical evaluation of micturitional dysfunction after the operation for rectal cancer and effects of mecobalamin on that dysfunction]

Examination including residual urine measurement, cystometry and urethral pressure profile was performed before and 8 weeks, 3 months and 6 months after the operation in 17 patients with rectal cancer who were divided into mecobalamin administered group (8 patients) and non-administered group (9 patients) at random. Administration of mecobalamin (500 gamma i.m., 3 times a week for 4 weeks) was started within 3 weeks after the operation. In the 17 patients, the rate of patients with residual urine over 51 ml was 65% at 8 weeks, 24% at 3 months and 24% at 6 months. The mean value of bladder pressure at maximum capacity after the operation in the 17 patients showed a significant increase compared to that before the operation, while the mean value of maximum urethral pressure after the operation showed a significant decrease compared to that before the operation. The bladder pressure in patients with residual urine less than 50 ml was significantly lower than that in patients with residual urine over than 5 ml. The bladder pressure in patients with residual urine reduced to less than 50 ml at 3 months showed a tendency to decline. The rate of patients with residual urine of less than 50 ml at 8 weeks was 50% in the mecobalamin administered group and 22% in the non-administered group. There was no significant difference in bladder pressure between the two groups, or before and after the administration of mecobalamin.

Bilateral macular colobomas in Leber's congenital amaurosis

Two siblings with Leber's congenital amaurosis had bilateral macular colobomas, nystagmus, extinguished ERGs, and degenerative salt and pepper like changes in the fundus. They had non-recordable or non-meaningful visually evoked cortical potentials in response to both flash and pattern stimuli. The ophthalmic conditions were thought to be inherited as an autosomal recessive trait.

[Clinical treatment of vulvar cancer]

Four cases of vulvar cancer during the four years from 1979 to 1983 were examined at Saitama Medical School. Radical vulvectomy was performed for three cases and radiation therapy was undertaken for another one in stage IV. 1) Lymph node metastasis was histologically recognized in one of the three cases after radical vulvectomy. The depth of stromal invasion in the case with lymph node metastasis was 8 mm and the others were 1 mm and 6 mm. 2) IAP, SCC, CEA, CA125 and ferritin were examined in the four cases. SCC, CEA, CA125 and ferritin values were within normal range in all cases, but IAP values elevated over the normal range in two. 3) Ultrastructurally, we observed vulvar cancer calls before and after administration of UFT or CDDP. The results suggested that UFT and CDDP are effective against vulvar cancer.

Pattern visual evoked cortical potential measurement of luminance threshold in retinitis pigmentosa

We measured the luminance threshold in eight patient (12 eyes) with retinitis pigmentosa using pattern reversal visual evoked cortical potentials (PVECPs). With decreasing pattern luminance (0 to 3.0 log unit neutral density filters), the amplitude of the p 100 component decreased linearly. Luminance threshold was determined by extrapolating the regression line of amplitude as a function of luminance to 0 microV. Our results showed that luminance threshold measured by PVECP was approximately 1.2 log units higher in patients with retinitis pigmentosa than in age-matched normal controls. Thus the PVECP may provide a way of quantitatively evaluating central retinal visual function in patients with retinitis pigmentosa.

[A case of urethrorectal fistula]

A 59-year-old man was hospitalized with complaints of diarrhea and pollakisuria. Retrograde urethrography, urethroscopy and urethral pressure profile revealed a fistula between the urethra and the rectum situated immediately above the external urethral sphincter. Surgical repair was performed by an abdominal approach. Following the total prostatectomy, the fistula was completely resected under direct vision. A closure of the anterior rectal wall and an anastomosis between the urethra and the bladder neck was performed. Operative results were satisfactory. Operative methods for the urethrorectal fistula are discussed.

[Transurethral resection of bladder neck in female patients with neurogenic bladder]

Transurethral resection of the bladder neck was performed in 6 female patients with neurogenic bladders who presented with a large volume of residual urine and bladder neck obstruction on voiding cystourethrography without detrusor hyperreflexia on cystometry. In 4 of the patients, transurethral sphincterotomy was performed concomitantly. Five of the patients demonstrated significant improvement in bladder emptying and 4 did not need self-catheterization. No complications of the operation were observed.

Na/K pump activity in the new membrane formed at first cleavage in Cynops pyrrhogaster eggs

Resting membrane potentials (Em) increased in the negative direction during first cleavage in Cynops pyrrhogaster eggs whose new membranes formed at first cleavage were exposed to bathing solutions by removing the vitelline envelopes. Em was -11.4 and -87.2 mV at the one- and two-cell stages, respectively. Na/K pump activity contributed to Em at the two-cell stage by about -30 mV. The distribution of Na/K ATPase activity was cytochemically studied by Ernst's method (S. A. Ernst, 1972, J. Histochem. Cytochem. 20, 23-38). The new membrane of the eggs at the two-cell stage showed the pump activity. But the activity was detected neither in the preexisting outer membrane of the eggs at the two-cell stage nor in the membrane at the one-cell stage.

