Well-differentiated osteosarcoma of the rib

Well-differentiated osteosarcoma is extremely rare, there is no sex predominance and the mean age is in the third decade. The tumor has a strong predilection for the long bones of the extremities, especially the metaphysis but may also occur in the diaphysis. Radiologically, the lesion shows no distinctive features, often simulating fibrous dyplasia or desmoplastic fibroma. We report a case of well-differentiated osteosarcoma involving the rib of a 45-year-old female. This is a peculiar case of well differentiated osteosarcoma involving an unusual site and older patient. We also discuss histological differential diagnosis as well as clinical features of this rare disease.

Paenibacillus campinasensis sp. nov., a cyclodextrin-producing bacterium isolated in Brazil

An alkaliphilic, endospore-forming bacterium isolated from Brazilian soil was taxonomically studied and is proposed as a new Paenibacillus species. This organism (strain 324T) was particularly distinguishable from other Paenibacillus species by its ability to grow optimally at pH 10 and 40 degrees C. The DNA G+C content was 5.0 mol%. The diamine acid of the cell-wall peptidoglycan was meso-diaminopimelic acid. MK-7 was the predominant menaquinone and anteiso-C15:0 was the major fatty acid. Levels of 16S rDNA similarity between strain 324T and other Paenibacillus species were 90.6-95.9%. Phylogenetically, strain 324T formed an evolutionary lineage distinct from other species within the evolutionary radiation encompassing the genus Paenibacillus. Based on phenotyic and chemotaxonomic properties, and phylogenetic inference, it is proposed that strain 324T should be placed in the genus Paenibacillus as a new species is strain 324T should be placed in the genus Paenibacilus as a new species, Paenibacillus campinasensis. This type strain of the new species is strain 325T (= KCTC 0364BP).

The effect of heterogeneous hyperimmune IgG antibody on prophylaxis and treatment of Pneumocystis carinii infection in rats

Immunotherapy has been used in support of trimethoprim-sulfamethoxazole treatment for Pneumocystis carinii pneumonia. The present study investigated the therapeutic or preventive effects of heterogeneous hyperimmune IgG antibody (HIA) in experimental rats. Their immunity was suppressed by steroid injection, and they were also injected peritoneally with HIA which reacted with 40-55, 92, 116, and 200 kDa bands of the crude antigen. All rats were infected by P. carinii and the cystic forms on lung impression smears were counted. The count was 20.5-76.5 (mean 52.5 + 19.3) in those which received steroid only, but decreased to 6.0-21.0 (mean 13.5 + 10.6) in those of group 3 which received HIA for the same duration. In other groups, the mean count ranged from 29.9 + 32.9 to 54.1 + 47.7, and in those which received 13.7 mg HIA the reduction effect was greater than in those which received 6.8 mg or 20.5 mg HIA. The present finding confirmed that in rats during the early stage of infection, the heterogeneous HIA to MSG antigen bands had a partial effect on P. carinii pneumonia, both prophylactically and therapeutically.

Isolation and characterization of a 40 kDa cysteine protease from Gymnophalloides seoi adult worms

A 40 kDa cysteine protease was purified from the crude extract of adult worms of Gymnophalloides seoi by two consecutive steps: Sephacryl S-200 HR and DEAE-Sephacel chromatography. Enzyme activities were completely inhibited by cysteine protease inhibitors. L-trans-epoxysuccinylleucylamido (4-guanidino) butane (E-64) and iodoacetic acid, strongly suggesting that the purified enzyme belongs to the cysteine family of proteases. The enzyme was maximally active at pH 4.5 in 0.1 M of buffer, and its activity was greatly potentiated in the presence of 5 mM dithiothreitol. The protease degraded macromolecules with differential capabilities; it degraded extracellular matrix proteins, such as collagen and fibronectin, with a stronger activity against collagen than fibronectin. However, the enzyme digested hemoglobin and human immunoglobulins only slightly, leaving them nearly intact after an overnight reaction. Our results suggest that the cysteine protease of G. seoi adults is potentially significant in the nutrient uptake from the host intestine.

Prevention of arachnoiditis and postoperative tethering of the spinal cord with Gore-Tex surgical membrane: an experimental study with rats

OBJECTIVE

Arachnoidal adhesions and inflammation were evaluated in 72 rats after spinal dural repair with one of three materials, i.e., Gore-Tex surgical membrane, collagen-coated Vicryl mesh, or lyophilized spinal dural allograft.

METHODS

Laminectomy at L1 was performed, and then a 3- x 4-mm segment of spinal dura mater and arachnoid membrane was excised. After implantation of the dural substitute, the animals were divided into normal and injured groups. In the injured group, a spinal cord injury was produced at the midpoint of the duraplasty site by the clip compression technique, with 25-g force for 1 minute. Neurological performance was assessed by the inclined plane technique, and groups of rats were killed at 8 to 24 weeks after surgery. The spinal column was removed en bloc and processed for histological examination.

RESULTS

There were no differences in neurological function among the three dural substitutes in either injured or noninjured rats. However, there were major differences among the groups in the incidence and severity of arachnoid adhesions and tethering. The neural tissue was bound to a thick neomembrane surrounding the lyophilized dural allograft and the collagen-coated Vicryl mesh. In contrast, the Gore-Tex surgical membrane induced only a thin membranous adhesion, which was loose and flexible. The inflammatory and foreign body response was most pronounced in rats treated with collagen-coated Vicryl mesh, at 8 and 24 weeks.

CONCLUSION

In the present study, Gore-Tex surgical membrane was a very good material for the surgical repair of spinal dural defects. Additional experimental studies are required to compare Gore-Tex membrane with autologous tissues.

Changes of the carotid artery Doppler flow velocity pattern after sublingual nitroglycerin in patients with hypertension

OBJECTIVE

To evaluate the applicability of carotid Doppler echography for the assessment of changes of peripheral hemodynamics in the hypertensives.

SUBJECTS

28 hypertensives (17 males, 11 females), mean age of 64 yrs and 40 normal controls (24 males, 16 females) mean age of 49 yrs.

