Computerized nuclear morphometry: a new morphologic assessment for advanced gastric adenocarcinoma

OBJECTIVE

To evaluate the correlation between the morphologic nuclear features and clinicopathologic parameters in patients with advanced gastric cancer.

SUMMARY BACKGROUND DATA

Nuclear profiles have been reported as useful prognostic predictors in various cancers. Data from computerized morphometries are objective and quickly derived using conventional microscopic analysis. However, this image analysis of nuclear features has rarely been applied to investigations of gastric adenocarcinoma. Moreover, it remains to be shown what types of biologic factors influence the nuclear features.

METHODS

Morphometric nuclear features (nuclear area, perimeter, and shape) were analyzed in 202 patients with serosal-invaded gastric cancer (stage II and III) who underwent curative gastrectomy. In each case, 300 cancer nuclei were analyzed on routine hematoxylin and eosin-stained slides through the use of a computer-assisted image analysis system by tracing the nuclear profiles (magnification x400) on a computer monitor. The morphometric data were compared with patient survival, clinicopathologic status, DNA ploidy pattern of tumors, expression of p53 protein, and proliferative activity of cancer cells.

RESULTS

Lymph node metastasis, lymphatic invasion, and venous invasion were more frequently detected in patients with large nuclear areas. Significant correlations were detected between the size of the nuclear area of cancer cells and the biologic factors of tumors, such as expression of p53, Ki-67 labeling index, and DNA ploidy pattern. The 5-year survival rate of the 100 patients in the large-nuclear group (nuclear area >45.3 microm2) was 47.6% and was significantly lower than the 74.4% rate of the 98 patients in the small-nuclear group (nuclear area < or =45.3 microm2). Moreover, the nuclear area was found to be an independent prognostic factor in the multivariate analysis.

CONCLUSIONS

Gastric cancer cells with a large nuclear area express mutated p53 protein and have high proliferative activity. Moreover, such cancer cells have high potential for invasion to the microvessels in the gastric wall. Thus, nuclear morphometry is a new and useful morphologic predictor for metastatic potential in advanced gastric cancer.

Adenocarcinoma arising in a tailgut cyst: report of a case

We report herein the unusual case of a 66-year-old woman found to have adenocarcinoma arising in a tailgut cyst. The patient had been observed for 6 months following the discovery of a presacral cystic mass measuring 10 x 9 cm for which she had refused surgery. The serum tumor marker, carcinoembryonic antigen, became slightly elevated, and diagnostic imaging distinctly revealed a tumorous lesion with papillary projection into the cyst lumen. The cystic mass was then excised through the transsacral approach. The pathological findings were compatible with moderately differentiated adenocarcinoma arising in a tailgut cyst. This entity is extremely rare, and only six cases, including our own, have been reported in the English literature. Early complete excision is advised because it is almost impossible to determine for certain whether presacral cystic masses are benign or malignant prior to surgery.

Chemo-enzymatic synthesis of a calcitonin derivative containing a high-mannose type oligosaccharide by endo-β-N-Acetylglucosaminidase from Arthrobacter protophormiae

Chemo-enzymatic addition of a high-mannose type oligosaccharide to eel calcitonin (CT), a calcium-regulating hormone, was examined. The endo-beta-N-acetylglucosaminidase from Arthrobacter protophormiae (Endo-A) transglycosylated the Man(6)-GlcNAc moiety from an ovalbumin-derived high-mannose type glycosyl asparagine, Asn(Man(6)-GlcNAc(2))-OH, to a calcitonin derivative, [Asn(GlcNAc)(3)]-CT, in which the N-acetyl-d-glucosamine (GlcNAc) is attached to the third l-asparagine (Asn) residue of the peptide, and a calcitonin derivative containing a high-mannose type oligosaccharide, [Asn(Man(6)-GlcNAc(2))(3)]-CT, was synthesized. The optimal reaction conditions for the synthesis of [Asn(Man(6)-GlcNAc(2))(3)]-CT from Asn(Man(6)-GlcNAc(2))-OH and [Asn(GlcNAc)(3)]-CT catalyzed by Endo-A were examined. The transglycosylation yield relative to the concentration of the [Asn(GlcNAc)(3)]-CT added was 32.7%, and 4.42 mg of [Asn(Man(6)-GlcNAc(2))(3)]-CT was prepared.