Temporal frequency characteristics of retinitis pigmentosa obtained by pattern visual evoked cortical potential to checkerboard stimuli

We examined temporal frequency curves by pattern visual evoked potential in 28 eyes suffering from retinitis pigmentosa (RP). The peak latency of the P100 component was 110.3 +/- 3.0 msec (S.E.), which was not significantly different from the 110.2 +/- 0.8 msec (S.E.) obtained from 60 normal controls. The P100 amplitudes of whole reversal frequencies, however, were decreased in patients with RP (p less than 0.05), especially at lower frequencies. We thought this phenomenon was useful for determining central visual function in patients with RP.

De novo guanylate synthesis in the commitment to replication in hepatoma 3924A cells

This work tested the relationship of guanylate and adenylate biosynthesis during the display of the proliferative program of rat hepatoma 3924A cells. Since serine, the major source of one-carbon units, competed with the substrate [14C]formate for purine labeling, serine-free medium was used in the assays. The initial rates of purine de novo synthesis with [14C]formate or L-[3-14C]serine followed Michaelis-Menten kinetics yielding similar Vmax values with apparent Kms of 0.5 and 0.038 mM, respectively. During the transition of cancer cells from plateau phase into logarithmic proliferation the specific activity of 5-phosphoribosyl 1-pyrophosphate synthase (EC 2.7.6.1, ribose phosphate pyrophosphokinase) increased 2.2-fold, followed by a 14-fold elevation of the concentration of 5-phosphoribosyl 1-pyrophosphate with a subsequent 8-fold rise in de novo purine synthesis. The ratio of guanylate to adenylate synthesis from IMP in plateau phase cells was 0.24 to 1. After replating the resting cells there was a sharp increase in the relative labeling of guanylates with a concurrent marked decrease in that of the adenylates, reaching an 8-fold rise in the ratio of guanylate to adenylate synthesis from IMP at the maximum deviation in the late lag phase at 20 to 24 h after seeding. This striking redirection in the distribution of label from IMP utilization to the preferential synthesis of guanylates during the expression of the biochemical proliferative program of cancer cells supports the potential significance of this pathway as a target of chemotherapy.

Rapid quantification of 11 prostanoids by combined capillary column gas chromatography and negative ion chemical ionization mass spectrometry: application to prostanoids released from normal human embryonic lung fibroblasts WI38 in a culture medium

The rapid and simultaneous quantification of 11 prostanoids has been carried out with a short-capillary gas chromatograph and negative ion chemical ionization (ammonia) mass spectrometer. The methoxime-trimethylsilyl ether-pentafluorobenzyl esters (MO-TMS-PFB) of nine prostanoids, PGA1, PGA2, PGB1, PGB2, PGD2, PGE1, PGE2, 6-oxo-PGF1 alpha and TXB2 and the TMS-PFB of two prostanoids, PGF1 alpha and PGF2 alpha, were separated in less than 5.5 min on a bonded OV-1 capillary column 0.25 mm i.d. x 6 m (0.15 micron thickness) using hydrogen as a carrier gas. PGD2, PGE2, PGF2 alpha, 6-oxo-PGF1 alpha and TXB2 were quantified up to 2.5 fmol injected (0.1 pmol derivatized) and both PGA2 and PGB2 up to 25 fmol injected (1 pmol derivatized). In order to maintain the stability of the prostanoids containing a carbonyl group, such as TXB2 during the purification and derivatization steps of biological materials, methyl acetate was used in place of methyl formate as an eluant for Sep-Pak C18 purification. Normal human embryonic lung fibroblasts W138 (5.63 x 10(5) cells in a log phase) produced: PGA2 15.28, PGB2 13.48, PGD2 7.95, PGE1 2.62, PGE2 177.76, PGF2 alpha 25.14, 6-oxo-PGF1 alpha 27.33 and TXB2 61.00 pmol in 10 ml of Eagle minimal essential medium.

[A case of neurogenic bladder complicated by an acute rash syndrome (measles?)]

A 24-year-old female patient was was admitted because of urinary retention, four days after the development of rash with fever to be diagnosed as measles by a doctor. Neurological examinations showed hyperesthesia in lower thoracic regions and increased deep tendon reflexes in lower extremities. Cystometric findings revealed an areflexic bladder with normal sensation. Cerebrospinal fluid examination showed mononuclear pleocytosis and slightly elevated levels of protein. There was no significant increase in serum measles antibody titer. She regained normal voiding by conservative treatment with an indwelling catheter for four days. The bladder motor paralysis was probably due to non-transverse myelitis in sacral spinal region. Neurological complications of measles are briefly discussed.