Recognition of sialosaccharide chains of glycophorin on damaged erythrocytes by macrophage scavenger receptors

Binding of mouse erythrocytes oxidized in vitro mildly with diamide, periodate or ADP/Fe3+, and the erythrocytes incubated in vitro in a serum-free medium for 12 h (in vitro aged erythrocytes) to mouse peritoneal macrophages was effectively inhibited by isolated glycophorin A, a major sialoglycoprotein of human erythrocyte membrane existing as oligomers in solution, and some of known ligands for macrophage scavenger receptors such as maleyl-BSA, dextran sulfate, fucoidan and polyinosinic acid. Binding of oxidized low density lipoprotein (ox-LDL) to macrophages was inhibited by glycophorin A as well as the known ligands. When the sialyl residues of the saccharide chains of glycophorin A were cleaved by neuraminidase, or the polypeptide of glycophorin A was digested by Pronase, which would destroy its oligomeric forms, the inhibitory effect of glycophorin A was decreased, suggesting that isolated glycophorin A binds to scavenger receptors depending on its sialyl residues and oligomeric structure. Glycopeptides prepared from the N-terminal region of glycophorin A containing most of the sialosaccharide chains of the molecule inhibited the binding of ox-LDL although the potency was lower than that of glycophorin A. N-Acetylneuraminic acid at a high concentration also inhibited the ox-LDL binding. Uptake and degradation of 125I-labeled ox-LDL by macrophages was inhibited by glycophorin A, N-acetylneuramin lactose, as well as the known ligands. 125I-labeled glycophorin A bound to macrophages, and the binding was inhibited by the unlabeled glycophorin A and the known ligands. Inhibitory activity of the unlabeled glycophorin A against the labeled glycophorin A-binding was lowered by neuraminidase and Pronase treatment. These results suggest that oxidized and in vitro aged mouse erythrocytes are recognized by scavenger receptors of mouse peritoneal macrophages, and the cell surface components recognized are sialosaccharide chains of glycophorin, possibly glycophorin A counterpart of mouse erythrocytes which clustered or aggregated in the membrane. The finding indicates that the cell surface sialosaccharides can be ligands for scavenger receptors when cells undergo denaturation by oxidative stress or other damaging effects.

Traumatic basilar impression: case report

A very rare case of traumatic basilar impression is reported. The patient, a 57-year-old man, was hit on the head vertically in the parietal region. X ray of the cervical spine and computed tomography (CT) scans showed intracranial indentation of the atlas and the odontoid process with a depressed fracture around the foramen magnum. There are no previous reports about this type of fracture.

Involvement of peroxynitrite in N-methyl-D-aspartate- and sodium nitroprusside-induced release of acetylcholine from mouse cerebral cortical neurons

Functional roles of peroxynitrite in N-methyl-D-aspartate (NMDA)- and sodium nitroprusside (SNP)-evoked releases of acetylcholine (ACh) from cerebral cortical neurons in primary culture have been investigated. NMDA increased the release of ACh in a dose-dependent manner, which was significantly suppressed by (+)-5-methyl-10,11-dihydro-5H-dibenzo-[a,d]cycloheptan-5,10-imine (MK-801), a non-competitive antagonist specific for the NMDA receptor complex, and NO synthase inhibitors. SNP also showed a concentration-dependent increase in ACh release. Hemoglobin significantly abolished the stimulatory effects of both NMDA and SNP on ACh release. In addition, superoxide anion scavengers such as superoxide dismutase and ceruloplasmin significantly reduced the increased ACh release evoked by NMDA and SNP. Synthesized peroxynitrite dose-dependently elevated the release of ACh. These results indicate that the increased release of ACh by NMDA and SNP is mediated through peroxynitrite formed in the reaction of superoxide anion with nitric oxide produced by NMDA receptor activation and liberated from SNP rather than nitric oxide itself.