METHODS

We recorded the right common carotid arterial Doppler flow velocity (BFV) pattern and measured the peak velocities of the percussion wave (P) and late rising tidal wave (T), the ratio of the two (P/T), the time interval between the two peaks corrected by heart rate (P-Tc), systolic flow velocity integral (FVI) and carotid artery diameter (CAD) before and after 0.4 mg dose of subligual nitroglycerin (NTG).

RESULTS

1) In hypertensives, the P wave velocity showed lower and P-Tc interval shorter than those of the normal controls at baseline. 2) After NTG, the P-Tc and P/T increased, but the T and FVI decreased significantly in both groups of subjects. 3) The P/T ratio was less significantly increased after NTG in the hypertensives than in the controls. These results suggest that NTG might have been involved in concomitant reduction and delay of the wave reflection from the peripheral vessels, preferentially in the normal subjects than in hypertensives.

CONCLUSIONS

The carotid Doppler echography can be useful for the evaluation of the changes of hemodynamics in the peripheral vessel such as carotid artery in hypertensive subjects.

Antimicrobial activity of propolis on oral microorganisms

Formation of dental caries is caused by the colonization and accumulation of oral microorganisms and extracellular polysaccharides that are synthesized from sucrose by glucosyltransferase of Streptococcus mutans. The production of glucosyltransferase from oral microorganisms was attempted, and it was found that Streptococcus mutans produced highest activity of the enzyme. Ethanolic extracts of propolis (EEP) were examined whether EEP inhibit the enzyme activity and growth of the bacteria or not. All EEP from various regions in Brazil inhibited both glucosyltransferase activity and growth of S. mutans, but one of the propolis from Rio Grande do Sul (RS2) demonstrated the highest inhibition of the enzyme activity and growth of the bacteria. It was also found that propolis (RS2) contained the highest concentrations of pinocembrin and galangin.

Molecular genetic characterization of alternatively spliced CD44 transcripts in human stomach carcinoma

CD44 is a member of cell surface glycoproteins which are involved in cell-matrix adhesion and tumor metastasis. Certain types of tumors express complex CD44 isoforms generated by alternative splicing of 2v-10v exons, and their expression appears to promote metastasis of tumor cells. Using a nested RT-PCR, we analyzed expression of CD44 variants in 26 stomach carcinoma, 21 matched normal tissues, and 2 carcinoma cell lines. We observed frequent and complex patterns of CD44 variant expression in tumor tissues. While exons 6v and 7v expression was detected in most normal and tumor tissues, exon 9v was most rarely detected. Exon 5v showed a significantly frequent expression in carcinoma, suggesting that its expression might contribute to the malignant progression. While exon 9v was frequently observed in diffuse-type tumors, the other 8 variant exons including 6v showed more frequent expression in intestinal-type tumors. Exons 9v and 10v were predominantly expressed in advanced tumor tissues and exon 8v was expressed more frequently in tumors of lymph node metastasis. We believe that series with a longer follow-up now need to be tested to clarify the association between CD44 splice variant expression and distant metastasis or long-term prognosis.

Pancreatic endocrine tumor admixed with a diffuse microcystic adenoma--a case report

We report a case of pancreatic endocrine tumor admixed with a diffuse microcystic adenoma in a 67-year-old woman with a six months history of melena. Whipple's operation and near-total pancreatectomy were performed under the impression of a pancreatic cancer with duodenal invasion. The pancreas was enlarged and was entirely replaced by sponge-like tiny cysts, which were lined by a single layer of periodic acid Schiff positive cuboidal cells. Also encountered was a gray white solid area at the head portion which extended to the duodenum with an intraluminal polyp formation. The compact area was composed of solid and acinar structures of tumor cells, which showed a positive reaction for chromogranin A and neuron specific enolase, separated by delicate highly vascularized stroma. To the best of our knowledge, this is the first case report published with immunohistochemical studies to deal with a pancreatic endocrine tumor admixed with a diffuse microcystic adenoma.

Renin angiotensin system in rabbit corpus cavernosum: functional characterization of angiotensin II receptors

PURPOSE

The regulation of the corporal smooth muscle tone is important in the process of penile erection. Although specific angiotensin (ANG) II binding to and effects of ANG II on some reproductive structures have been studied, the presence of the renin-angiotensin system has not yet been defined in the corpus cavernosum. ANG II is formed from ANG I by angiotensin I-converting enzyme (ACE). ANG II and ANG I produce contractions in vascular smooth muscles. Two subtypes of ANG II receptors (AT1 and AT2) have been characterized. The purpose of the present experiments was to determine whether the renin-angiotensin system regulates rabbit corpus cavernosum smooth muscle tone.

MATERIALS AND METHODS

A strip of rabbit corpus cavernosum was mounted in an organ chamber to measure the isometric tension. The specific binding for 125I-ANG II was characterized by in vitro autoradiography.

RESULTS

ANG II and ANG I, precursor of ANG II, contracted corpus cavernosum smooth muscle dose-dependently, but the response of smooth muscle to ANG I was 10-fold less than that to ANG II. Contractile responses of smooth muscle to ANG II and ANG I were blocked by Dup 753, a specific inhibitor of ANG II type 1 receptor, but not by PD 123,319, a specific inhibitor of ANG II type 2 receptor. The effect of ANG I was attenuated by captopril, an inhibitor of ACE. Specific binding sites for 125I-ANG II were found in the corpus cavernosum. The dissociation constant (Kd) was 5.32 +/- 1.65 nM. and maximum binding capacity (Bmax) was 305.72 +/- 85.24 amol/mm. Specific binding of 125I-ANG II was displaced by Dup 753 (10(-6) M) but not by PD 123,319 (10(-5) M). The inhibitory constant (Ki) for Dup 753 was 8.09 +/- 2.51 nM.

CONCLUSION

The present results suggest that the renin-angiotensin system is involved in the regulation of corpus cavernosum smooth muscle tone of rabbit and the ANG II receptor subtype AT1 is important in the regulation of penile erection.

