Febrile seizures associated with influenza A

To clarify the clinical impact of influenza A on the development of febrile seizures (FS), consecutive FS patients brought to our hospital between October 2003 and September 2004 were prospectively surveyed. Patients infected with influenza A (influenza A patients) and those uninfected with influenza (non-influenza patients) were compared with regard to clinical characteristics of FS. Influenza infection was determined by rapid antigen test and/or serologically. Associations of influenza A with atypical findings of FS, including partial seizures, prolonged seizures, multiple seizures during the same illness, and 30-min or longer prolonged postictal impairment of consciousness (PPIC), were analyzed by multiple logistic regression. A total of 215 patients (47 influenza A and 168 non-influenza patients) were enrolled in the study. Age was significantly higher in the influenza A group (39.85+/-22.16 months vs. 27.51+/-17.14 months, P<0.001). Of 42 patients aged 48 months or older, which corresponded to the 80th percentile for age, 15 (35.7%) were influenza A patients, with a significantly higher incidence of such patients than in the subgroup of patients aged 47 months or younger (32/173, 18.5%) (P=0.015). On multiple logistic regression analysis, influenza A was independently associated with PPIC (odds ratio: 4.44, 95% confidence interval: 1.52-12.95, P=0.006), but not with other atypical findings. The positive association of influenza A with PPIC suggests that influenza may affect state of consciousness at the same time that it induces seizures with fever.

Classification of benign infantile afebrile seizures

PURPOSE

The aim of this study is to classify infantile cases with benign seizures into known epileptic syndromes, thereby facilitating discussion of clinical factors that could play an important role in diagnosis.

SUBJECTS

Fifty-seven patients with afebrile seizures fulfilling all of the following criteria were enrolled: (1) normal development prior to the onset, (2) no underlying disorders nor neurological abnormalities, (3) onset before the age of four and (4) normal interictal EEG and neuroimaging findings.

RESULTS

Thirty-nine cases (Group A) were characterized by an association of mild gastroenteritis. The remaining 18 cases were divided into two groups according to the seizure type. One group had partial seizures (Group B, 13 cases) while the other was suspected to have generalized seizures (Group C, 5 cases). Age at onset was significantly higher for Group A (19.5 +/- 5.5 months) than Groups B (5.3 +/- 1.8 months) (p<0.001) and C (5.8 +/- 3.5 months) (p=0.038). Positive family history of seizure disorder, seizure cluster tendency, and the efficacy of lidocaine against seizure clusters were common in the three groups.

CONCLUSIONS

Features in Group A were consistent with benign convulsions with mild gastroenteritis (proposed by Morooka) [Morooka, K., 1982. Mild diarrhea and convulsions. Shonika 23, 134-137 (in Japanese)], those of Group B with benign partial epilepsy in infancy [Watanabe, K., Yamamoto, N., Negoro, T., Takaesu, E., Aso, K., Furune, S., Takahashi, I., 1987. Benign complex partial epilepsies in infancy. Pediatr. Neurol. 3, 208-211], and those of Group C with benign infantile convulsions [Fukuyama, Y., 1963. Borderland of epilepsy with special reference to febrile convulsions and so-called infantile convulsions. Seishin Igaku 5, 211-223 (in Japanese)]. The distinction between these syndromes depends upon age at onset, association with gastroenteritis, and ictal symptomatology. In our experience, however, it was not easy to catch seizure type accurately in clinical situations. As far as the results of ictal video-EEG monitoring ever carried out concern, focal initiation of parxysmal discharges was demonstrated in all cases, not only of BPEI but also of apparent generalized seizures examined without exception. These observations led the authors to conclude that the identity of BIC is dubious, most probably it will represent a subtype of BPEI.

The 17-kDa sheath protein in enamel proteins induces cementum regeneration in experimental cavities created in a buccal dehiscence model of dogs

BACKGROUND AND OBJECTIVE

Commercially available enamel proteins, such as Emdogain, are clinically used for periodontal regeneration. However, the real mechanisms behind the bioactivities of enamel proteins is still unclear, as enamel proteins have multicomponents. The purpose of this in vivo study was to identify the cementum regeneration-promoting factor in enamel proteins that is clinically used for periodontal regeneration to induce cementum-promotive and osteopromotive activities.

MATERIAL AND METHODS

Cementum regeneration, which is an important part of periodontal regeneration, was examined in experimental cavities prepared on a buccal dehiscence model of dogs. The purification of enamel protein with cementum regeneration activity was carried out by gel filtration and ion exchange chromatographies of newly formed secretory enamel.

RESULTS

Cementum regeneration activity was found in the aggregate comprising 13-17-kDa sheath proteins along with a small amount of amelogenins, found in the newly formed secretory enamel. In these proteins, cementum regeneration activity was detected upon application of the 17-kDa sheath protein, but not by other lower molecular-weight sheath proteins and amelogenins. However, the purified 17-kDa sheath protein induced cementum regeneration activity only in a small area, although the regenerated cementum was thick. The activity of the 17-kDa sheath protein was believed not to have been a result of contamination by growth factors such as transforming growth factor-beta1 (TGF-beta1) found in the enamel protein, as the application of TGF-beta1 induced weak cementum regeneration activity.

