[An autopsy case of Smith-Lemli-Opitz syndrome]

A 17 month-old girl was found dead in her bed. The findings of a juditial autopsy revealed that she had a cleft palate, low-set and accessory ears, and syndactyly of right and left second and third toes and right third and fourth toes. Her birth size was small and subsequently she failed to thrive. Organ anomaly, such as atriaol septal defect, accessory spleens, and uterus bicornis bicollis were found. From these findings, this case was diagnosed as a Smith-Lemli-Opitz syndrome.

Identification and dynamics of paraquat in the bone marrow, thymus and spleen in rats using immunohistochemical techniques

We reported the immunohistochemical identification of paraquat in the immune and hematopoietic systems such as bone marrow, spleen and thymus. Twelve paraquat-poisoned rats were sacrificed in 3 h, 12 h, 3 days, 7 days and 10 days after intravenous administration of paraquat. In the bone marrow, paraquat was localized in several types of blood cells (granulocyte, erythrocyte and megakaryocyte) and their precursors between 24 h and 7 days after the injection. In the thymus, paraquat was mainly localized in the medulla between 12 h and 7 days after the injection, whereas in the spleen, it was mainly localized in the red pulp between 12 h and 10 days after administration of paraquat.

[Gastric motility in patients with spleen-deficiency symptoms]

By using a method for synchronously-detecting gastric myoelectric activity and intraluminal pressure and a radioimmunoassay of plasmic motilin, gastric motility, plasmic level of motilin and their relationship in 12 normal individuals and in the patients with a variety of Spleen-Deficiency (SD) Syndromes, i.e. 12 SD with Cold type (H type), 7 SD with Stomach-Yin-Deficiency type(I type), 38 SD with Heat type (R type) and 6 SD with Liver-Qi-Stagnation type (U Type) were investigated. The results showed: degree of myoelectric dysrhythmia and rate of electro-mechanical decouple in all patients (except for I type) were much higher than those in the normals (P < 0.01 or P < 0.05); both mean frequency and amplitude of contraction in the patients were decreased; percentage of contractive action in the patients (except for I type) was lower than that in the normals (P < 0.05); plasmic level of motilin in the patients (except for I type) had a tendency to increase and had a linear correlation to degree of myoelectric dysrhythmia (r = 0.33, P < 0.01). It was suggested that some significant disorders of gastric motility exist in different SD patients and there might be an intrinsic cause effect relationship among increased plasmic motilin, myoelectric dysrhythmia and abnormal mechanical motion. The similar changes suggested that there is pathophysiological mechanism of SD syndrome. Furthermore, this synchronously-detecting method was useful to discover intrinsic relationship between gastric myoelectric activity and mechanical motion.

Intercellular localization of leukotoxin (9:10-epoxy-12-octadecenoic acid) in lungs in rats by an immunoelectron microscopy

In this paper intercellular localization of leukotoxin (9:10-epoxy-12-octadecenoic acid, LTx) in neutrophils and alveolar macrophages of rats exposed to the 100% oxygen was demonstrated by a pre-embedding method of an immunoelectron microscopy. The Sprague-Dawley rats were treated with the 100% oxygen for 72 hrs, and the lungs were stained with anti-LTx IgG (Fab) by an immunocytochemical method and examined by a transmission electron microscope. The positive reactions with anti-LTx IgG (Fab) was shown strongly in the rough-surfaced endoplasmic reticulum (rER) and cell membranes of the neutrophils and alveolar macrophages. This result indicates that LTx is produced in biomembrane-rich organelle of alveolar macrophages as well as neutrophils dependently on the treatment period under hyperoxia conditions, suggesting that LTx is closely related to biological reactions and is an important chemical mediator on pulmonary diseases.