Evolutionary stasis of M1 gene of human influenza A viruses and the possibility of their subtyping by restriction analysis of M1 gene polymerase chain reaction product

Nucleotide (nt) and amino acid (aa) sequences of the M1 protein in 36 human influenza A viruses were analyzed. The neighbor joining tree of the nt sequences revealed several lineages associated with past epidemics of human influenza. However, the tree of aa sequences revealed only few specific lineages. This discrepancy in phylogeny between nt and aa sequences indicates that the M1 protein of human influenza A virus nearly reached an evolutionary stasis. A simple subtyping method of human influenza A viruses by restriction fragment length polymorphism (RFLP) analysis of M1 gene polymerase chain reaction (PCR) products is discussed.

Cloning and characterization of two catA genes in Acinetobacter lwoffii K24

Two novel type I catechol 1,2-dioxygenases inducible on aniline media were isolated from Acinetobacter lwoffii K24. Although the two purified enzymes, CD I1 and CD I2, had similar intradiol cleavage activities, they showed different substrate specificities for catechol analogs, physicochemical properties, and amino acid sequences. Two catA genes, catA1 and catA2, encoding by CD I1 and CD I2, respectively, were isolated from the A. lwoffii K24 genomic library by using colony hybridization and PCR. Two DNA fragments containing the catA1 and catA2 genes were located on separate regions of the chromosome. They contained open reading frames encoding 33.4- and 30.4-kDa proteins. The amino acid sequences of the two proteins matched well with previously determined sequences. Interestingly, further analysis of the two DNA fragments revealed the locations of the catB and catC genes as well. Moreover, the DNA fragment containing catA1 had a cluster of genes in the order catB1-catC1-catA1 while the catB2-catA2-catC2 arrangement was found in the catA2 DNA fragment. These results may provide an explanation of the different substrate specificities and physicochemical properties of CD I1 and CD I2.

Renin angiotensin system in rabbit corpus cavernosum: functional characterization of angiotensin II receptors

PURPOSE

The regulation of the corporal smooth muscle tone is important in the process of penile erection. Although specific angiotensin (ANG) II binding to and effects of ANG II on some reproductive structures have been studied, the presence of the renin-angiotensin system has not yet been defined in the corpus cavernosum. ANG II is formed from ANG I by angiotensin I-converting enzyme (ACE). ANG II and ANG I produce contractions in vascular smooth muscles. Two subtypes of ANG II receptors (AT1 and AT2) have been characterized. The purpose of the present experiments was to determine whether the renin-angiotensin system regulates rabbit corpus cavernosum smooth muscle tone.

MATERIALS AND METHODS

A strip of rabbit corpus cavernosum was mounted in an organ chamber to measure the isometric tension. The specific binding for 125I-ANG II was characterized by in vitro autoradiography.

RESULTS

ANG II and ANG I, precursor of ANG II, contracted corpus cavernosum smooth muscle dose-dependently, but the response of smooth muscle to ANG I was 10-fold less than that to ANG II. Contractile responses of smooth muscle to ANG II and ANG I were blocked by Dup 753, a specific inhibitor of ANG II type 1 receptor, but not by PD 123,319, a specific inhibitor of ANG II type 2 receptor. The effect of ANG I was attenuated by captopril, an inhibitor of ACE. Specific binding sites for 125I-ANG II were found in the corpus cavernosum. The dissociation constant (Kd) was 5.32 +/- 1.65 nM. and maximum binding capacity (Bmax) was 305.72 +/- 85.24 amol/mm. Specific binding of 125I-ANG II was displaced by Dup 753 (10(-6) M) but not by PD 123,319 (10(-5) M). The inhibitory constant (Ki) for Dup 753 was 8.09 +/- 2.51 nM.

CONCLUSION

The present results suggest that the renin-angiotensin system is involved in the regulation of corpus cavernosum smooth muscle tone of rabbit and the ANG II receptor subtype AT1 is important in the regulation of penile erection.

Clinical characteristics of progressive vitiligo

BACKGROUND

Vitiligo is an acquired hypopigmentary disorder with a progressive clinical course. Various clinical characteristics and their significance in the progression of vitiligo were evaluated.

METHODS

A clinical study was carried out on 400 patients who had visited the Vitiligo Special Clinic of Severance Hospital, Yonsei University College of Medicine. Questionnaires were completed regarding progression, sex, family history, clinical type, onset age, duration of disease, Koebner's phenomenon, leukotrichia, and mucosal involvement, and the results were recorded.

RESULTS

Progression of vitiligo was seen in 355 patients (88.8%); 45 patients (11.2%) did not show progression. No difference in sex, onset age, or leukotrichia was noted between the two groups; however, patients with positive family histories, nonsegmental clinical type, longer duration, Koebner's phenomenon, and mucous membrane involvement showed more progression of vitiligo.

CONCLUSIONS

Clinical characteristics such as family history, clinical type, duration of disease, Koebner's phenomenon, and mucous membrane involvement, may be relevant in predicting the progression or prognosis of vitiligo.

Complete sequence of the UPP gene encoding uracil phosphoribosyltransferase from Mycobacterium bovis BCG

The nucleotide sequence of a 799 bp fragment of Mycobacterium bovis BCG containing the putative upp gene that encodes a uracil phosphoribosyltransferase (UPRTase [EC 2.4.2.9]) has been determined. The upp gene of BCG has an open reading frame (ORF) of 621 bp (207 amino acids) starting with GTG (position 112) and ending with TGA (position 733), and its molecular mass was calculated to be 21,864 Da. Comparative analyses of the deduced amino acid sequence of BCG UPRTase with the UPRTase of six bacterial genera revealed that 24% (50/211) of the residues are perfectly conserved and 32% (67/211) of the residues are well conserved.