CONCLUSION

It is concluded that the 17-kDa sheath protein itself exhibits cementum regeneration activity, although other factors may be needed to demonstrate its full ability.

[Changes of electroencephalographic findings in a case of migraine with various neurological symptoms]

We report here an 1-year-old boy who was diagnosed as sporadic hemiplegic migraine demonstrated transient changes in electroencephalographic (EEG) background activity accompanied with migraine attacks. The attacks were associated with various neurological complications such as impairment of consciousness and hemiplegia and so on, which coincided with the changes of EEG findings. When his first headache developed with fever and impairment of consciousness, diffuse slow waves (1-2 Hz, 250-300 microV) appeared transiently. The slow wave gradually improved thereafter, and disappeared on the 24th day. On the 25th day, when he had the second attack with left hemiplegia and impairment of consciousness and sensation, slow waves, (2-3 Hz, 250-300 microV) appeared on right side of the brain. Constriction of the right middle cerebral artery was found on MR angiography at that time. The EEG change had improved to normal background activity 3 days after the episode. This unique case demonstrated that transient EEG changes seem to be correlated with the existence of unconsciousness and the laterality of the ischemic insult. We may assume that the changes of electroencephalographic findings may represent the cortical dysfunction caused by vascular constriction.

Retroperitoneoscopic Radical Nephrectomy in Obese Patients: Outcomes and Considerations

OBJECTIVE

To determine whether obesity is associated with surgical outcome in Japanese patients undergoing retroperitoneoscopic radical nephrectomy (RRN).

PATIENTS AND METHODS

Between November 1999 and March 2005, we performed 98 RRN procedures for patients with renal cell carcinoma. Patients with a body mass index (BMI) of 25.0 or more were defined as obese (group A, n=33) and those with a BMI of <25.0 were defined as non-obese (group B, n=65), in accordance with the criteria of the Japan Society for the Study of Obesity. Patient background, degree of surgical invasiveness, and period of convalescence were compared between groups A and B.

RESULTS

No statistically significant differences were observed between the groups in terms of age, gender, tumor laterality, tumor size, and time until resumption of oral intake and ambulation. However group A had a significantly longer insufflation time (172.1 vs. 137.4 min), greater blood loss (195.3 vs. 48.4 ml) and higher renal specimen weight (440.0 vs. 306.0 g) than group B.

CONCLUSION

Obesity is not a factor that affects patient eligibility for RRN, but is a risk factor for longer insufflation time and greater blood loss.

Acceleration of wound healing by combined gene transfer of hepatocyte growth factor and prostacyclin synthase with Shima Jet

Although skin diseases are one of the target diseases for gene therapy, there has been no practical gene transfer method. First, we examined gene transfer efficiency of the spring-powered jet injector, Shima Jet, which was originally developed as a non-needle jet injector of insulin. Local gene expression was about 100 times higher when the luciferase plasmid was transferred by the Shima Jet than by a needle. Gene transfer of beta-galactosidase revealed gene expression in the epidermis. Based on these results, we then examined the potential of gene therapy using the Shima Jet for wound healing. An increase of cellular proliferation of the epidermis and the number of microvessels in the granulation tissue was observed after hepatocyte growth factor (HGF) gene transfer. An increase in blood flow around the wound was observed after prostacyclin synthase (PGIS) gene transfer. Moreover, promotion on wound healing was observed in HGF gene transferred group, and further promotion was observed in combined gene transferred group as assessed by measuring wound area. These results indicate that co-transfer of HGF and PGIS genes by the Shima Jet could be an effective strategy to wound healing.

An ESR Spin-Label Study on Molecular Mobility in the Interface between Microphases of a Diblock Copolymer: Effects of Admixture of Homopolymers That Are Miscible with One of the Blocks

Molecular mobility in the interfacial region of a microphase-separated structure was studied in binary mixtures of AB-type diblock copolymers and homopolymers (miscible with only A) by the spin-label technique. In this study, we prepared (a) binary blends of polystyrene-block-poly(methyl acrylate) (PS-block-PMA) and homopolymer poly(cyclohexyl acrylate)'s having the number-averaged molecular weight (Mn) of 1000 (PCHA-S) and (b) having the Mn of 17300 (PCHA-L), and (c) binary mixtures of the PS-block-PMA and homopolymer PS with the Mn of 900 (PS-1). Emphasis was placed on effects of the molecular weight and the miscibility of added homopolymers on the mobility in the interfacial region of the microphase separation. Selective incorporation of the added PCHA-S, PCHA-L, and PS-1 into the PS phase of the PS-block-PMA was confirmed by modulated-temperature differential scanning calorimetry (MDSC) measurement as a decrease in the glass transition temperature of the PS phase. Moreover, the MDSC and small-angle X-ray scattering (SAXS) measurements suggested that the spatial distributions of the PCHA-S and PS-1 in the PS phase were relatively uniform because of their small Mn. On the other hand, the distribution of the PCHA-L in the PS phase was somewhat heterogeneous because of the large Mn of the PCHA-L. The spin-label at the junction point of the PS-block-PMA allowed us to estimate the mobility in the interfacial region of the microphase separation. Influence of the PCHA-S and PCHA-L on the mobility in the interfacial region was negligible even though the relatively uniform distribution of the PCHA-S in the PS phase was suggested by the SAXS and MDSC. More uniform distribution of the PS-1 than that of the PCHA-S in the PS phase was suggested by the SAXS, and the mobility in the interfacial region was slightly enhanced by the addition of the PS-1. However, the mobility was almost constant against an increase in the PS-1. The PS-1 was considered to be penetrated into the interfacial region and activated the mobility, but the fraction of the PS-1 in the interfacial region was constant irrespective of the blended amount of the PS-1. These results suggest that effects of homopolymers on the mobility in the interface are significantly related to their spatial distribution in the host phase.