Personal identification from human remains using morphological characteristics and DNA analysis

This report describes personal identification of four parts of a dismembered human body on the basis of physical characteristics and DNA analysis. A 69-year-old woman suffering from depression went missing from her home in May 1992. Five days after her disappearance, a female torso was found in a river. In a two-week period thereafter, a left forearm, a female head and neck and a right forearm were found consecutively in the same river. Although the end of the cervical vertebra was anatomically identical to that of the torso, the two forearms did not match. However, DNA analyses with a single-locus DNA probe pYNH24, DO alpha typing and a multi-locus DNA probe "Myo", indicated that these four parts came from the same person. The missing woman had undergone lobectomy of the right pulmonary upper lobe, and had suffered from slight scoliosis of the thoracic vertebrae and a second lumbar vertebral compression fracture. These characteristics were also observed in the torso. In order to obtain more conclusive evidence, DNA fingerprinting using DNA extracted from the torso, the missing woman's brother and her daughter was performed using the DNA probes described above. The data obtained indicated that the remains were those of the missing woman.

Experience with cloned mitochondrial DNA analysis to forensic practice

The sequencing method of the D-loop region of cloned mitochondrial DNA (mtDNA) together with multilocus and single locus DNA probe patterns was applied to identification of the dismembered and putrefied remains of a pregnant woman. The multilocus DNA fingerprinting was useful to identify whether or not 4 dismembered remains were from the body of the same person, whereas the single locus DNA analysis was useful to decide that the suspect was the father of the fetus. On the other hand, the sequencing method of the D-loop region of cloned mtDNA after amplification by polymerase chain reaction (PCR) was particularly advantageous to highly degraded and contaminated DNA specimens.

[Effects of dimethylformamide on the monocytophagocytic system of rodents]

The effects of Dimethylformamide (DMF) on monocytophagocytic system (MPS) of rodents were studied. The results showed large dose of DMF (1/20 LD50) with oral administration could significantly inhibit the functions of colloidal carbon clearance of MPS in Wistar rats, and of non-specific phagocytosis of sheep red blood cells (SRBC) by peritoneal macrophage in Kunming mice, and could also lowered significantly the levels of Fc and C3b receptors on the surface of peritoneal macrophage in mice. This showed DMF could cause obvious damage to MPS.

[Study of clinical pathology and discussion of surgical strategy in comprehensive mitral valvuloplasty]

The results of clinical pathologic study of 162 mitral valves (MV) intraoperatively and pathologic anatomy of 8 excised MV were reported. Type I 64 cases, type II 23 cases and type III 75 cases. The pathogenic causes were congenital heart disease in 22 cases degeneration in 27 cases infective endocarditis in 1 case and rheumatic disease in 112 cases. Of the excised MV, 7 rheumatic lesion with type III. All valve components were involved. The valve leaflets thickened significantly and valve orifice changed like a funnel or semi-funnel shape. Under light microscope there was no interface between the increased collagen fibers and the valve tissue. Some superficial collagen fibers appeared hyalinosis. The calcification, local necrosis and inflammatory cell infiltration could be seen in some cases but the rheumatic bodies and the chordae tendineae wrapped up in the thickened valve tissue only in one case respectively degenerative lesion with thin chordae tendineae which appeared muco-hyalinosis and ruptured in three points. According to the clinical pathology of MV the indication and surgical technique are discussed.

Comparison of Shams' test for rectal mucus to an immunological test for fecal occult blood in large intestinal carcinoma screening. Analysis of a check-up of 6480 asymptomatic subjects