Ischemic necrosis of the entire femoral head and rapidly destructive hip disease: potential causative relationship

OBJECTIVE

Rapidly destructive hip disease (RDHD) is an uncommon disorder of the hip that has been considered a disease of unknown cause and distinct from ischemic necrosis of the femoral head. The objective of this study was to investigate ischemic necrosis of the femoral head as one potential cause of RDHD.

DESIGN AND PATIENTS

In 600 patients who underwent MR imaging of the hip, 20 cases of ischemic necrosis involving the entire femoral head in 18 patients (3%) were retrospectively studied with routine radiography and MR imaging. All patients had surgically confirmed ischemic necrosis of the femoral head.

RESULTS AND CONCLUSIONS

All patients showed rapid destruction of the femoral head on routine radiography and MR imaging as compared with the gradual onset of clinical symptoms. Plain radiographs showed several bone fragments at the inferomedial aspect of the femoral head (75%), acetabular erosions (55%), eccentric depression at the lateral articular surface of the femoral head conforming to the adjacent acetabulum (35%), and mild osteoarthritis (15%). Bone sclerosis was often present at sites of impaction between the femoral head and the acetabulum. MR imaging showed marked distention of the joint capsule in all cases. In 14 of 20 cases, the contents of the joint space showed predominantly low or intermediate signal intensity on T1- and T2-weighted images. Ischemic necrosis involving the entire femoral head may represent one of the causes of RDHD.

Oncogenic osteomalacia caused by a phosphaturic mesenchymal tumor of the oral cavity: a case report

We report a case of oncogenic osteomalacia associated with a phosphaturic mesenchymal tumor in a 31-year-old woman. She was presented with severe generalized bone and muscle pain and was restricted to bed. She lost 20 cm in height over the 8 years since she had first noticed a pain in her thigh. A walnut-sized, hard, soft tissue tumor was found very easily beside her lower molar teeth Radiologic examination revealed a remarkable decrease in bone density and multiple pathologic fractures of spine, femur and phalangeal bones. Severe hypophosphatemia, hyperphosphaturia, low plasma 1,25-dihydroxyvitamin D3 level and high plasma PTH level were disclosed at presentation. Histomorphometric examination revealed an extensive area of unmineralized osteoid and little mineralizing activity. A pharmacologic dose of 1 alpha-hydroxyvitamin D3 or or 1,25-dihydroxyvitamin D3 slightly increased the serum phosphate level and renal tubular reabsorption of phosphate, and slightly decreased plasma PTH level without any symptomatic improvement. Histologic examination of the tumor revealed a mixed connective tissue tumor that consisted of central woven bones and surrounding primitive spindle cells with prominent vascularities. After removal of the tumor, all biochemical, hormonal and radiologic abnormalities disappeared with remarkable symptomatic improvement.

Ten-year experience of phototherapy in Yonsei Medical Center

Phototherapy with PUVA or UVB has been used to treat a wide variety of diseases such as psoriasis, vitiligo, atopic dermatitis and mycosis fungoides, etc. The present study was performed to investigate the pattern of phototherapy in the phototherapy clinic of Yonsei Medical Center. One thousand six hundred ninety two patients who received PUVA or UVB phototherapy were included in this study. We analyzed the protocols for phototherapy between 1985 and 1994. The number of phototherapy per year increased sharply until 1991 and thereafter it has remained relatively constant. The most common age group at the start of phototherapy was the third decade. The most common indications for PUVA and UVB phototherapy were vitiligo and psoriasis, respectively. Most patients had received less than 50 treatments of PUVA and less than 200 J/cm2 of cumulative UVA. Most patients had received less than 50 treatments with UVB and cumulative UVB doses were variable. We had not found any malignancy in the skin. Since the maximum safe cumulative doses of UVA or UVB have not yet been established, it is difficult to decide when phototherapy should be discontinued. The data presented in this study needs to be further analyzed in correlation with photoaging and cancer development for the safe usage of phototherapy.

Envelope gene sequence variation among Japanese encephalitis viruses isolated in Korea

The nucleotide (nt) sequences of the envelope (E) gene of 4 Japanese encephalitis virus (JEV) isolates from Korea (K82PO1, K87P39, K91P55 and K94PO5) were determined and the deduced amino acid (aa) sequences were compared within themselves and with the published sequences of 16 other JEV strains originating from other parts of Asia. Homologies of 87.2 - 95.6% at the nt level and 95.8 - 98.0% at the aa level among the Korean JEV isolates were found. aa positions 89, 129, 220, 225, 327, 366, 456 and 477 characterized the Korean isolates. According to the phylogenetic analysis based on the E gene nt sequence, the Korean isolates formed distinct subgroup consisting of at least 2 genetic types.

Myxoma of the mandible

Myxoma of the jaw bone is a peculiar and rare tumor. A case of myxoma of the mandible is described in a 38-year-old man. The plain X-ray showed multiple osteolytic destructive lesions in the molar root area. CT scans demonstrated osteolytic expansile lesions with mild enhancement of the solid portion of the mass. Histologically, the tumor is composed of plump stellate cells with abundant amorphous myxoid stroma.

Biochemical characteristics of osmophilic yeasts isolated from pollens and honey

A total of 1752 strains of osmophilic yeasts were isolated from honey and pollens. Forty-three strains of osmophilic yeasts produced polyols, among which 6 strains produced erythritol in good yields. On the other hand, 52 osmophilic yeasts converted sucrose to fructooligosaccharides, among which 8 strains produced both extra and intracellular beta-fructofuranosidase, which converted sucrose to fructooligosaccharides. This investigation concluded that osmophilic yeasts converted sucrose not only to polyols, but also to fructooligosaccharides in good yields.

Left subclavian artery bypass graft in complicated arterial switch operation

We report the successful use of left subclavian artery bypass graft in a newborn infant with complete transposition of the great arteries accompanied by an unusual coronary artery pattern, in whom left coronary artery insufficiency developed after the arterial switch operation. This procedure has shown good clinical results, with interesting follow-up angiographic findings 8 months after the operation.