Co-localization of von Willebrand factor with platelet thrombi, tissue factor and platelets with fibrin, and consistent presence of inflammatory cells in coronary thrombi obtained by an aspiration device from patients with acute myocardial infarction

BACKGROUND

Detailed histochemical analysis of coronary thrombi obtained freshly from acute phase of myocardial infarction patients may provide information necessary to understand the mechanism of coronary occlusive thrombus formation.

METHODS AND RESULTS

Coronary thrombi causing myocardial infarction were obtained from 10 consecutive patients of myocardial infarction in the acute phase, using a newly developed aspiration catheter. All the fixed specimens of coronary thrombi, by hematoxylin and eosin staining, were found to contain three major constituents, namely, platelets, densely packed fibrin and inflammatory cells, including polymorphonuclear and mononuclear cells, although their distribution in each specimen is totally heterogeneous. Immunohistochemical staining revealed the prominent presence of von Willebrand factor (VWF) at the sites of platelet accumulation, presence of tissue factor and platelets at the sites of deposition of fibrin fibrils. It also revealed the presence of CD16-, CD45- and CD34-positive cells, yet the functional roles of these cells have still to be elucidated. There are weak positive correlation between the number of inflammatory cells involved in the unit area of coronary thrombi specimen and the time of collection of the specimens after the onset of chest pain.

CONCLUSIONS

In spite of various limitations, our results contain information suggesting the possible role of VWF in platelet-thrombus formation, possible important role played by tissue factor and activated platelets in the formation of fibrin fibrils, and the positive relationship between inflammatory cells migration and the formation of occlusive thrombi in human coronary arteries.

[Prospective study of first unprovoked seizure]

We prospectively examined the natural history of children who suffered a first unprovoked seizure (FUS). Forty-five children who suffered a seizure without any detectable precipitating factors were enrolled in this study. Absence seizure, myoclonic seizure, and epileptic spasms were excluded from this study. They were followed for at least 2 years without anti-epileptic medications in 43 cases (2 were given drugs). Thirty patients (66.7%) had another seizure during follow up. Of the 30 patients with recurrence, 11 suffered the second seizure within 1 month, 19 within 3 months, 24 within 6 months, 26 within 1 year, and 30 within 2 years. Occurrence of generalized convulsions, a past history and family history of febrile seizures, epileptic discharges on the EEG (especially a diffuse pattern), and developmental delay prior to the FUS were risk factors for seizure recurrence. Up to one third of the patients had no more recurrent seizures during the next 2 years, so it seems reasonable to follow FUS patients without medication.

Decomposition of carbon dioxide by metals during gamma irradiation

We have proposed a technique to enhance the decomposition of carbon dioxide by gamma irradiation. This is possible by putting metal components into CO2 gas to promote the conversion of gamma rays to lower-energy electrons through Compton, photoelectron and cascading electron knock-on events in metals. Numerical simulations using the EGS code indicated that the number of lower-energy electrons ejected from metals into CO2 gas increases with increasing Z number and/or density of the metals; this was supported by the experimental results, i.e., the CO2-containing metals with a higher Z number exhibited a greater efficiency for production of CO. In addition, production of CO could be enhanced by carefully controlling the volume and surface area of metal components as well as the proximity to adjacent metal components. These experimental results successfully demonstrated that modification of the kinds of metal components and metal structures can control the energy and the number of electrons ejected from the metals and can lead to enhancement of production of CO from CO2.

FIV-infected cats respond to short-term rHuG-CSF treatment which results in anti-G-CSF neutralizing antibody production that inactivates drug activity

The hematological and virological effects of recombinant human granulocyte colony-stimulating factor (rHuG-CSF) were evaluated in feline immunodeficiency virus (FIV)-infected cats. Six age-matched, FIV-infected cats used in this cross-over study were injected subcutaneously with 5 microg/kg of rHuG-CSF daily for 3 weeks, while six control cats received a placebo. Five of six rHuG-CSF-treated cats had significant increases in neutrophil counts that peaked on days 11-21 of treatment. All rHuG-CSF-treated cats exhibited an increase in myeloid:erythroid ratios of the bone marrow cells without significant changes in lymphocyte, CD4 counts, CD4/CD8 ratios, RBC counts, FIV antibody titers, and FIV loads in peripheral blood, and without clinical and hematological toxicities. Five of six rHuG-CSF-treated cats developed antibodies to rHuG-CSF by 14-21 days of treatment, which correlated with decreasing neutrophil counts and increasing neutralizing antibodies to rHuG-CSF. Three cats re-treated with rHuG-CSF rapidly developed neutralizing antibodies to rHuG-CSF, while one cat also developed neutralizing antibodies to recombinant feline G-CSF (rFeG-CSF). Overall, rHuG-CSF treatment increased neutrophil counts in FIV-infected cats without affecting the infection status of cats. However, long-term use of rHuG-CSF is not recommended in cats because of the neutralizing antibody production to rHuG-CSF that affects the drug activity. In addition, a preliminary finding suggests that repeated treatment cycle can also induce cross-neutralizing antibodies to rFeG-CSF, which may potentially affect the homeostasis of endogenous FeG-CSF.