The sugar moiety detected from rectal mucus by the Galactose oxidase-schiff (Shams' test) is considered a substitutive test for immunological fecal occult blood test (FOBT) in screening colorectal carcinoma. Two strategies of screening were applied in 6480 subjects over 40 years of age, and 130 cm flexible colonoscope used for sigmoidoscopy or pancolonoscopy. Of them, 3820 were taken for immune FOBT (SPA test) and Shams' test. Only those who showed positive tests were chosen for 60 cm flexible sigmoidoscopy, while another 2660 subjects for both sigmoidoscopy and tests at the same time. Additionally, 130 cm flexible pancolonoscopy was carried out in 103 individuals with positive Shams' test for evaluating the false positive rate. Shams' test showed a sensitivity of 85.7% for colorectal cancer, 47.1% for adenomas in preselected patients, while the positive rate of SPA test were 90.5% and 41.2% respectively. In 3820 asymptomatic subjects undergoing sequential screening (aged 45 years and higher), Shams' test showed 9.1% positive, SPA showed 11.2% and 620 (16.2%) subjects were selected for sigmoidoscopy based on their positive galactose oxidase result or positive FOBT result. Two early stage carcinomas and 33 adenomas (0.32% and 4.2% respectively in sigmoidoscopy) were found. Another 2 660 subjects were taken for sigmoidoscopy screening. Four carcinomas and 78 adenomas were found. Of them, only two carcinoma (50%) and 17 (21.8%) or 22 (28.2%) adenomas were positive in Shams' or SPA test. But both tests combined in screening showed a rate of 61.3% in adenomas and 75.0% in cancers. 103 subjects with positive Shams' test were taken for pancolonoscopy. 82.5% showed no lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case report of acute death caused by hyperextension injury of neck]

We report an autopsy case of acute death from an upper cervical spinal cord injury caused by hyperextension of the neck. A 59-year-old drunken man who had been suffering from cervical spondylosis was slapped in the face, fell flat on his face, and remained as such for 4 hours. The victim was carried to a hospital, he had already been dead on arrival. Although he received an intensive care, he remained unconscious for 12 hours until a cardiac arrest. The findings of an autopsy were as follows: Externally, excoriation on the forehead and the left eyebrow and slight subcutaneous hemorrhage in the dorsum of the nose were observed. The intervertebral disk and the anterior longitudinal ligament between the 5th and 6th cervical vertebrae were severed, and a lot of bleeding in the region of the injuries was observed. The 6th cervical spinous process was fractured in the direction to a major axis. A part of the posterior root filaments was torned and the bleeding points could be seen on the front of the 6th cervical spinal cord. In the cross section of the 6th cervical spinal cord, the typical hemorrhagic necrosis could be recognized surrounding the central canal, whereas the similar finding was observed at the second cervical spinal cord. On the histopathological examinations, in C2, C5-C6 regions marked ischemic changes and hemorrhagic necrosis could be observed. From these post-mortem results, we diagnosed that the victim died from an upper spinal cord damage due to a stretching consequence of the hyperextentional injury.

Novel detection of plankton from lung tissue by enzymatic digestion method

Studies are reported on the enzymatic digestion method for detection of plankton from lung tissue by using proteinase K with sodium dodecyl sulphate. This method is simple, safe and effective for detection of not only phytoplankton including diatoms but zooplankton which are destroyed by the acid digestion method. The present method is, therefore, much more advantageous for diagnosis of drowning than the disorganization method using strong acids.

Immunohistochemical localization of paraquat in skin and eye of rat

Immunohistochemical techniques were used to observe the localization of paraquat in the skin and eyes of rats. Paraquat poisoned rats were killed 3 h, 12 h, 24 h, 3 days, 7 days and 10 days after intravenous administration of paraquat. In skin, paraquat was localized in the ducts of sweat glands and sebaceous glands between 3 and 10 days after paraquat injection. In eyes, weak positive findings were observed in nerve fibers of retina between 3 and 10 days after the injection. In cornea, paraquat was localized in epithelial cells at the first 3 h and between 3 and 10 days after paraquat administration. Since skin occupies a vast area of the body in animals, as an organ, it seems to be an important storage pool for the redistribution of paraquat.

Transport characteristics of paraquat across rat intestinal brush-border membrane

The mechanism of absorption of paraquat, which is a type of quaternary ammonium compound (QAC), was studied using rat intestinal loops and brush-border membrane vesicles. Approximately 47% and 37% of radioactively labeled paraquat injected into jejunal and ileal loops disappeared, respectively, after 60 min. Since only a small amount of radioactivity was detected in the mucosal fraction, most of the paraquat that disappeared from the intestinal lumen was considered to have been carried away by the bloodstream, indicating that paraquat absorption was greater than expected. In spite of its low lipid solubility, the uptake of paraquat by brush-border membrane vesicles reflected smooth penetration into the intravesicular space rather than binding to the membrane. According to the increase in extravesicular paraquat concentration, paraquat uptake in the early stage was saturable. Moreover, early paraquat uptake was significantly inhibited by structurally-related QACs such as tetramethylammonium and choline, but not by an endogenous dicationic amine (putrescine). On the other hand, inside-negative membrane potential had no significant effect on the time course of paraquat uptake. From these results, it is suggested that paraquat is absorbed through a specialized mechanism associated with the carrier-mediated transport system for choline on the brush-border membrane.