Internal pH crisis, lysine decarboxylase and the acid tolerance response of Salmonella typhimurium

Salmonella typhimurium possesses an adaptive response to acid that increases survival during exposure to extremely low pH values. The acid tolerance response (ATR) includes both log-phase and stationary-phase systems. The log-phase ATR appears to require two components for maximum acid tolerance, namely an inducible pH homeostasis system, and a series of acid-shock proteins. We have discovered one of what appears to be a series of inducible exigency pH homeostasis systems that contribute to acid tolerance in extreme acid environments. The low pH-inducible lysine decarboxylase was shown to contribute significantly to pH homeostasis in environments as low as pH 3.0. Under the conditions tested, both lysine decarboxylase and sigma s-dependent acid-shock proteins were required for acid tolerance but only lysine decarboxylase contributed to pH homeostasis. The cadBA operon encoding lysine decarboxylase and a lysine/cadaverine antiporter were cloned from S. typhimurium and were found to be 79% homologous to the cadBA operon from Escherichia coli. The results suggest that S. typhimurium has a variety of means of fulfilling the pH homeostasis requirement of the ATR in the form of inducible amino acid decarboxylases.

Changing phosphorus content of the U.S. diet: potential for adverse effects on bone

The dietary intake of phosphorus in the United States is high relative to calcium. Intake estimates from the 1989-1991 Continuing Surveys of Food Intakes by Individuals conducted by the U.S. Department of Agriculture show that for both men and women, median calcium intakes do not meet the 1989 Recommended Dietary Allowances (RDAs) for most age groups over 10 y of age, whereas phosphorus intakes exceed the RDAs for most age groups. The use of phosphorus-containing food additives in the processing of foods contributes substantially to the daily phosphorus intake, and their use is increasing. Because much of the phosphorus through food additive use is not reflected in the estimates of phosphorus intakes derived from national food consumption surveys, these estimates underestimate true dietary intakes of phosphorus. High phosphorus intake has been shown to cause secondary hyperparathyroidism and bone loss in several animal models. High phosphorus, low calcium consumption consistent with current observed intake levels resulted in changes in calcium-regulating hormones that were not conducive to optimizing peak bone mass in young women. Evidence that such high phosphorus intakes may impair synthesis of the active metabolite of vitamin D and disrupt calcium homeostasis particularly in older women are discussed.

Calcific tenosynovitis associated with calcific myonecrosis of the leg: imaging features

The findings with histologically proven calcific tenosynovitis of the tibialis anterior tendon associated with calcific myonecrosis are described. This case emphasizes the typical appearance of this unusual relationship such as peripheral plaque-like calcifications of the tendon sheath, fluid-calcium levels, presentation as painless mass, and calcification and liquefaction of muscle bundles.

Detection of antibodies to human melanoma cells in vitiligo and alopecia areata by Western blot analysis

Antibody reactivity to human melanoma cells (SK-Mel-23) was investigated in 48 patients with vitiligo, 14 with alopecia areata (AA), and 35 normal control individuals by Western blot analysis. Antibodies to SK-Mel-23 were found in 44 (92%) of the patients with vitiligo, in 7 (50%) of the patients with AA, and in 14 (40%) of the normal control individuals. Significant differences between patients with vitiligo and normal controls were found in the incidence and distribution of antibodies, but no significant differences were found between patients with AA and normal controls. The antibodies were predominantly directed to one or more antigens of approximately 110 KD, 103 KD, 88 KD, 70 KD, 56 KD, 46 DK, or 41 KD. The most common responses were to 110 KD, 88KD, and 70 KD antigens. These antibodies were present in 60%, 60%, and 73% of the patients with vitiligo; 7%, 14% and 35% of the patients with AA; and 11%, 11% and 40% of normal control individuals, respectively. There were no statistical differences in the incidence of antibodies to pigment cells between segmental and non-segmental vitiligo. These findings suggest that autoreactivity to pigment cells occurs mostly in patients with vitiligo and might be a secondary immune reaction to destroyed pigment cells.

Identification of autoantibody to melanocytes and characterization of vitiligo antigen in vitiligo patients

Patients with vitiligo have circulating antibodies to melanocytes. To identify vitiligo antibodies and characterize the antigens by vitiligo antibodies, sera of 18 patients with vitiligo, 18 with Behcet's disease, 22 with syphilis and 14 normal control subjects were analyzed by indirect immunofluorescence, live cell ELISA, and immunoblotting. In indirect immunofluorescent microscopy and live cell ELISA, most vitiligo sera showed positive immunofluorescence and high optical density on the surface of melanocytes cultured from normal and vitiligo patients, indicating that autoantibodies in the vitiligo sera may react with vitiligo antigens on the surface of melanocytes. When the same experiments were performed with malignant melanoma cell lines and fibroblasts, no significant differences in the immunofluorescence and optical density were observed between normal and vitiligo sera. And the sera of patients with Behcet's disease or syphilis showed no significant difference in the reaction of live cell ELISA to fibroblasts, IGR-3 and melanocytes. The antibody titers of vitiligo patients in live cell ELISA decreased following systemic steroid treatments. Immunoblot analysis demonstrated that 44% of vitiligo sera was directed to melanocyte antigen with a molecular weight of 65 kDa. Inhibition assay using rabbit anti-melanocyte antibody showed inhibition of reaction between vitiligo sera and melanocytes in ELISA and immunoblotting. These findings support the hypothesis that the sera of vitiligo patients have autoantibodies mostly directed to the 65-kDa antigen and this antigen may originate mostly from the melanocyte surface.