Role of nitric oxide in learning and memory and in monoamine metabolism in the rat brain

1. We investigated the effects of NG-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide (NO) synthase, on the performance of rats in a radial arm maze and in habituation tasks, and on monoamine metabolism in the brain. 2. Daily administration of L-NAME (10-60 mg kg-1) resulted in a dose-dependent impairment of performance during the acquisition of the radial arm maze task, while it failed to affect performance in those rats that had previously acquired the task. 3. The rate of decrease in locomotor activity in the habituation task in the L-NAME-treated rats was significantly less than that in control rats. 4. NG-nitro-D-arginine methyl ester (D-NAME, a less active inhibitor of NO synthase) showed no effects in the above behavioural tasks. 5. NO synthase activity was significantly decreased in both the L-NAME and D-NAME-treated rats, with the magnitude of inhibition being greater in the L-NAME-treated animals. 6. The content of 5-hydroxyindoleacetic acid (5-HIAA) in the hippocampus and the 5-HIAA/5-hydroxytryptamine ratio in the hippocampus and cortex were significantly decreased in the L-NAME (60 mg kg-1)-treated rats compared with these values in the controls. 7. Striatal 3,4-dihydroxyphenylacetic acid (DOPAC) content was significantly increased in the L-NAME (60 mg kg-1)-treated rats compared with the values in the controls, while the DOPAC/dopamine ratio was not changed. 8. These results suggest that: (i) NO may play an important role in performance during the acquisition,but not retention, of the radial arm maze task, and (ii) that endogenous NO may be involved in the regulation of monoamine metabolism.

[Intrathoracic transposition of the musculocutaneous flap in treating empyema]

A 62-year-old woman suffered right empyema caused by methicillin-resistant staphylococcus aureus (MRSA) which occurred following a pancreatico-duodenectomy. After open drainage thoracotomy, intrathoracic transposition of the extended musculocutaneous (MC) flap of the latissimus dorsi was performed. The patient is now in good health, without recurrence of either the empyema or the carcinoma, 19 months after the operation. The MC flap, compared to muscle flap, has the advantages that (1) larger empyema cavities can be obliterated, and (2) the deformity of the thoracic wall can be minimized, because of the small range of resected rib segments and well-preserved volume of subcutaneous tissue in the flap long after transposition.

The attenuation of suppression of motility by triazolam in the conditioned fear stress task is exacerbated by ethanol in mice

We investigated whether triazolam attenuated the suppression of motility in the conditioned fear stress task in mice and whether ethanol modified the effects of triazolam. When mice were placed 24 hours later (retention test) in the same environment in which they had previously been exposed to an electric foot shock (training), they exhibited a marked suppression of motility (conditioned fear stress). Triazolam (0.01-0.1 mg/kg, s.c.), administered before training, attenuated the suppression of motility in the conditioned fear stress task in a dose-dependent manner, without affecting the sensitivity to an electric foot shock. The doses of triazolam that attenuated the suppression of motility were much lower that those of chlordiazepoxide (5-10 mg/kg, s.c.). Neither drug, administered before the retention test, attenuated the suppression of motility in the conditioned fear stress task. These results suggest that both benzodiazepines may inhibit the process of acquisition, but not the process of recall, of memory. Ethanol (1 g/kg, p.o.), which, by itself, did not affect either the suppression of motility or the sensitivity to an electric foot shock, exacerbated the attenuation of the suppression of motility in the conditioned fear stress task induced by both triazolam (0.01 mg/kg) and chlordiazepoxide (5 mg/kg). These results suggest that ethanol exacerbates the effects of benzodiazepines.

Diagnostic relevance of abortion-associated human embryonic antigen expressed on the cell surface of tumour promoter-treated Bloom syndrome cells

We detected stable expression of human embryonic antigen associated with spontaneous abortion (HEAA) on the cell surface of a tumour promoter-treated B lymphoblastoid cell line (BS-SHY) originating from Bloom syndrome. We used indirect immunofluorescence and diluted serum from 44 patients who had recurrent spontaneous abortions. With the use of the panning procedure, we separated characteristic cells expressing strong HEAA. The BS-SHY-HEAA cells separated here would be useful for measuring serum antibody (against HEAA) produced by patients with recurrent abortions. It was also noted that aborters who received husbands' leukocyte immunization have lost this antibody, and have delivered successful pregnancies at term. Using HEAA proteins, we conducted Western blotting analysis for the amino acid sequencing (mol. wt 77 kDa). Amino acid sequencing data indicated that HEAA had 87.5% homology to the immunoglobulin (Ig) VHIII region in the framework. Recently, the protective value of high dose i.v. administration of immunoglobulin in the treatment of recurrent spontaneous abortions has been reported to be similar to that of leukocyte immunization. Therefore, the BS-SHY-HEAA cells appear to provide a valuable tool for rapid serological diagnosis and for evaluating the efficacy of immunotherapy with husbands' leukocytes in patients with recurrent spontaneous abortions.