A pilot study on lidocaine tape therapy for convulsions with mild gastroenteritis

The aim of this study was to clarify the efficacy and safety of lidocaine tape therapy (LDT) in patients with convulsions with mild gastroenteritis (CwG). Twenty-one consecutive episodes of CwG were treated with LDT therapy. The dose of LDT was 36 mg in patients with body weights of <15 kg, 54 mg in those with body weights between 15 and 20 kg, and 72 mg in those with body weights of >20 kg. LDT was attached on the back of each patient every 12 h. Application of LDT was continued for 48 h. The serum levels of lidocaine (LD) were measured 4 h after the first attachment of LDT. The seizures completely ceased in 13 episodes (62%) after the application of LDT, while a recurrence of seizures was observed in the other 8 episodes. Drip infusion of LD was performed in 4 of these 8 episodes. The serum LD levels were only measurable in 6 infants (average, 0.4 microg/ml; range, 0.2-0.5 microg/ml). In the other patients, the serum LD levels were below the lower limit of measurement. Adverse effects of LDT were not observed in any patients. LDT therapy was safe and effective in patients with CwG.

Cellular immune responses to feline immunodeficiency virus (FIV) induced by dual-subtype FIV vaccine

Vaccine-induced T cell responses to FIV were assessed by measuring FIV-specific cytokine and cytotoxic-effector molecule production. A total of 22 cats at 10-12 weeks of age received either dual-subtype FIV vaccine (n=12), uninfected cell lysate (n=5) consisting of cells used to produce vaccine viruses, or no immunization (n=5). Significant increases in mRNA and protein production of T-helper 1 (Th1) cytokines (IL-2, IFNgamma), mRNA production of a cytotoxic-effector molecule (perforin), and lymphoproliferation response were observed in peripheral blood mononuclear cells (PBMC) from dual-subtype FIV-vaccinated cats after in vitro stimulation with inactivated FIV. In contrast, no statistically significant increase in FIV-stimulated mRNA production of Th2 cytokines (IL-4, IL-6) or other cytotoxic-effector molecules (TNFalpha, FasL) was observed in the PBMC from dual-subtype vaccinated cats. Moreover, no FIV-specific increases in the IFNgamma, IL-2, and perforin mRNA productions and in the IFNgamma bioactivity and lymphoproliferation responses were observed in the PBMC from cell-immunized cats. These observations suggest that IFNgamma induction, lymphoproliferation, and significant portion of IL-2 and perforin productions in the PBMC from dual-subtype vaccinated cats are clearly specific for viral antigens. Overall, dual-subtype FIV vaccine elicited strong Th1 response (IFN(, IL-2), which may contribute to the vaccine protection by enhancing the perforin-mediated cytotoxic-cell activity against FIV.

Non-invasive assessment of cardiac output during exercise in healthy young humans: comparison between Modelflow method and Doppler echocardiography method

AIMS

The Modelflow method can estimate cardiac output from arterial blood pressure waveforms using a three-element model of aortic input impedance (aortic characteristic impedance, arterial compliance, and systemic vascular resistance). We tested the reliability of a non-invasive cardiac output estimation during submaximal exercise using the Modelflow method from finger arterial pressure waveforms collected by Portapres in healthy young humans.

METHODS

The Doppler echocardiography method was used as a reference method. Sixteen healthy young subjects (nine males and seven females) performed a multi-stage cycle ergometer exercise at an intensity corresponding to 70, 90, 110 and 130% of their individual ventilatory threshold for 2 min each. The simultaneous estimation of cardiac output (15 s averaged data) using the Modelflow and Doppler echocardiography methods was performed at rest and during exercise.

RESULTS AND CONCLUSION

The Modelflow-estimated cardiac output correlated significantly with the simultaneous estimates by the Doppler method in all subjects (r = 0.87, P < 0.0001) and the SE of estimation was 1.93 L min-1. Correlation coefficients in each subject ranged from 0.91 to 0.98. Although the Modelflow method overestimated cardiac output, the errors between two estimates were not significantly different among the exercise levels. These results suggest that the Modelflow method using Portapres could provide a reliable estimation of the relative change in cardiac output non-invasively and continuously during submaximal exercise in healthy young humans, at least in terms of the relative changes in cardiac output.