Immunohistochemical localization and dynamics of paraquat in the stomach and esophagus of rats

The dynamics of paraquat in the stomach and esophagus of rats were demonstrated using immunohistochemical techniques. The Rats were killed 3h, 12h, 24h, 3 days, 7 days and 10 days after intravenous administration of paraquat. In the stomach, paraquat was localized in the epithelial cells between 24 h and 10 days after injection, whereas in the esophagus, paraquat was localized in epithelial cells and the lamina propria mucosa between 12h and 10 days after administration. Although these findings were similar to those observed in the intestine of rats, no clear changes in the distribution of paraquat with time were observed, suggesting that the stomach and esophagus are important reservoirs for the redistribution of paraquat.

Production and characterization of antibodies reactive with leukotoxin

A sensitive radioimmunoassay was developed for the determination of leukotoxin (9: 10-epoxy-12-octadecenoic acid), which was reported to exist in human burned skin and neutrophils, and was regarded as a toxic and/or defensive substance in living beings. The leukotoxin was conjugated with bovine serum albumin by means of the mixed anhydride technique as immunogen and rabbits were immunized over 4 months. According to a titration test of antiserum, forty-fold diluted antiserum was found to bind approximately 50% of about 4,000 dpm of methylated leukotoxin labeled with [14C] carbon. The detection limit of leukotoxin was at least as low as 5 ng in this radioimmunoassay by use of a polyetylene glycol precipitation method. This antiserum had a strong specificity to leukotoxin and no cross-reactivity with the other analogs tested.

Five year digital replantation series from the frigid zone of China

A series of 208 digital replantations from the frigid zone within the People's Republic of China is presented. The extremely cold climate (often -20 degrees C to -30 degrees C) presents the problem of warming exposed amputated digits prior to replantation without causing further damage. An overall replantation survival rate of 94% is reported, and this includes 45 cases of multiple digit amputation. Longer periods of ischemia seem to be tolerated under these unusually frigid conditions. Problems encountered within the series and suggestions for successful outcomes are discussed.

Immunohistochemical classification of astrocytes in infants by glial fibrillary acidic protein staining and application to forensic practice

This study was designed to assess whether development of the astrocytes in central nervous system (CNS) is delayed in victims of the sudden infant death syndrome (SIDS), and to try the classification of astrocytes by a morphological method. The glial fibrillary acidic protein (GFAP) is the major component of astrocytic fiber and is characteristic of astrocytes in the human CNS. An immunohistochemical study identificating this protein was carried out on infant brains to evaluate astrocytes. Morphologically 39 brains of infants aging under 12 months old, that including 10 asphyxia, 13 respiratory infections and 16 SIDS cases, were stained for GFAP by the peroxidase-anti-peroxidase (PAP) method. According to their staining pattern astrocytes were classified into 4 cell types: Type I cells were seen during the non-proliferating period, Type II cells during the low-proliferating period, Type III cells during the moderate-proliferating period and Type IV cells during the high-proliferating period. On the basis of this classification of astrocytes, it was observed that the first and most reactive pattern of physiological proliferation was in infant brains four months old after birth in the asphyxia cases. The staining grade of astrocytes was significantly less in white matter in the SIDS victims compared with age-matched of the respiratory infections and asphyxia. Therefore, we suggest that development of brain in the SIDS cases is delayed to controls and that the SIDS is associated with a developmental CNS disorder. Among 3 group cases the retarded staining pattern of the astrocytes in SIDS is interesting and might give a helpful approach to diagnosis of the cause of death for SIDS.