The impact of osteonectin for differential diagnosis of osteogenic bone tumors: an immunohistochemical and in situ hybridization approach

Thirty-three osteosarcomas at various grades of histologic differentiation, including chondroblastic, osteoblastic, and fibroblastic variants, were investigated immunohistochemically for evidence of osteonectin. Twenty-two cases of varying types of osteosarcoma were examined with in situ hybridization for mRNA expression of osteonectin. Immunohistochemically, osteonectin was present in all the osteosarcomas in this study. With in situ hybridization, 12 out of 22 osteosarcomas showed a positive signal. Two osteochondrosarcomas, seven chondrosarcomas, and one mesenchymal chondrosarcoma were also studied with regard to the localization of osteonectin, either immunohistochemically or by in situ hybridization. Immunohistochemically, osteonectin was present in all the chondroid lesions except for one osteochondroma. However, in situ hybridization of osteonectin mRNA was negative in all the chondroid lesions we studied. This study revealed that immunohistochemical localization of osteonectin is not useful in providing conclusive diagnosis of osteosarcoma. In situ hybridization of osteonectin mRNA might be useful in differentiating osteosarcoma from nonsteogenic bone tumors.

Influence of 17- alpha-estradiol on catecholamine secretion from the perfused rat adrenal gland

OBJECTIVES

It has been known that adrenal corticosteroids influence the expression of adrenomedullary catecholamine-synthetizing enzymes and also suppress the emission of axonal-like processes in cultured chromaffin cells. In the present study, it was attempted to investigate the effect of 17-alpha-estradiol on catecholamine (CA) secretion evoked by acetylcholine (ACh). DMPP. McN-A-343, excess K+ and Bay-K-8644 from the isolated perfused rat adrenal gland.

METHODS

Mature male Sprague-Dawley rats were anesthetized with ether. The adrenal gland was isolated by the method of WaKade. A cannula used for perfusion of the adrenal gland was inserted into the distal end of the renal vein. The adrenal gland, along with ligated blood vessels and the cannula, was carefully removed from the animal and placed on a platform of a leucite chamber.

RESULTS

The perfusion of 17-alpha-estradiol (1-100 uM) into an adrenal vein for 20 min produced relatively dose-dependent inhibition in CA secretion evoked by ACh (5.32 mM). DMPP (100 uM for 2 min). McN-A-343 (100 uM for 2 min) and Bay-K-8644 (10 uM for 4 min), while it did not affect the CA secretory effect of high K+ (56 mM). Also, in the presence of 17-beta-estradiol. CA secretion of ACh. DMPP and McN-A-343, without any effect on excess K(+)-evoked CA sectretion was depressed. However, in adrenal glands pre-loaded with 17-alpha-estradiol (10 uM) plus tamoxifen (2 uM), which is known to be a selective antagonist of estrogen receptors (for 20 min). CA secretory responses evoked by ACh. DMPP and McN-A-343 were condiderably recovered as compared to that of 17-alpha-estradiol only, but excess K(+)-induced CA secretion was not affected. However, pre-treatment with 17-alpha-estradiol in the presence of meclopramide (dopaminergic antagonist) did not affect the secretory effect of CA evoked by ACh. DMPP, McN-A-343 and high potassium.

CONCLUSIONS

These results suggest that 17-alpha-estradiol causes the marked inhibition of CA secretion evoked by cholinergic receptor stimulation, but not that by excess K+, indicating strongly that this effect may be mediated by inhibiting the influx of extracellular calcium into the rat adrenomedullary chromaffin cells through the activation of inhibitory estrogen receptors, and it also plays a modulatory role in regulating CA secretion.

Assessment of diagnostic utility of anti-CD34 in soft tissue tumors

We have performed this study to define the usefulness of an anti-human progenitor cell antigen-1(anti-CD34) to distinguish some kinds of soft tissue tumors in formalin-fixed, paraffin-embedded tissues. Sixty three cases of vascular, fibrohistiocytic, neural and other tumors were immunostained for CD34 using the streptavidin-biotin immunoperoxidase method. All of the vascular tumors including hemangiomas, epithelioid hemangioendotheliomas, hemangiopericytomas, and lymphangiomas revealed strong CD34 positivity along the cytoplasmic membranes. Among the fibrohistiocytic lesions, all of five examples of dermatofibrosarcoma protuberans showed diffuse, strong, and linear staining along the cytoplasmic processes. In contrast, none of the benign fibrous histiocytomas and malignant fibrous histiocytomas expressed CD34. CD34-positive cells with delicate dendritic processes could be identified within the normal nerves, neuromas, neurofibromas, and Antoni B areas of neurilemomas. However, all of the malignant peripheral nerve sheath tumors were uniformly negative. In addition, an epithelioid sarcoma and four cases of leiomyosarcoma revealed focal, weak positivity with anti-CD34. In conclusion, this study demonstrated variable anti-CD34 staining pattern of certain fibrohistiocytic, muscle, and neural tumors and confirmed the potential usefulness of anti-CD34 in differentiating fibrous histiocytoma from dermatofibrosarcoma protuberans. It's also helpful to diagnose epithelioid hemangioendothelioma from other epithelioid-type tumors.

Relationship between tissue plasminogen activator, plasminogen activator inhibitor and CT image in chronic subdural hematoma

The present study was performed to investigate the relationship between the concentrations of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) and the CT images in 23 cases of chronic subdural hematomas (SDHs). The concentrations of t-PA and PAI-1 were quantified by enzyme-linked immunosorbent assay (ELISA). Chronic SDHs were divided into five groups according to their appearance on computed tomography: high-density (n = 4), isodensity (n = 8), low-density (n = 5), mixed-density (n = 3), layering (n = 3) types. The volume of hematoma was measured with an image analyzing software program. The concentrations of t-PA were higher in layering (41.2 +/- 0.3 ng/ml, mean +/- standard error of the mean) and high-density (40.0 +/- 1.1 ng/ml) types compared to those of low-density (23.3 +/- 4.1 ng/ml) and iso-density (25.1 +/- 3.7 ng/ml) types. The concentrations of PAI-1 were lower in layering (95.9 +/- 1.0 ng/ml) and high-density (103.4 +/- 34.5 ng/ml) types compared to that of low-density (192.5 +/- 2.6 ng/ml) type. So the ratio between t-PA and PAI-1 (t-PA/PAI) was greater in layering and high-density types. The volume of hematoma was larger in mixed-density and layering types but statistically insignificant. These results presumably suggest that the ratio between t-PA and PAI concentration may contribute to the pathogenesis of the chronic SDH.

