Clinical characteristics and natural history of antenatally diagnosed fetal uropathy. An analysis of 55 cases

The clinical characteristics and natural history of 55 cases with antenatally diagnosed fetal uropathy were investigated. Percutaneous aspiration of the fetal pelvic or vesical urine was performed to decompress progressive unilateral hydronephrosis in 2 cases and to evaluate renal function in another 2 cases of bilateral hydronephrosis. As the postnatal diagnosis, upper urinary tract dilatation (hydronephrosis or hydronephroureter, 33 cases) and renal dysplasia (15 cases) made up 87% of all cases. A combination of hydronephrosis in one kidney and renal dysplasia in the other was also found in another 2 cases. Among 35 cases with upper urinary tract dilatation, 27 cases demonstrated pelviureteric junction stenosis and surgical intervention was necessary in 15 cases. In 17 cases with renal dysplasia, spontaneous regression was observed in only 3 cases and surgical intervention by means of percutaneous nephrostomy and nephrectomy was performed in 4 and 6 cases, respectively.

Extraabdominal fixation of the gubernaculum inhibits testicular descent in newborn rats

Within 48 hours after birth, newborn rats were anesthetized, and the distal tip of the gubernaculum was exposed extraabdominally, then fixed to the fascia of the groin on the left or the right side under a dissecting microscope (6x). In the sham-operated rats, the distal tip of the gubernaculum was merely exposed. Nonoperated rats were used as controls. In 60- to 90-day-old operated rats (n = 42), all testes were located in the superficial inguinal position, and the incidence of cryptorchidism was 100% on the operated side. In the sham-operated rats (n = 28), 27 of 28 testes descended into the scrotum, and one was located in the perineum; the incidence of cryptorchidism was 3.6% on the operated side. All testes also descended into the scrotum, and the incidence of cryptorchidism was 0% in controls (n = 20). The incidence of cryptorchidism was significantly higher among operated rats than among sham-operated or control rats (P < .001). The testicular weight and the germinal epithelia of the cryptorchid testes were significantly lower than those of the scrotal testes in both sham-operated and control rats. Therefore it is suggested that the extraabdominal fixation of the distal tip of the gubernaculum in newborn rats induces cryptorchidism. The present model is considered to be a simple and useful one to investigate the process of testicular maldescent and inhibited growth of the testis in cryptorchidism.

Dual pathways of tubular morphogenesis of vascular endothelial cells by human glioma cells: vascular endothelial growth factor/basic fibroblast growth factor and interleukin-8

In this study, we examined whether human glioma cells are angiogenic in a model using human microvascular endothelial cells, and also which factor is responsible for the glioma-dependent angiogenesis. Tubular morphogenesis in type I collagen gel by human microvascular endothelial cells was stimulated in the presence of 10 and 100 ng/ml of vascular endothelial growth factor (VEGF), 10 ng/ml basic fibroblast growth factor (bFGF) and 10 ng/ml of interleukin-8 (IL-8). Tube formation of the microvascular endothelial cells was assayed in the glioma cell lines IN157 and IN301, co-cultured using the double chamber method. IN301 cells had much higher levels of VEGF, bFGF and transforming growth factor-beta mRNA than IN157 cells, whereas the two had similar levels of transforming growth factor-alpha mRNA. By contrast, IN157 cells had much higher levels of IL-8 mRNA than IN301 cells. IN301-dependent tubular morphogenesis was inhibited by anti-VEGF or anti-bFGF antibody, and the inhibition was almost complete when anti-VEGF and anti-bFGF antibodies were present. On the other hand, IN157-dependent tubular morphogenesis was inhibited by anti-IL-8 antibody, but not by anti-VEGF or anti-bFGF antibodies. These findings demonstrated dual paracrine controls of tumor angiogenesis by human glioma cells. One is mediated through VEGF and/or bFGF, and the other, through IL-8.