[Rupture of dissecting aortic aneurysm associated with the right-sided aortic arch and anomalous course of the left brachiocephalic vein--a case report]

A case of ruptured dissecting aortic aneurysm (DeBakey IIIb) associated with the right sided aortic arch and anomalous course of the left branchiocephalic vein was reported. A sixty-nine-year-old female suddenly had the severe back pain and soon fell into shock. The diagnosis of a ruptured dissecting aortic aneurysm associated with the right sided aortic was obtained on CT scanning. CT films also showed the left brachiocephalic vein behind the ascending aorta. Emergency operation was performed through median sternotomy and left thoracotomy. The descending aorta, forming an aneurysm with the aberrant subclavian artery, prominently protruded far to the left, and was located behind the trachea and the esophagus. Extra-anatomical bypass grafting was performed between the ascending aorta and the distal descending aorta. The patient eventually died of multiple organ failure on the 11th day after operation. These findings were confirmed by autopsy. A rare vascular anomaly with aortic dissection was reported, and a surgical approach to that lesion was discussed.

Synthesis and investigation of N4-substituted cytarabine derivatives as prodrugs

Esters of Cytarabine-N4-carboxylates 2a-i and succinamates 3a-f were synthesized as prodrugs of cytarabine (Ara-C) with the aim of developing improved derivatives for oral or parentral administration. At pH 2 series 2 showed relative higher stability than 3, while both series of esters revealed matched stability at pH 7. All esters were susceptible to enzymatic hydrolysis by rat plasma and liver homogenate with half lives ranged from 0.14 h to 12 d, and showed improved stability against cytidine deaminase. A parabolic relation was shown between Kobs of enzymatic hydrolysis and Vw. All compounds are more lipophilic than the parent drug, Ara-C.

[Intracellular signal transduction of endocrine organs and expanded DNA fragment size in myotonic dystrophy]

The Ellsworth-Howard (EH) test was performed in 16 patients with myotonic dystrophy (DM), who were divided into two groups according to serum calcium level; Group I showing normal serum calcium (8 patients) and Group II with hypocalcemia (8 patients). Patients in Group II were recognized as having pseudohypoparathyroidism (PHP) type II and those in Group I as normal. Therefore, it was suggested that an abnormality of A kinase might be present in Group II patients. We additionally performed the thyrotropin releasing hormone (TRH) tolerance test in the same patients and 7 normal controls to examine an abnormality of C kinase. delta TSH (delta TSH: peak minus pre TSH) values in DM patients were significantly lower than those in normal controls. Moreover, delta TSH values in Group II were significantly lower than those in Group I. It was suggested that the abnormality of C kinase might be present in Group II patients. Taken together, our results indicated that some patients with DM might possess abnormalities of signal transduction of both A and C kinases. We compared the degree of endocrine involvement determined by both the EH test and the TRH tolerance test with expanded DNA fragment (EF) size determined by standard Southern blot analysis using an appropriate cDNA probe (cDNA25 probe). There was significant negative correlation between EF size and the results of the EH test and negative correlation between the EF size and the results of the TRH tolerance test. These findings suggested that EF size might be correlated with disease severity in affected endocrine organs.

Intrathoracic transposition of the musculocutaneous flap in treating empyema

Intrathoracic transposition of the musculocutaneous (MC) flaps of the latissimus dorsi and rectus abdominis was performed after open-drainage thoracotomy in 6 patients with empyema. The MC flaps were designed in such a way that the muscle-bearing skin paddle was extended well beyond the distal muscle borders. The MC flaps thus provided substantially larger pieces compared to muscle flaps. With the exception of one patient with persistent bronchopleural fistula whose empyema recurred due to the reopening of the fistula, the thoracic closure was successful in all patients. Postoperative magnetic resonance imaging revealed a well-preserved volume of subcutaneous tissue in the flaps, while the muscle portions of the flaps had atrophied. In conclusion, compared to muscle flaps, MC flaps have the advantages that (1) larger empyema cavities can be obliterated, and (2) the deformity of the thoracic wall can be minimized because of the small range of resected rib segments and well-preserved volume of subcutaneous tissue in the flap long after the transposition. The use of MC flaps is thus indicated for the empyema cavity remaining when a cavity is cleaned up of granulatous tissue with eradication of bronchopleural fistula.