Regular threshold-energy increase with charge for neutral-particle emission in collisions of electrons with oligonucleotide anions

Electron-DNA anion collisions were studied using an electrostatic storage ring with a merging electron-beam technique. The rate of neutral particles emitted in collisions started to increase from definite threshold energies, which increased regularly with ion charges in steps of about 10 eV. These threshold energies were almost independent of the length and sequence of DNA, but depended strongly on the ion charges. Neutral particles came from breaks of DNAs, rather than electron detachment. The step of the threshold energy increase approximately agreed with the plasmon excitation energy. It is deduced that plasmon excitation is closely related to the reaction mechanism.

[Survey of vaccination and viral infections for children with severe myoclonic epilepsy in infancy]

A study group for establishment of a proposed immunization program for neurologically high risk children (Chief, Kihei Maekawa) sponsored by the Ministry of Health, Labour and Welfare of Japan is preparing a proposal for patients with epilepsy. Severe myoclonic eplepsy in infancy (SMEI) is an intractable epilepsy which often presents with status epilepticus and triggered by hyperthermia and viral infections. In this study we investigated the history of vaccination in children with SMEI to compare the risk of vaccination with that of natural contraction of infection. Fifty-eight patients with SMEI, aged from 2 to 25 years, were enrolled in this study. A total of 359 vaccines were given to these subjects. The vaccination rates were high for BCG (71%) and polio (1st; 71%, 2nd; 53%), and then fell gradually after the onset of SMEI (DPT-1st; 48%. DPT-2nd; 45%, DPT-3rd; 38%, DPT-4th; 24%, mumps; 21%, varicella; 19%, rubella 31%). However, the measles vaccine was given at a relatively high rate (55%) before the age of three. When patients suffered from measles, rubella, mumps or influenza, they had a high risk of severe neurological complications, such as convulsive status, disturbance of consciousness and encephalopathy. These complications were documented in 63% of all episodes of naturally contracted infections. This rate was significantly higher (p < 0.0001) than that associated with vaccination (7.2%). However, hyperthermia and convulsion developed more frequently (p = 0.012) after measles vaccine was given, as compared to other vaccines. Thus, administration of these vaccines to patients with SMEI in conjunction with other preventive measures against seizure induced by hyperthermia, may meet the needs of their parents.

A prospective, randomised comparison of single and three piece acrylic foldable intraocular lenses

AIMS

To compare the postoperative performance of single and three piece acrylic foldable intraocular lenses (IOLs).

METHODS

20 patients underwent bilateral cataract surgery with a single piece SA30AL IOL in one eye and a three piece MA30BA IOL in the other eye. The eyes were randomly assigned to either a single or three piece lens. The amount of IOL decentration and tilt, area of anterior capsule opening, and degree of posterior capsule opacification were measured using the Scheimpflug anterior segment analysis system (Nidek EAS-1000). Visual acuity and contrast sensitivity were examined. Measurements were performed by masked examiners before and 1 day, 1 week, 1, 3, 6, and 18 months after surgery.

RESULTS

There were no significant differences between the two groups (p>0.05, paired t test) in the amount of IOL decentration, IOL tilt, area of anterior capsule opening, degree of posterior capsule opacification, best corrected visual acuity, and contrast sensitivity throughout the 18 month follow up period.

CONCLUSION

The single and three piece acrylic foldable IOLs are equally stable in the eye after surgery.

[Double valve replacement for infective endocarditis following osteomyelitis; report of two cases]

Infective endocarditis(IE) is relatively common but it is lethal complication of osteomyelitis. We report the case of 2 patients who had been diagnosed as IE during their conservative therapy of osteomyelitis. Both of the patients had been admitted because of severe back pain. Then IE was revealed from congestive heart failure and/or persistent fever. As several times of echocardiogram showed the progression of valvular lesion despite their antibiotic therapies, they underwent the operation of aortic and mitral valve replacements. On bacteremia-related disease like osteomyelitis, high index of suspicion and early diagnosis of IE are essential to its successful treatment.

The behavior and effect of isopoly (S-carboxymethyl-L-cysteine) derivatives of nucleic acid bases

Isopoly(S-carboxymethyl-L-cysteine) derivatives of nucleic acid bases were prepared as antisense compounds. These compounds in vitro have been found to form stable complex with oligo-DNA or RNA. This paper deals with effect of antisense compounds in vivo. The target in this paper is the sequence of the PSD-95 protein linked with NMDA receptor. Excess passing of calcium ions through the loss of the signal pathway without PSD-95 proteins caused by antisense compound. The cells detailing with L-cysteine derivatives showed the lowest percentage of 19.1%. The data were compared with that of phosphotioate antisense compound.

Study about the inhibition of L-cysteine derivatives of nucleic acid bases in protein production

Isopoly (S-carboxymethyl-L-cysteine) derivatives of nucleic acids bases were prepared as antisense compounds. In past study, we investigated the properties of these compounds in vitro, and revealed that these compounds in vivo regulated the cell death presumably due to the inhibition of protein production. In this study, western and northern blots were carried out in order to reveal the mechanism of this inhibition for N-methyl-D-aspartate receptor in neuroblastoma x glioma hybrid NG108-15 cell line. In addition, we investigated the resistance of these compounds against cell extract and the metabolism. In conclusion, we proved that these compounds inhibited the protein production by antisense mechanism.