Chemotherapy for progressive pilocytic astrocytomas in the chiasmo-hypothalamic regions

Over the past 25 years, we have treated 17 patients with chiasmo-hypothalamic astrocytomas. Before 1988, the initial treatments consisted of surgery and/or radiotherapy, while since 1989, 4 children (1 male, 3 females, aged 3-8 years) were treated primarily with chemotherapy. None of them was associated with neurofibromatosis. After a biopsy of the tumor, the intravenous administration of ranimustine (MCNU; 30-86 mg/m2) and/or nimustine (ACNU; 30.3-64.1 mg/m2) was given without radiation therapy. Chemotherapy was usually given as an out-patient, with a total of 5-13 courses. The total doses of MCNU and ACNU administered ranged from 150 to 570 mg and from 64.8 mg to 100 mg, respectively. After chemotherapy 2 patients showed clinical improvement and tumor regression on neuro-imaging, while one patient showed clinical improvement and tumor size stabilization on neuro-imaging. The remaining one child, however, showed a clinical worsening and tumor progression on neuro-imaging studies. He was thus treated with a second chemotherapy regimen with carboplatin and etoposide, which brought about tumor regression. The acute and subacute toxicity of chemotherapy was mild. All patients are now leading almost normal lives with a median of 43 months after diagnosis. Although a longer and more careful clinical observation is required, the authors conclude that chemotherapy with MCNU and/or ACNU may benefit patients with unresectable pilocytic astrocytoma requiring treatment. The advantages of this therapy include its mild side effects and the lack of any hospitalization in most patients. It may also delay the need for radiation therapy, which can have a deleterious effect on the young developing brain.

Acquired Chiari I malformation and syringomyelia associated with bilateral chronic subdural hematoma. Case report

The authors report a case of bilateral chronic subdural hematoma in a 25-year-old woman who had occipital and neck pain. Magnetic resonance imaging revealed progressive caudal descent of the cerebellar tonsils (acquired Chiari I malformation) and a large eccentric syrinx in the spinal cord from the C3-T7 levels. Spontaneous disappearance of the chronic subdural hematomas resulted in radiographic resolution of both lesions, as well as clinical improvement. Theories of syringomyelia formation, the relationship to acquired Chiari I malformation, and the implications of this case are discussed.

Intracellular signal transduction of PBAN action in lepidopteran insects: inhibition of sex pheromone production by compactin, an HMG CoA reductase inhibitor

Pheromone biosynthesis activating neuropeptide (PBAN) regulates sex pheromone production in the pheromone glands of many species of female moths. In order to probe the biochemical steps as well as underlying mechanisms regulated by PBAN, we have tested the effect of chemicals on sex pheromone production by using an in vitro assay. Among the chemicals we tested here, compactin, a specific 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitor, clearly inhibited the pheromone biosynthesis in the silkworm, Bombyx mori, and the common cutworm, Spodoptera litura. Since the activation of HMG CoA reductase occurs by dephosphorylation mediated by a specific phosphatase and the biochemical step regulated by PBAN in bombykol biosynthesis is similar to the one catalyzed by HMG-CoA reductase in cholesterol biosynthesis, the present results support the idea that phosphoprotein phosphatase has a significant role to regulate bombykol production in the intracellular transduction of PBAN action in B. mori.

The effect of the excision of future scrotal skin on testicular descent in neonatal rats: a new experimental model of cryptorchidism

The ingunoscrotal skin of neonatal rats was widely excised on either the right or left side to examine the role of the scrotum in testicular descent. At the age of 10 days, gubernacular migration was observed to be significantly inhibited on the operated side in comparison with that on the nonoperated side. At the age of 60 to 90 days, 12 of 17 testes on the operated side were located in the superficial inguinal position, 2 were in the perineum, and another 3 had descended into the contralateral nonoperated scrotum. All the testes descended into the scrotum on the nonoperated side and in the normal control rats. Though the histological development was remarkably inhibited in the cryptorchid testis, the contralateral descended testis did show the same histological appearance as that of the control testes in 90-day-old rats. This new model of cryptorchidism is considered to provide a simple technique for investigating the mechanism of testicular descent and the impaired development of the testes in cryptorchidism.