Regulation of early T cell development by the engagement of TCR-beta complex expressed on fetal thymocytes from TCR-beta-transgenic scid mice

Transgenic expression of the beta-chain of T cell antigen-receptor (TCR) is known to induce the generation of CD4+ CD8+ thymocytes in the immunodeficient scid mouse, in which thymocyte development is otherwise arrested at CD4- CD8- cells. It is not clear, however, whether or not the thymocyte development is controlled by ligand engagement of the TCR-beta complex on the cell surface. In the present study, we have examined how the engagement by Ab of the TCR-beta complex expressed on the TCR-beta-transgenic scid fetal thymocytes can regulate the generation of CD4+ CD8+ thymocytes. Organ cultures of CD4- CD8- day 14 fetal thymocytes from the TCR-beta-transgenic scid mice resulted in the generation of CD4- CD8+ and then CD4+ CD8+ cells. The initial step from CD40- CD8- cells to CD4- CD8+ cells was enhanced by the addition of anti-TCR-beta Ab, whereas the subsequent step from CD4- CD8+ cells to CD4+ CD8+ cells was markedly inhibited by anti-TCR-beta Ab. These results indicate that ligand engagement of the TCR-beta complex can positively and negatively regulate the early thymocyte development. Moreover, the finding that engagement of TCR-beta complex inhibits the generation of CD4+ CD8+ cells suggests that the induction of CD4+ CD8+ thymocytes by the TCR-beta transgene is not an immediate consequence of cell-surface engagement of the TCR-beta complex but requires liberation from the continued TCR-beta signaling.

Elevation of plasma noradrenaline levels in urethane-anaesthetized rats by activation of central prostanoid EP3 receptors

1. We studied the effects of intracerebroventricular (i.c.v.) administration of prostaglandin E2 (PGE2) and its receptor subtype ligands on plasma levels of catecholamines in urethane-anaesthetized rats. 2. Administration of PGE2 (0.15, 0.3 and 1.5 nmol per animal, i.c.v.) dose-dependently elevated plasma levels of noradrenaline (NA), while the levels of adrenaline were not affected. 3. Administration of sulprostone (EP3/EP1 agonist) and misoprostol (EP3/EP2 agonist) effectively elevated plasma NA levels in a dose-dependent manner (0.1, 0.3, and 1.0 nmol per animal). Butaprost (EP2 agonist) (0.3, 1.0 and 3.0 nmol per animal) was without effect. 17-Phenyl-omega-trinor PGE2 (EP1/EP3 agonist) effectively elevated plasma NA levels only at its highest dose (1.0 nmol per animal), but this elevation was not attenuated by pretreatment with SC-19220 (selective EP1 antagonist) (20 nmol per animal, i.c.v.). 4. The potency of these test agents in elevating plasma levels of NA was as follows; misoprostol > sulprostone > PGE2 > > 17-phenyl-omega-trinor PGE2 > > > butaprost. These results suggest that activation of central prostanoid EP3-receptors induces central sympathetic outflow in rats.

A new family of Boucher-Neuhäuser syndrome: coexistence of Holmes type cerebellar atrophy, hypogonadotropic hypogonadism and retinochoroidal degeneration: case reports and review of literature

The association of familial hypogonadism with progressive cerebellar ataxia is only rarely encountered, and the exact link between the symptoms remains unknown. We report here two sisters presenting with Holmes type cerebellar ataxia, hypogonadotropic hypogonadism and retinochoroidal degeneration recently diagnosed as Boucher-Neuhäuser syndrome. There was consanguinity between the parents of the affected individuals and the condition seemed to be inherited as an autosomal recessive defect. On endocrinological examinations, in both cases, the responses of LH and FSH to LH-RH (100 micrograms) were impaired even after repetitive stimulation with LH-RH (400 micrograms, 7 days), suggesting that the hypogonadism was due to a primary pituitary disturbance. Impaired GH responses to GRF (100 micrograms) and insulin-induced hypoglycemia (0.1 U/kg) were also noted. The two sisters shared an almost identical clinical and endocrinological picture. Their karyotypes were 46, XX. They had been treated for primary and secondary amenorrhea at the age of 20 years and neurological problems had started at the age of 30 years. This unique family displays clinical evidence of a possible common mechanism responsible for a progressive hypothalamo-pituitary and cerebellar impairment of late onset.