Transfection of fluorescent probed antisense compounds: L-cysteine derivatives of nucleic acid bases

Antisense with L-cysteine derivative (CAS) can recognize DNA and forms the complementary duplex with DNA. So the properties of CAS in vitro and in vivo were examined in this study. CAS was resistant to proteinase K and stabilized RNA against RNase HI. Moreover using fluorescent CAS, the localization was observed by fluorescence microscope and confocal microscope. As a result, CASs were accumulated inside the nucleus in NG108-15.

Effective transduction and stable transgene expression in human blood cells by a third-generation lentiviral vector

Difficulty in gene transduction of human blood cells, including hematopoietic stem cells, has hampered the development of gene therapy applications for hematological disorders, encouraging the development and use of new gene delivery systems. In this study, we used a third-generation self-inactivating (SIN) lentiviral vector system based on human immunodeficiency virus type 1 (HIV-1) to improve transduction efficiency and prevent vector-related toxicity. The transduction efficiency of the HIV-1-based vector was compared directly with the Moloney murine leukemia virus (MLV) SIN vector in human leukemia cell lines. Initial transduction efficiencies were almost 100% for the HIV and less than 50% for the MLV vectors. Similar results were observed in 11 types of primary cells obtained from leukemia or myeloma patients. Transgene expression persisted for 8 weeks in cells transduced with the HIV vector, but declined with the MLV vector. In addition, resting peripheral blood lymphocytes and CD34(+) hematopoietic cells were transduced successfully with the HIV vector, but not with the MLV vector. Finally, we confirmed vector gene integration in almost all colony-forming cells transduced with the HIV vector, but not with the MLV vector. In conclusion, this lentiviral vector is an excellent gene transduction system for human blood cells because of its high gene transduction and host chromosome integration efficiency.

Concurrent chemoradiotherapy with daily low dose intra-arterial cisplatin plus 5-fluorouracil for stage IV nasopharyngeal cancer

This study aims to treat locally-advanced nasopharyngeal cancer by concurrent conventional irradiation at 2.0 Gy/day five days per week up to a total dose of 68 Gy, and daily intra-arterial infusion of cisplatin 3 mg/m2 plus 24 hours intravenous drip infusion of 5-fluorouracil 150 mg/m2 per day, five days per week. All of five enrolled patients completed the schedule, and treatment compliance was considered to be identical. Of the five patients evaluable for response, four with complete response (80%) and one with partial response (20%), with an overall response rate of 100% was achieved. The median survival time was 26 months. Two-year survival of the patients was 80%. This regimen showed marginal mucositis but well tolerated. We concluded that this treatment option is safe and effective for the locally-advanced nasopharyngeal cancer.

[Differential diagnosis in children having delirium associated with high fever]

Children who present delirium associated with high fever may develop with encephalitis or encephalopathy, especially in influenza infection. The aim of this study is to differentiate the patients with the central nervous infection or with the parasomnias from benign transient delirium in patients who visit the emergency room complaining of illusions. Ten patients aged from 2 to 7 years were enrolled in this study. There were 2 patients with central nervous infection, one with encephalo-myelitis due to mycoplasma infection and one with acute necrotizing encephalopathy due to influenza infection. The remaining 8 patients had benign delirium associated with high fever which disappeared in a self-limiting manner. Three patients had a febrile seizure (FS) and 4 patients had family history of FS. The points to differentiate the delirium with parasomnias from benign type is fearful expression, positive past history, autonomic nerve symptoms. Delirium consisted of visual hallucination, and occurred in association with sleep except in the patients with encephalopathy who became delirious when they were awake. Abnormal neurological findings such as meningeal signs and disturbed consciousness, appearance of delirium in the waking state, and marked slowing in the EEG background activity were considered to be warning factors useful in differentiating the benign type from the delirium with central nervous infection.

[Surgical treatment to an old patient with right coronary artery aneurysm; report of a case]

The patient was 75-year-old woman. The patient was referred to our hospital for operation due to a developing right coronary artery aneurysm. The coronary artery angiography showed that the aneurysm was 3 cm in diameter which had not existed two years previously, and with a 75% distal stenosis. The operation was made during cardiac arrest. A sapheous vein graft was used to bypass to the distal artery first. Then the aneurysm was resected, and both proximal and distal arteries were ligated. The pacemaker was implanted on the third postoperative day for sick sinus syndrome, the patient got a better recovery. Surgical treatment should be recommended to coronary artery aneurysm, and sapheous vein was a good selection for bypass graft when the diameter of native artery was relatively large.

Resonant neutral-particle emission in collisions of electrons with peptide ions in a storage ring

Electron-biomolecular ion collisions were studied using an electrostatic storage ring with a merging beam technique for singly protonated peptides (angiotensin I, II, and III). A strong neutral-particle emission at around 6.5 eV was found in addition to neutrals from recombination at low energies. The rates of the high-energy peak greatly decreased with a slight decrease in the number of amino-acid residues from angiotensin I to III. These results suggest that some peptide bonds were selectively cleaved.