Expression of p53 protein, PCNA, and Ki-67 in osteosarcomas of bone

Expressions of p53 protein, a product of the tumor suppressor gene were studied in osteosarcomas relating to various prognostic factors. Thirty-four osteosarcomas were investigated immunohistochemically with a monoclonal antibody clone PAb240, which recognizes a common conformational epitope of mutant p53 proteins and another clone PAb1801, which reacts with both wild- and mutant-type p53 proteins. The results were compared with expressions of proliferating cell nuclear antigen (PCNA) and Ki-67 providing a simple method for the assessment of growth fractions of tumors. PAb240 stained nuclei and cytoplasm of tumor cells in 8 of 34 osteosarcomas (23.5%), whereas PAb1801 reacted in all 34 osteosarcomas (100%). Fifteen tumors (44.1%) showed positivity for PAb1801 in more than half of the tumor cells. Twelve patients were alive and thirteen were dead. Tumors from 9 patients (75%) who survived revealed only focal positive immunoreactions with PAb1801 and tumors from 6 patients (46.1%) who died revealed diffuse reactions. Twelve cases (35.3%) showed a high PCNA index (> 40%) and fibroblastic osteosarcomas revealed the highest PCNA positivity. Twenty-two cases (64.7%) revealed a very low Ki-67 index (less than 10%) and Ki-67 index showed a good correlation with PCNA positivity (r = 0.6247). Expressions of both wild-and mutant-type p53 protein, PCNA, and Ki-67 were not correlated with other clinical or pathological parameters.

Osteocalcin expression in primary bone tumors--in situ hybridization and immunohistochemical study

Osteocalcin is one of the most abundant noncollagenous proteins found in adult bone. It is a highly conserved gamma-carboxyglutamic acid-containing protein that is believed to be produced exclusively by osteoblasts. In this study, intracellular and extracellular localization of osteocalcin in osteosarcoma was examined with anti-osteocalcin antibody and in situ hybridization using a synthetic oligonucleotide. Immunohistochemically, osteoblastic osteosarcomas were all positive for osteocalcin. The chondroblastic osteosarcomas were positive on the neoplastic chondrocytes. The five fibroblastic osteosarcomas out of seven were positive for osteocalcin immunostaining over the neoplastic spindle cells. Five cases of osteoblastic osteosarcomas out of seven were positive for osteocalcin in situ hybridization. Two cases of chondroblastic osteosarcomas and three cases of fibroblastic osteosarcomas were positive for in situ demonstration of osteocalcin. The malignant tumor giant cells were positive for osteocalcin immunostaining 83%. They were also positive for in situ hybridization. The benign giant cells in five giant cell tumors and five aneurysmal bone cysts were negative for osteocalcin immunostaining. The benign giant cells in three chondroblastoma and three Paget's disease were positive for osteocalcin. In this study, the osteocalcin in situ hybridization and immunostaining has very important meaning for making differential diagnoses of, especially giant cell rich bone forming tumors.

Well-differentiated, low-grade osteosarcoma of the clivus

A case of well-differentiated osteosarcoma of the sphenoid bone was reported. The pathological differentiation of this rare entity from fibrous dysplasia, the radiographic appearance, and the differential diagnosis were discussed.

Perspective on the 1986 Food and Drug Administration assessment of the safety of carbohydrate sweeteners: uniform definitions and recommendations for future assessments

Carbohydrate sweeteners in the diet, which are sources of added sugars, have recently undergone changes that vary considerably among countries. The major driving force for these changes is a technological development that permits conversion of corn and other starches to sweeteners. Major changes in the type of sweeteners used in the United States began in the mid-1970s. In 1986 the US Food and Drug Administration comprehensively evaluated exposures and potential health effects of sugars contained in carbohydrate sweeteners. A UK Department of Health report followed in 1989. An overview of issues is provided, terminologies used to describe sugars and sweeteners are defined, the findings of the US and UK reports are reviewed, trends in the availability of added and naturally occurring sugars are evaluated, and recommendations for future assessment of sugars are discussed. The potential problem of underreporting of food intakes in national food consumption surveys is also reviewed.

Protection by lysosomal hydrolase inhibitors against cytotoxicity of 2-chloroethylethyl sulfide

A possible participation of lysosomal hydrolases in the cytotoxicity of 2-chloroethylethyl sulfide in spleen lymphocytes was investigated using inhibitors of lysosomal phospholipases and proteases. Pepstatin (6 microM) and leupeptin (60 microM), inhibitors of lysosomal proteases, raised the viability of lymphocytes exposed to 2-chloroethylethyl sulfide from 63 to 87 and 88% of control, respectively. Serine protease inhibitors showed no significant effect on viability. Aminoglycoside inhibitors of lysosomal phospholipases were also found to prevent the decrease in viability of spleen lymphocytes exposed to 2-chloroethylethyl sulfide, and the effectiveness of these aminoglycosides (30 microM) was as follows: gentamicin > kanamycin > streptomycin, with viability increased to 89, 79 and 67%, respectively. In contrast to a co-operative action between leupeptin and gentamicin, the protection by pepstatin was reduced in the presence of gentamicin. Moreover, the order of the aminoglycosides in terms of the extent to which they antagonized the protective action of pepstatin was the same as their order of efficacy in preventing the cytotoxicity of CEES. It is suggested that inhibitors of lysosomal hydrolases reduce the cytotoxicity of 2-chloroethylethyl sulfide, presumably through lysosomal stabilization in spleen lymphocytes.