Orthotopic liver transplantation for ornithine transcarbamylase deficiency with hyperammonemic encephalopathy

Ornithine transcarbamylase (OTC) deficiency is an X chromosome-linked disorder causing hyperammonemic encephalopathy with a very poor prognosis. We describe here two patients with OTC deficiency, one a late on-set female patient (case 1) and the other a neonatal-onset male patient (case 2), who were successfully treated with orthotopic liver transplantation (OLTx). The OTC activity in the excised liver was 10% and 0% of control, respectively. Hyperammonemic encephalopathy was controlled with medical therapy in case 1 until the of 5 years, but the complicated course in case 2 in which hyperammonemia required peritoneal dialysis and hemodialysis in the neonatal period necessitated OLTx with a reduced-size liver at the age of 80 days. Both patients had restoration of serum ammonia level to normal in 2 and 3 days after liver replacement, and both patients have normal neurological and developmental status after 2 and 0.5 years of postoperative follow-up. These cases illustrate not only the metabolic cure of this disorder, but also the need to preserve neurological integrity by aggressive medical management of the hyperammonemia preoperatively and early surgical intervention when indicated, even if this is required very early in life.

Identification of iso(18p) marker chromosome by fluorescence in situ hybridization with single-copy DNA probe

The patient displayed the clinical features consistent with tetrasomy (18p) syndrome, who had an extra small metacentric iso(18p) chromosome in otherwise normal karyotype. Identification of the marker chromosome used the chromosome 18 band-specific fluorescence in situ hybridization strategy.

Inhibitory action of acyclovir (ACV) and penciclovir (PCV) on plaque formation and partial cross-resistance of ACV-resistant varicella-zoster virus to PCV

Penciclovir has potent antiviral activity against varicella-zoster virus (VZV). We have characterized the inhibitory effects of penciclovir and acyclovir on the plaque formation of cell-free VZV and cross-resistance of acyclovir-resistant VZV to penciclovir. The apparent effective concentration for 50% plaque reduction (EC50) of penciclovir determined on the third day was significantly lower than that determined on the fourth or fifth day. The size of plaques was smaller in the presence of penciclovir than in the presence of acyclovir. The effective concentrations for 50% reduction of the number of infected cells per plaque were 1.40 and 5.00 micrograms/ml for penciclovir and acyclovir, respectively. Thus penciclovir suppressed spread of infection within developing plaques more efficiently than acyclovir. Five acyclovir-resistant VZV strains with altered DNA polymerase selected by acyclovir were examined for cross-resistance to penciclovir. They were 11- to 18-fold more resistant to ACV than the parent strain, but only 4- to 5-fold more resistant to PCV. Penciclovir-triphosphate carrying the 3'-hydroxyl group of 2'-deoxyribose might have better affinity to the altered viral DNA polymerase than acyclovir-triphosphate without the 3'-hydroxyl group.

Hot water extracts of Chlorella vulgaris reduce opportunistic infection with Listeria monocytogenes in C57BL/6 mice infected with LP-BM5 murine leukemia viruses

The bacterial elimination after infection with Listeria monocytogenes was impaired in mice with murine acquired immunodeficiency syndrome (MAIDS) by infection with LP-BM5 murine leukemia virus. Oral administration of hot water extracts of Chlorella vulgaris (CVE) restored the capacity of MAIDS mice to eliminate L. monocytogenes in association with improvement of the deteriorated immune response to L. monocytogenes. DTH response to Listeria in CVE-treated MAIDS mice was significantly higher than that of MAIDS mice after Listeria infection in association with increases in number of CD4+CD8- and CD4-CD8+ alpha beta T-cells in the infected sites. CVE might be effective in the treatment of opportunistic infection in retrovirus-induced immunodeficient patients.

Possible involvement of nitric oxide in quinolinic acid-induced convulsion in mice

Quinolinic acid (QA) induced clonic and tonic convulsions in mice when it was injected into the cerebral ventricle. Pretreatment with L-arginine (L-Arg), a substrate of nitric oxide (NO) synthase (NOS), and/or 5,6,7,8-tetrahydrobiopterin (THB), cofactor of NOS, tended to potentiate QA-induced convulsion. NG-monomethyl-L-arginine (NMMA), a competitive NOS inhibitor, diminished QA-induced convulsion. This effect of NMMA was attenuated by coadministration of L-Arg or THB. Sodium nitroprusside (SNP), which spontaneously releases NO, did not potentiate, but diminished QA-induced convulsion. These findings suggest that an endogenous NO may be involved, at least in part, in QA-induced convulsion in mice, and that an exogenous NO released from SNP may cause downregulation of N-methyl-D-aspartate (NMDA) receptor activity, and thereby prevent the excessive excitation of NMDA receptors and subsequent convulsion caused by QA.