Monkey pulpal response to adhesively luted indirect resin composite inlays

Monkey pulpal responses to resin-bonded indirect resin composite inlays were histopathologically evaluated by placing them in either etched-enamel, total-etched, or adhesive-resin-lined cavities. Initial pulpal responses caused by re-exposure of the cut dentin surfaces and luting procedure subsided if a tight marginal seal was secured by final cementation of the inlay. The adhesive resin coating of freshly cut dentinal walls/floors seems to provide a new technique to protect the dentin and pulp in indirect restorations requiring temporary sealing.

Physiological effects in vitro of calcitonin gene-related peptide on gubernacular contractility with or without denervation

The gubernaculum in neonatal rats has been shown previously by direct observation to contract rhythmically in response to exogenous calcitonin gene-related peptide (CGRP), but the physiological properties of these contractions were unknown. In the first study the authors investigated gubernacular contractility in vitro using a strain gauge to see if there were characteristics of skeletal or smooth muscle. Both the frequency and the amplitude of contractions were significantly enhanced by CGRP, and isotonic tension of the gubernaculum and the duration of contractions were also increased after CGRP. The effect of CGRP on gubernacular contractions appeared several minutes after adding CGRP, and it was independent of the acetylcholine action, which induced only a single twitch response of the gubernaculum. In the second study the authors investigated the effect on gubernacular contractility of prior transection of the genitofemoral nerve (GFN), which contains CGRP. Vigorous contractions occurred in 85% of denervated gubernacular compared with 46% of controls (P < .01). These data provide the first quantitative evidence of rhythmic gubernacular contractions, and suggest that CGRP enhances gubernacular contractility by a direct effect independent of acetylcholine. Further, the contractile properties resemble those of differentiated cardiac muscle or primitive embryonic skeletal muscle. GFN transection enhances the gubernacular contractile response to exogenous CGRP, which is consistent with the GFN being the normal source of CGRP for the gubernaculum in vivo.

Intracellular transduction in the regulation of pheromone biosynthesis of the silkworm, Bombyx mori: suggested involvement of calmodulin and phosphoprotein phosphatase

We have tested the effects of chemicals on bombykol production in vitro in the silkworm, Bombyx mori, to probe the biochemical steps as well as underlying mechanisms regulated by PBAN. These results suggest the involvement of calmodulin and phosphoprotein phosphatase in the intracellular signal transduction of PBAN action.

Expression of vascular endothelial growth factor and its possible relation with neovascularization in human brain tumors

To examine which growth factors correlate with neovascularization in human brain tumors, the mRNA levels of transforming growth factor alpha, transforming growth factor beta, basic fibroblast growth factor, and vascular endothelial growth factor (VEGF) genes were determined by a Northern blot analysis in surgically obtained human gliomas and meningiomas. The vascular development was determined by counting the number of microvessels which were immunostained with von Willebrand factor. We normalized the growth factor mRNA levels versus the glyceraldehyde phosphate dehydrogenase mRNA level. In the 17 gliomas and 16 meningiomas examined, the mRNA of transforming growth factors alpha and beta, basic fibroblast growth factor, and VEGF were expressed at various levels. Among those 4 growth factors, the mRNA levels of VEGF, but not those of transforming growth factors alpha and beta and basic fibroblast growth factor, correlated significantly with vascularity in both gliomas (correlation coefficient r = 0.499; P < 0.05) and meningiomas (correlation coefficient r = 0.779; P < 0.001). These findings thus suggest that VEGF may be a positive factor in tumor angiogenesis in both human gliomas and meningiomas.

The progressive degeneration of interlobular bile ducts in biliary atresia: an ultrastructural study

The ultrastructure of the interlobular bile ducts were observed in hepatic specimens obtained at surgery in ten patients with biliary atresia, in order to investigate the progress of their degeneration over time after the onset of the disease. As an index for the passage of time, the degree of fibrosis in the portal tracts was investigated. Then the ultrastructural features in the interlobular bile ducts were contrasted with the grading of portal fibrosis Generally, the ultrastructural changes of the interlobular bile ducts were more marked in the cases with severe portal fibrosis than that observed in the cases with mild fibrosis. This correlation suggests that the degeneration of the interlobular bile ducts progressively worsens over time after the obliteration of the extrahepatic bile duct.