Opposing effects of ultraviolet B irradiation on interleukin-1 receptor antagonist and interleukin-1 alpha messenger RNA expression in a human epidermoid carcinoma cell line

Interleukin-1 receptor antagonist (IL-1RA) is a cytokine that acts to antagonize IL-1 activity without agonist function. The expression of IL-1RA has been reported in many cell types, including the keratinocyte that covers the outer most part of the skin. However the modulation of IL-1RA by ultraviolet B (UVB), which is the most biologically active UV, has not been reported yet. We therefore selected a keratinocyte cell line with a cytokine-producing profile similar to that of keratinocytes and tested the effect of UVB on its ability to produce IL-1RA mRNA. IL-1RA mRNA was constitutively expressed in the cell line and began to be suppressed by 3 h after the UVB irradiation with 100 mJ/cm2. The level of IL-1RA expression became lowest by 16 h after the irradiation with 100 mJ/cm2. Simultaneously, IL-1 alpha mRNA started to increase by 1 h and peaked by 3-16 h after the irradiation with 10-100 mJ/cm2. The differential expression of IL-1 alpha and IL-1RA mRNA following exposure to a high dose (100 mJ/cm2) of UVB may markedly potentiate the role of IL-1 in UV-induced inflammation.

An immunohistochemical study of the expression of p53 protein in colon cancer

A total of 471 cases of colonic adenocarcinomas and 28 cases of colonic adenomas were examined immunohistochemically to evaluate the expression of p53 protein in the light of their relationship with various prognostic factors. A monoclonal antibody, p53 DO-7, was used in the study. Two hundred and fourteen adenocarcinomas (45.5%) showed positive staining for p53, however only three of the adenomas (10.3%) were positive (P < 0.05). p53 was stained to neoplastic nuclei. Adjacent normal mucosal cells were negative. There were no significant correlations between p53 expression and prognostic parameters such as age, sex, gross configuration, modified Astler-Coller stages, microscopic tumor growth patterns, tumor depth, tumor size and lymph node involvements. However, left sided adenocarcinomas (49.3%) expressed p53 more often than right sided adenocarcinomas (35.6%) (P = 0.01). The positive rates were different according to the histologic differentiation; 45.2% in well differentiated, 51.3% in moderately well differentiated, 23.8% in poorly differentiated, and 26.5% in mucinous carcinomas (P = 0.011). The mean survival periods of the p53 positive and negative groups were 29 months and 32 months, respectively (P = 0.385). However, overall survival for patients with grade one and two positive p53 was better than those of grade three and four positive cases (P = 0.028). In conclusion, the result of this multivariate analysis suggests that immunohistochemically strong p53 protein expression (more than 30% of tumor cells) has value in estimating a prognosis for patients with colorectal adenocarcinomas.

Treatment of stable vitiligo with autologous epidermal grafting and PUVA

BACKGROUND

Previous reports have shown the benefits of epidermal grafting for vitiligo.

OBJECTIVE

Our purpose was to evaluate the effectiveness and complications of epidermal grafting in combination with PUVA on stable vitiligo refractory to conventional treatments.

METHODS

In 100 patients with stable refractory vitiligo we performed epidermal grafting with suction blisters followed by PUVA treatment. The grafted sites were examined for repigmentation for up to 5 years.

RESULTS

Excellent repigmentation was observed at all grafted sites, especially on the face except for the lip and the alae nasae. PUVA treatment resulted in spreading of the pigmentation. Poor results were observed on the neck, axillae, and overlying bony prominences. Hyperpigmentation of the recipient and donor sites was frequently observed. Only six patients had recurrence and/or adjacent new lesions. Depigmentation developed at the donor site in only one patient with generalized vitiligo. Long-term observation in these patients indicates that repigmentation obtained by this method is permanent.

CONCLUSION

Although epidermal grafting in combination with PUVA has some limitations, it is an easy, safe, inexpensive, and effective treatment for various types of stable refractory vitiligo.

Two human cases of Thelazia callipaeda infection in Korea

Thelazia callipaeda were observed from a 7-month old baby who lived in Uijongbu in 1989 and from a 42-year old man who lived in Anyang in 1994. These are the 23rd and 24th records of human thelaziasis in Korea as the literature are concerned.

A small cell osteosarcoma on the calcaneus--a case report

Small cell osteosarcoma is rare, representing 1-4% of all osteosarcomas. We experienced a case of small cell osteosarcoma in an 8-year-old girl on her calcaneus. Histologically, the tumor consists of small round cells that resemble those of Ewing's sarcoma, and variable foci of lacy osteoid formation between tumor cells. The rare location, histologic characteristics and differential diagnostic points are discussed.

Diet and heart disease: health claims

The Nutrition Labeling and Education Act of 1990 states, in part, that a product is misbranded if it bears a claim that characterizes the relationship of a nutrient to a disease or health-related condition (health claim), unless the claim is made in accordance with Food and Drug Administration (FDA) regulations. In response to the new law, on January 6, 1993, the FDA promulgated regulations that described general requirements for health claims on foods in conventional food forms and specific requirements for seven authorized health claim topics. Three authorized claims are related to heart disease: dietary saturated fat and cholesterol and coronary heart disease; fruits, vegetables and grain products that contain fiber, particularly soluble fiber, and risk of coronary heart disease and sodium and hypertension. The general requirements regulation specifies the scientific standard for assessing the validity of claims, criteria for the qualification of claims, conditions for disqualification and general labeling requirements for health claims. Approval for health claims is based on the totality of publicly available scientific evidence and significant agreement among experts qualified by scientific training and experience to evaluate the relationship. On January 4, 1994, the FDA finalized similar requirements for health claims on dietary supplements.

Chondromyxoid fibroma of the femur: a case report with intra-cortical location

Chondromyxoid fibroma (CMF) is the least common benign cartilaginous tumor, comprising less than 0.5 to 1% of all skeletal neoplasms. This subject was a 16-year-old female with a three-year history of pain involving the distal femoral metaphysis. This case showed an unusual feature: it was intracortical in location. Radiologic differential diagnosis included metaphyseal fibrous defect, periosteal chondroma, simple or aneurysmal bone cyst, and cortical abscess. On operation, the lesion filled the intracortical defect with whitish myxoid soft tissue, bulging into the adjacent soft tissue. Microscopically, it showed typical features of chondromyxoid fibroma composed of mainly myxoid nodules and peripheral fibrous elements with focal chondroid differentiation.