Allosterically controllable maxizyme-mediated suppression of progression of leukemia in mice

Chronic myelogenous leukemia (CML) is a hematopoietic malignant disease associated with expression of a chimeric BCR-ABL gene. We recently succeeded in designing a novel allosterically controllable ribozyme, the maxizyme (Tanabe et al. Biomacromolecules 2000, 1, 108-117; Kuwabara et al. Biomacromolecules 2001, 2, 788-799), that not only specifically cleaves BCR-ABL mRNA and induces apoptosis in cultured CML cells but also shows significant inhibition against the growth of an established BV173 cell line in a mouse model (Tanabe et al. Nature 2000, 406, 473-474). As an extension of our studies, we tested the maxizyme against primary CML cells in the same mouse model. The maxizyme under the control of a tRNA(Val) promoter showed significant inhibition against the growth of the primary bone marrow cells from a Japanese patient with CML. Specifically, to examine the applicability of the maxizyme in the treatment of CML, we assessed the antitumor effect of the maxizyme in murine models of CML. Fourteen weeks after the injection of primary CML cells into a NOD-SCID mouse, the bone marrow of the mouse was filled with primary CML cells as a result of diffuse leukemia. In marked contrast, when maxizyme-expressing primary CML cells were injected, the mouse remained disease-free. These results further strengthen our earlier suggestion that the maxizyme technology might provide a useful approach to the treatment of CML.

Exercise training improves ageing-induced decrease in eNOS expression of the aorta

AIMS

Ageing impairs endothelial function such as the regulation of vascular tone. The release of nitric oxide (NO), which has a potent vasodilator effect and antiatherosclerotic property, is decreased in the aorta of aged rats. Exercise training, however, has been reported to increase the expression of endothelial NO synthase (eNOS) in the aorta of young rats. In aged rats, it is not known whether the expression of eNOS is altered by exercise training. We hypothesized that exercise training would improve the ageing-induced decrease in eNOS expression in vessels, and examined the messenger RNA (mRNA) and protein expression of eNOS in the aorta of sedentary-young rats (sedentary-young group; 4 months old), sedentary-aged rats (sedentary-aged group; 23 months old), and swim-trained aged rats (training-aged group; 23 months old, swimming training for 8 weeks, 5 days week(-1), 90 min day(-1)).

RESULTS

Body weight was significantly lower, and citrate synthase activity in the epitrochlearis muscle was significantly higher in the training-aged group compared with the sedentary-aged group. The mRNA expression of eNOS in the aorta was significantly higher in the training-aged group than in the sedentary-aged group, while it was significantly lower in both the sedentary-aged and training-aged groups than in the sedentary-young group. The expression of eNOS protein in the aorta was also significantly higher in the training-aged group than in the sedentary-aged group, while it was also significantly lower in the sedentary-aged group, but not in the training-aged group, than in the sedentary-young group.

CONCLUSION

The present results revealed that the production of eNOS in the aorta decreases with ageing, and that the decreased production is increased by exercise training in aged rats, which may produce beneficial effects on the impaired cardiovascular system caused by ageing.

Neopterin, biopterin, and nitric oxide concentrations in the cerebrospinal fluid of children with central nervous system infections

We measured neopterin, biopterin and nitric oxide (NO) concentrations in the cerebrospinal fluid of pediatric patients with central nervous system (CNS) infectious diseases. The nitric oxide and neopterin concentrations were significantly elevated in encephalitis patients, especially in two cases with serious neurological sequelae, while the biopterin levels were not elevated. The bacterial meningitis patients, on the contrary, had high cerebrospinal fluid concentrations of neopterin and biopterin, but not of NO. Although these findings are preliminary, it may suggest that cerebrospinal fluids nitric oxide would be a useful marker to prospect neurological prognoses in the CNS infections.

Survey of nasal colonization by, and assessment of a novel multiplex PCR method for detection of biofilm-forming methicillin-resistant staphylococci in healthy medical students

We surveyed the prevalence of nasal colonization by biofilm-forming methicillin-resistant staphylococci in healthy medical students, who had never had contact with patients, using polymerase chain reaction (PCR) to detect themec A gene, production of penicillin-binding protein 2' (PBP2'), and quantitative assay of biofilm formation on polystyrene. Anterior nasal swabs from 90 students were cultured on mannitol salt and oxacillin salt screening agar plates. In total, 231 staphylococcal isolates belonging to 10 species from 88 students were identified, of which 139 from 77 (88%) students were Staphylococcus epidermidis. The overall prevalences of methicillin-resistant and biofilm-forming staphylococci were 48% (43 of 90) and 59% (53 of 90) for the medical students, respectively. In total 30 (33%) students carried biofilm-forming methicillin-resistant staphylococci in the nares, all of which were identified as S. epidermidis. For rapid detection of biofilm-forming methicillin-resistant S. epidermidis (MRSE), we devised a novel multiplex PCR method to assess a total of 243 staphylococcal isolates, including the 231 isolates from the students. The multiplex PCR assay used six primers to amplify atl E and ica ADB, which are responsible for the biofilm formation ofS. epidermidis, and mec A genes. The multiplex PCR assay revealed that 68 (96%) isolates were detectable in 71 biofilm-forming MRSE isolates, which corresponded to 93% (28 of 30) of biofilm-forming MRSE carriers. Surveillance of nasal colonization with biofilm-forming MRSE using this multiplex PCR in healthcare workers and patients, might provide useful information for the establishment of infection control procedures toward biofilm-forming MRSE.