Regulation of early T cell development by the engagement of TCR-beta complex expressed on fetal thymocytes from TCR-beta-transgenic scid mice

Transgenic expression of the beta-chain of T cell antigen-receptor (TCR) is known to induce the generation of CD4+ CD8+ thymocytes in the immunodeficient scid mouse, in which thymocyte development is otherwise arrested at CD4- CD8- cells. It is not clear, however, whether or not the thymocyte development is controlled by ligand engagement of the TCR-beta complex on the cell surface. In the present study, we have examined how the engagement by Ab of the TCR-beta complex expressed on the TCR-beta-transgenic scid fetal thymocytes can regulate the generation of CD4+ CD8+ thymocytes. Organ cultures of CD4- CD8- day 14 fetal thymocytes from the TCR-beta-transgenic scid mice resulted in the generation of CD4- CD8+ and then CD4+ CD8+ cells. The initial step from CD40- CD8- cells to CD4- CD8+ cells was enhanced by the addition of anti-TCR-beta Ab, whereas the subsequent step from CD4- CD8+ cells to CD4+ CD8+ cells was markedly inhibited by anti-TCR-beta Ab. These results indicate that ligand engagement of the TCR-beta complex can positively and negatively regulate the early thymocyte development. Moreover, the finding that engagement of TCR-beta complex inhibits the generation of CD4+ CD8+ cells suggests that the induction of CD4+ CD8+ thymocytes by the TCR-beta transgene is not an immediate consequence of cell-surface engagement of the TCR-beta complex but requires liberation from the continued TCR-beta signaling.

Molecular cloning of cDNA for equine ovarian inhibin/activin beta A subunit

cDNAs encoding equine inhibin/activin beta A subunit were isolated from an equine follicle cDNA library and characterized. Using primers based on the rat inhibin/activin beta A subunit cDNA sequence, a RT-PCR was performed to generate the probe for screening. Four positive clones were isolated. Analysis of the nucleotide sequence of these clones revealed that two pairs of identical clones were present, Eq-beta A-1 (0.9 kb) and Eq-beta A-2 (1.5 kb). Eq-beta A-2 clone contained a complete open reading frame encoding 426 amino acids. The deduced amino acid sequence of equine inhibin/activin beta A subunit showed high similarity (> 90%) to those of five other mammalian species. Northern blot analysis revealed that placenta from mare on day 180 of pregnancy contained a 1.5 kb inhibin/activin beta A subunit mRNA.

Brain distribution characteristics of xanthine derivatives and relation to their locomotor activity in mice

The relationship between the brain distribution and motor activity in mice of the xanthines, theophylline, enprofylline, 1-methyl-3-propylxanthine (MPX) and oxpentifylline was investigated. Their plasma protein binding and hydrophobicity were also examined. When these xanthines were administered orally, enprofylline and oxpentifylline had no effect on motor activity. While theophylline increased motor activity over 10 mg kg-1, MPX caused a decrease in such activity over 10 mg kg-1. The protein-binding behaviour varied among these xanthines and was closely related to their hydrophobicity, which is represented as a logarithmic partition coefficient (log PC). MPX had the highest hydrophobicity, while oxpentifylline had the lowest. Brain distribution characteristics varied among these xanthines, with the rank order of their brain penetration ratio, calculated as the ratio of brain to unbound plasma concentrations, being theophylline > oxpentifylline > MPX > enprofylline. The inhibition constants (Ki) for adenosine A1 receptors and cyclic 3',5'-adenosine monophosphate (cAMP)-phosphodiesterase (PDE) of these xanthines were 44.6 and 134, > 1000 and 112, 26.4 and 49, and > 1000 and 111 microM for theophylline, enprofylline, MPX, and oxpentifylline, respectively. These findings suggest that the lack of effects of enprofylline and oxpentifylline on motor activity is probably due to their low brain penetration ratio or low adenosine A1 affinity in comparison with theophylline. The decrease in the motor activity by MPX may be, in part, mediated by cAMP or adenosine.

Impairment of respiratory rhythmogenesis and sequelae of bacterial meningitis

A 9-year-old boy with respiratory disturbance associated with medullary lesions after pneumococcal meningitis is reported. Although he lives a normal daily life, he cannot cough or sneeze. A polysomnographic study revealed a low respiration rate and an irregular respiratory rhythm not only during REM sleep but also during slow wave sleep, and marked desaturation during sleep. Respiratory function tests including CO2 response revealed normal values. Magnetic resonance imaging demonstrated bilateral small lesions in the medulla. This patient is unusual because respiratory rhythm is impaired, without decreased ventilatory capacity or CO2 response, supporting the possibility that rhythmogenetic respiratory neurons are located in a limited area of the human medulla.