Capsaicin increases the frequency of cryptorchidism in flutamide-treated rats

Capsaicin, a specific neurotoxin that irreversibly results in degeneration of sensory C fibers of the peripheral nerves, was investigated for its ability to affect testicular descent. In particular, we investigated the ability of prenatal flutamide, postnatal capsaicin or combined prenatal flutamide with postnatal capsaicin to induce undescended testes in rats. Within these treatment groups the frequency of maldescent was 42% in the animals treated prenatally with flutamide, 32% with postnatal capsaicin, and 100% with prenatal flutamide and postnatal capsaicin. Of interest, it was found that all animals that received capsaicin had maldevelopment of the scrotum. Our data suggest that capsaicin increased the frequency of cryptorchidism in rats prenatally treated with flutamide, perhaps by inhibition of scrotal development. These findings indicate that sensory nerves to the scrotum may affect scrotal development and testicular descent.

Transabdominal testicular descent is really ovarian ascent

Some investigators have suggested that testicular descent relative to the ovary is actually caused by the relative upward growth of the structures adjacent to the testis and that in the early phase of descent the testis is anchored to the inguinal region as the embryo enlarges. This concept was founded on results from the dissection of human fetuses. In this study the development of the urogenital system in fetal mice is examined using scanning electron microscopy to determine the distance between the bladder neck and the lower pole of the gonad. The results of this study confirm that transabdominal descent of the testis relative to the ovary is in one sense really ascent of the ovary in the fetal mouse, while the testis is anchored to the inguinal region by the developed gubernaculum. The testis shows real movement at the beginning of the inguinoscrotal phase of testicular descent at birth.

Relationship between surface area for adhesion and tensile bond strength--evaluation of a micro-tensile bond test

OBJECTIVES

The purpose of this study was to test the null hypothesis that there is no relationship between the bonded surface area of dentin and the tensile strength of adhesive materials.

METHODS

The enamel was removed from the occlusal surface of extracted human third molars, and the entire flat surface was covered with resin composite bonded to the dentin to form a flat resin composite crown. Twenty-four hours later, the bonded specimens were sectioned parallel to the long axis of the tooth into 10-20 thin sections whose upper part was composed of resin composite with the lower half being dentin. These small sections were trimmed using a high speed diamond bur into an hourglass shape with the narrowest portion at the bonded interface. Surface area was varied by altering the specimen thickness and width. Tensile bond strength was measured using custom-made grips in a universal testing machine.

RESULTS

Tensile bond strength was inversely related to bonded surface area. At surface areas below 0.4 mm2, the tensile bond strengths were about 55 MPa for Clearfil Liner Bond 2 (Kuraray Co., Ltd.), 38 MPa for Scotchbond MP (3M Dental Products), and 20 MPa for Vitremer (3M Dental Products). At these small surface areas all of the bond failures were adhesive in nature.

SIGNIFICANCE

This new method permits measurement of high bond strengths without cohesive failure of dentin. It also permits multiple measurements to be made within a single tooth.

The effect of flutamide on testicular descent in rats examined by scanning electron microscopy

The effect of prenatal flutamide exposure on testicular descent was investigated by using scanning electron microscopy (SEM) in prenatal and postnatal rats. In 20-day-old fetal rats, SEM showed no significant difference in the degree of gubernacular development or testicular descent relative to the kidney between flutamide-treated (74.5 +/- 2.2 U) and control rats (73.3 +/- 1.5 U); however, there was significant inhibition in oestrogen-treated rats (44.3 +/- 2.2 U) (P < .001). (The distance between the kidney and the bladder neck was standardized to 100 U.) In 5-day-old rats, SEM showed inhibited downward growth of the processus vaginalis in flutamide-treated rats. The length of processus vaginalis below the inguinal ligament was 32.8 +/- 2.4 U in flutamide-treated rats and 51.7 +/- 1.8 U in controls (P < .001). In 30- to 35-day-old mature rats, the frequency of cryptorchidism was 41.3% for flutamide-treated rats and 0% for controls (P < .001). Some cryptorchid testes were located in the lower abdominal cavity (10.9%); others were in the suprainguinal position (26.1%) or on the line of descent in the inguinal region (4.3%). In the flutamide-treated group, no testes were located in the posterior abdominal cavity, near the kidney. These results suggest that transabdominal descent of the testis is independent of androgen action, but that androgens control inguinoscrotal descent of the testis by regulating gubernacular migration and the growth of the processus vaginalis.