Successful replantation of digits and restoration of partial hand function: a case report

A case of a five-finger amputation and avulsion injury with salvage of two digits combined with island flap coverage of the remaining skin defect is reported. The salvaged digits were replanted onto the ulnar and radial borders of the hand stump and rotated to oppose one another. Recovery of partial hand function is reported.

Detection and identification of human influenza viruses by the polymerase chain reaction

A series of oligonucleotide primers are described which hybridize to conserved regions of influenza virus cDNA and prime DNA synthesis in Taq polymerase catalyzed amplification reactions (PCR). Primers were designed to hybridize as nested pairs and, following a two-step amplification, produce uniquely sized DNA fragments diagnostic for viral type and subtype. Influenza A and B matrix-protein genes and the influenza C haemagglutinin gene were targets for the type-specific primers. Subtype-specific primers targeted conserved sequences within the three haemagglutinin or two neuraminidase subtypes of different human influenza isolates. The utility of this method was demonstrated using computer search methods and by accurately amplifying DNA from a variety of influenza A, B, and C strains. Type-specific primer sets showed a broad type specificity and amplified DNA from viral strains of unknown sequence. Restriction mapping and DNA sequencing showed that fragments amplified in this manner derived from the input template, confirming the accuracy of the method and demonstrating how PCR can be used to quickly derive sufficient sequence information for analysis of viral relatedness. Subtyping primers were able to distinguish accurately between the three haemagglutinin (H1, H2, H3) and two neuraminidase (N1, N2) alleles of human influenza A isolates. Again DNA was amplified from viruses of unknown sequence confirming that most of these primer sets may prove useful as broad range subtyping reagents. In order to simplify the work associated with analysis of many samples, we have also devised a rapid method for the isolation of viral RNA and synthesis of cDNA. Using this 'mini-prep' technique, it is possible to detect, amplify, and identify picogram quantities of influenza virus in a single day, confirming that PCR provides a useful alternative to existing methods of influenza detection.

Replantation of severed fingers: two unique cases

Two cases of amputated digits are reported. One involved a period of ischemia at freezing temperatures, and the other at unusually high temperatures. Both fingers survived upon replantation. The implications of extreme temperature upon ischemic tissues are discussed.

Allele loss on chromosome 16 associated with progression of human hepatocellular carcinoma

Loss of heterozygosity on chromosome 16 is a common genetic alteration in human hepatocellular carcinoma (HCC). To clarify the pathogenetic significance of allele loss on chromosome 16, we performed restriction fragment length polymorphism analysis of 70 surgically resected tumors by using 15 polymorphic DNA markers for chromosome 16. Loss of heterozygosity on chromosome 16 was detected in 36 (52%) of 69 informative cases, and the common region of allele loss in these 36 tumors was located between the HP locus (16q22.1) and the CTRB locus (16q22.3-q23.2). These losses occurred more frequently in HCCs of poor differentiation, of larger size, and with metastasis, whereas they were not detected in HCC at the earliest stage. In addition, these losses were not associated with presence or absence of hepatitis B virus DNA integration or hepatitis C virus infection. These results show that loss of heterozygosity on chromosome 16 is a late event occurring after hepatocarcinogenesis and strongly suggest that this phenomenon is involved in enhancement of tumor aggressiveness during progression of HCC.

Frequent loss of heterozygosity on chromosomes 16 and 4 in human hepatocellular carcinoma

By restriction fragment length polymorphism analysis, we examined loss of heterozygosity at 34 loci on 23 chromosomes in 35 surgically resected human hepatocellular carcinomas. Allele losses at the HP locus on chromosome 16q22 and at the MT2P1 locus on chromosome 4p11-q21 were detected in 57% (8/14) and 50% (8/16) of cases, respectively. Loss of heterozygosity on chromosomes 16q and 4 occurred simultaneously in 4 of 7 informative cases for both loci, and seemed to be important in the development of human hepatocellular carcinoma irrespective of the presence of hepatitis B virus infection. In contrast, the incidence of allele loss was low at the other loci, e.g., chromosome 1p, 3p, 11p, 13q or 17p, where one allele is frequently lost in other cancers.