Monocyte proliferation induced by modified serum is associated with endogenous M-CSF production: evidence for involvement of a signalling pathway via scavenger receptors

It was found that human serum stored for 2 months at 4 degrees C (modified serum) induced monocyte proliferation and simultaneous macrophage colony stimulating factor (M-CSF) production by these cells in vitro. Cell number, estimated by DNA content, doubled after 10 days in culture in the presence of modified serum, while it decreased in culture with freshly thawed control serum. As the addition of more than 2.5 ng/ml of recombinant M-CSF significantly supported monocyte survival/proliferation, cells were cultured for 10 days in medium supplemented with control serum, and endogenous M-CSF production was investigated by enzyme-linked immunosorbent assay. M-CSF concentration in the supernatants was 15-30 ng/ml after 10 day in culture with modified serum, a level that might be sufficient for monocyte proliferation. The modified serum induced M-CSF from freshly isolated monocytes, while M-CSF was hardly detected in cultures supplemented with control serum. Assay for peroxidized lipid and agarose gel electrophoresis demonstrated that the modified serum contained more oxidized low density lipoproteins (LDL) than the control serum. Ligands of scavenger receptors, which are receptors for oxidized LDL, such as dextran sulphate, polyinosinic acid, heparin and acetylated LDL also significantly induced M-CSF production from human monocytes, although this was at levels below 2 ng/ml. These results indicate that serum modified by oxidation stimulates monocytes to produce M-CSF resulting in their proliferation, and that signalling via scavenger receptors is one of the mechanisms responsible for this induction of M-CSF.

Neuropilin-2 is overexpressed in the rat brain after limbic seizures

Structural rearrangement and synaptic reorganization are known to occur in the brain after seizures. If neuronal rearrangement after seizures always results in abnormal hyperexcitability, it would provide an accurate pathway to the appropriate target and as a result, it may be the mechanism of epileptogenesis. This study examined the mechanism of axon guidance in the mature rat brain after seizures by evaluating the expression of the axonal guidance molecule, neuropilin-2. We assessed the expression of neuropilin-2 by northern blotting and immunohistochemistry in rat with seizures created by kindling stimulation and kainate injection.The neuropilin-2 mRNA level was increased in the whole brain of the rats at 24 h after either type of seizure. Neuropilin-2 mRNA was not increased at 2 weeks after the last stimulation. Immunohistochemistry demonstrated that neuropilin-2 protein was increased in the dentate gyrus and the entorhinal cortex in the both seizure models. These findings suggested that there was overexpression of neuropilin-2 in the brains of mature rats with different types of seizure. Accordingly, neuropilin-2 might regulate remodeling after seizures as it does during the development of the hippocampal formation. Our findings suggest that axons may not project and outgrow 'aberrantly' after seizures, but may be regulated by the chemorepellent effect through neuropilin-2.

Odontoblasts enhance the maturation of enamel crystals by secreting EMSP1 at the enamel-dentin junction

The temporal expression patterns and activity distributions of enamelysin and EMSP1, which are the major proteinases in immature enamel, were characterized. Extracellular matrix fractions from developing porcine incisors, individually comprised of predentin, dentin, and four secretory-stage enamel samples, including the highly mineralized enamel (HME) at the enamel-dentin junction (EDJ), were isolated, and their resident proteinases were identified by zymography. Soft-tissue fractions, which included cells from the extension site of enamel formation (ESEF), secretory- and maturation-stage ameloblasts, and odontoblasts, were characterized histologically and by RT-PCR for their expression of enamelysin and EMSP1. A significant finding was that EMSP1, expressed by odontoblasts, concentrates in the HME, but is not detected in predentin or dentin. We conclude that odontoblasts deposit EMSP1 via their cell processes into the deepest enamel layer, which facilitates the hardening of this layer and contributes significantly to the functional properties of the EDJ.

Noggin blocks osteoinductive activity of porcine enamel extracts

Enamel extracts induce biomineralization such as osteogenesis and cementogenesis, but the molecular component responsible for this activity remains uncertain. We fractionated enamel extracts from developing pig teeth and isolated the osteoinductive fraction. Proteins from pig enamel scrapings were extracted under alkaline conditions (pH 10.8) and fractionated with the use of a Sephadex G-100 (size exclusion) column. The ability of each fraction to enhance alkaline phosphatase (ALP) activity was assayed in ST2 cells, a mouse bone marrow stromal cell line. The osteoinductive fraction of enamel extracts (OFE) was found in fractions 44 and 45, which induced ST2 cells to express the phenotype of bone-forming osteoblasts, and to form mineralized nodules. Furthermore, the ALP activity of ST2 cells exposed to OFE was reduced by noggin, an antagonist of BMPs, and OFE reacted with BMP-2/4 antibody in dot-blot analysis. These results indicate that OFE contains BMPs that contribute to the induction of biomineralization.