Microporous dentin zone beneath resin-impregnated layer

The purpose of this study was to investigate marginal microleakage by examining the resin/dentin interface using a cryo-SEM and a silver ion penetration method. Class 5 cervical cavities were restored using an adhesive resin system following treatment with 37% phosphoric acid gel. The cavity wall adaptation was observed using cryo-SEM to avoid specimen damage. This observation showed excellent marginal adaptation of material to cavity walls and no gap formation. However, silver ions had penetrated beneath the resin-impregnated layer when observed with conventional SEM images, which showed the leakage of silver ions between the resin and decalcified tooth structure without gap formation. This study suggests that the bonding monomers of Clearfil Photo Bond were not fully able to penetrate into the demineralized dentin after phosphoric acid etching, thus leaving a porous zone as a microleakage pathway beneath the resin-impregnated layer.

Effect of aging on dentin bonding

The purpose of this paper was to evaluate the effect of aging of dentin on the tensile bond strengths of four dentin bonding systems using proximal dentin of premolars extracted from young (aged from 9-21 years) and old (aged from 42-64 years) patients. Clearfil Linerbond System and Super Bond D-Liner showed higher bond strengths to both young and old teeth than those of Clearfil Photo Bond and Resto Bond 3. However, similar bond strengths to both young and old teeth for all four products were obtained despite the effects of aging. Furthermore, a SEM study of the site of bond failure revealed the persistence of the resin impregnated layer on the dentin surface, in spite of the difference of bonding system and dentin, indicating that adhesive failure tended to occur at the interface between the bonding resin and the resin impregnated layer.

Motility function of the esophagus before primary anastomosis in esophageal atresia

Two patients with a long gap esophageal atresia without tracheoesophageal fistula underwent an esophageal manometric study before primary anastomosis and one of them underwent an identical study after operation. Before operation both patients showed peristaltic contraction in the proximal esophagus when swallowing which was always followed by a coordinated contraction of the distal esophagus the same as in that of the normal esophagus. These peristaltic contractions induced a reflex relaxation of the lower esophageal sphincter (LES). After operation the manometric studies of the repaired esophagus demonstrated an abnormal esophageal motility, with simultaneous contractions occurring when swallowing in the proximal to the distal esophagus. In addition, the reflex relaxation of LES was incomplete. These data suggest that even if the intraluminal continuity is defective, the esophageal motility function is not disturbed in the proximal to distal esophagus in preoperative esophageal atresia, and that intraoperative mobilization and denervation may be suggested to be an important factor in esophageal dysmotility even when esophageal atresia is successfully repaired.

[Cardiorespiratory responses during flume swimming and treadmill running in swimmers]

The present study was designed to compare cardiorespiratory responses of swimmers to swimming and running. Six male trained college swimmers performed maximal work test (progressive method) in flume swimming and treadmill running. VEmax during swimming (128.3 +/- 20.6 l/min) was about 4% lower than during running (133.2 +/- 9.9 l/min). VO2max during swimming (3628 +/- 228 ml/min) was significantly higher than during running (3408 +/- 222 ml/min). HRmax during swimming (191 +/- 8 beats/min) was significantly lower than during running (198 +/- 6 beats/min). VO2 at ventilatory threshold (VT) during swimming (2177 +/- 183 ml/min) was significantly higher than during running (1699 +/- 214 ml/min). %VO2max at VT during swimming (60.1 +/- 4.2%) was significantly about 10% higher than during running (49.8 +/- 4.4%). These results suggest that subjects of this study have specific cardiorespiratory adaptation to swimming from a long period of swim training.

Postoperative MRI evaluation of anorectal malformations with clinical correlation

Sixteen postoperative patients with anorectal malformation were evaluated by MRI, and the results compared with the clinical assessment. Patients were classified into three groups--good (group 1, n = 10), fair (group 2, n = 3) and poor (group 3, n = 3)--on the basis of Kelly's clinical score of incontinence. The degree of development of the puborectalis and external sphincter muscles and the levator hammock was evaluated on MRI in comparison with patients without anorectal disease. The proportions of fair or poor development of the muscles were 37% in group 1,22% in group 2 and 67% in group 3. Although fair or poor development of the muscles was seen more frequently in group 3, there was no statistically significant difference between groups. However, poorly developed muscles were seen only in patients with fair or poor clinical scores. The difference in the anorectal angle measured on sagittal MRI images between patients in group 1 and groups 2 or 3 was significant. Our study indicates that MRI evaluation based solely on muscle development can be misleading, and measurement of the anorectal angle should be included in the MRI evaluation.

Right-sided diaphragmatic hernia following group B streptococcal pneumonia and sepsis

A case of right-sided diaphragmatic hernia following group B streptococcal pneumonia and sepsis is reported herein. The clinical course was characteristic. The position of the right hemidiaphragm was initially normal. After an antecedent group B streptococcal infection, an abnormal shadow indicating either pneumonia or a pleural effusion on the chest x-ray was recognized and an elevation of the bowel and liver into the right hemithorax gradually appeared. Repair of the hernia was indicated and the postoperative result was excellent. The relationship between a delayed-onset diaphragmatic hernia and a group B streptococcal infection is still unknown. Increased intrathoracic pressure caused by mechanical ventilation coupled with an abnormal lung compliance due to inflammation may have resulted in the delayed herniation. Among various methods for diagnosis applied, chest x-ray and ultrasonography were noninvasive and useful.

Comparison of the conversion rates of alpha-linolenic acid (18:3(n - 3)) and stearidonic acid (18:4(n - 3)) to longer polyunsaturated fatty acids in rats

The delta 6-desaturase reaction is regarded to be the rate-limiting step in the conversion of linoleic acid (18:2(n - 6)) to arachidonic acid (20:4(n - 6)). The same is probably also the case with the conversion of alpha-linolenic acid (18:3(n - 3)) to eicosapentaenoic acid (20:5(n - 3)). However, there are very few in vivo studies that directly compared the conversion rate between 18:3(n - 3) and stearidonic acid (18:4(n - 3)), which is the delta 6-desaturated product of 18:3(n - 3). We compared this rate by feeding rats on a lipid-free diet supplemented with lard (9%, w/w) and 18:3(n - 3) ethyl ester (1%) diet or on a diet containing lard (9%) and 18:4(n - 3) ethyl ester (1%). A lard (10%)-supplemented diet was used as the control diet. The fatty acid compositions of total phospholipids, triglycerides and free fatty acids of both liver and plasma were measured after 1 or 3 weeks on different diets. The molar ratio of 20:5(n - 3) of most lipid fractions was about 2-fold higher in rats fed the 18:4(n - 3)-supplemented diet than in rats fed the 18:3(n - 3)-supplemented diet. 18:4(n - 3) was found in the liver lipid fraction in only a very small amount, even in the 18:4(n - 3)-supplemented groups. Thus, desaturation at C-6 is suggested to be the rate-limiting step in the conversion of 18:3(n - 3) to 20:5(n - 3).

Manometric evaluation of gastrointestinal motility in a case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS)

We report on a manometric study of the esophagus, stomach, duodenum, jejunum and anorectum in a case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS). An esophageal examination showed normal esophageal contractions and a positive rectoanal reflex was obtained in an anorectal manometry. However, the continuous fasting manometric recording of the antrum, duodenum and jejunum lasting a total of 12 hours revealed a severe motility disturbance of the gastrointestinal tract. During the examination a band of low amplitude contractions was observed in the antrum only once and it was followed by small rhythmic contractions of the duodenum, but none of propagated or spontaneous contractions were seen in the jejunum.