[Drug-induced pneumonitis]

Drug can cause various types of lung damages, with drug-induced pneumonitis (including acute interstitial pneumonia, usual interstitial pneumonia, desquamative interstitial pneumonia, nonspecific interstitial pneumonia, bronchiolitis obliterans with organizing pneumonia, eosinophilic pneumonia and hypersensitivity pneumonitis) being the most important among them. The incidence and the causative agents of drug induced pneumonitis have varied over time. Before 1980, anticancer agents and gold salts were the main drugs, and the number of causative drugs (61) and case reports was small. Recently, pneumonitis has increasingly been caused by Chinese herbal medicines, antibiotics, chemotherapy agents, anti-inflammatory drugs, analgesics, cytokines, and gold salts, and the number of case reports and drugs involved (177) has increased. Drug-induced pneumonitis has characteristics that depend on the causative agent. Review of our patients and reports in Japan revealed the following. Pneumonitis caused by anti-inflammatory drugs, analgesics, and antibiotics generally develops at 1-2 weeks after starting administration, and bronchoalveolar lavage and histologic examination of lung biopsies reveals the features of eosinophilic pneumonia. Such pneumonitis is associated with a high frequency of a positive drug lymphocyte stimulation test (DLST), and has a good outcome. Conversely, with pneumonitis caused by anticancer and immunosuppressive agents, the onset is often delayed and the disease has features of diffuse interstitial pneumonia and pulmonary fibrosis. The frequency of a positive DLST is low, and the outcome is generally poor. Pneumonitis induced by Chinese herbal medicines, gold salts, and antituberculosis agents has intermediate features between the above two types :i.e., it develops after 2-3 months or six months (gold salts), and resembles either eosinophilic pneumonia, BOOP or interstitial pneumonia. For in vitro identification of causative drugs, the DLST and the leukocyte migration inhibition test (LMIT) are generally used. The latter test is superior in sensitivity, suggesting that the mechanism of this test involves cytokines such as IL-1 alpha, IL-1 beta, IL-2, TNF-alpha, and IL-8.

Biodiesel fuel production from plant oil catalyzed by Rhizopus oryzae lipase in a water-containing system without an organic solvent

A new enzymatic method of synthesizing methyl esters from plant oil and methanol in a solvent-free reaction system was developed. It is anticipated that such plant oil methyl esters can be used as a biodiesel fuel in the future. Lipase from Rhizopus oryzae efficiently catalyzed the methanolysis of soybean oil in the presence of 4-30 wt% water in the starting materials; however the lipase was nearly inactive in the absence of water. The methyl ester (ME) content in the reaction mixture reached 80-90 wt% by stepwise additions of methanol to the reaction mixture. The kinetics of the reaction appears to be in accordance with the successive reaction mechanism. That is, the oil is first hydrolyzed to free fatty acids and partial glycerides, and the fatty acids produced are then esterified with methanol. Although R. oryzae lipase is considered to exhibit 1(3)-regiospecificity, a certain amount of 1,3-diglyceride was obtained during the methanolysis and hydrolysis of soybean oil by R. oryzae lipase solution. Therefore, the high ME content in the reaction mixture is probably attributable to the acyl migration from the sn-2 position to the sn-1 or sn-3 position in partial glycerides.

Intranuclear iron deposition in hepatocytes and renal tubular cells in mice treated with ferric nitrilotriacetate

Cytoplasmic and intranuclear iron depositions were observed in the livers and kidneys of male and female ddY mice treated for 4-12 weeks with ferric nitrilotriacetate (Fe-NTA), a known renal carcinogen that acts through the production of free radicals. The intranuclear iron deposition consisted of a spherical aggregation of ferritin particles of approximately 10 nm diameter, as revealed by immunohistochemical staining and electron microscopy. Although the incidence of renal tumours was greater in the males than in the females, the incidence of iron depositions did not differ with gender. The most abundant intranuclear iron depositions were observed in the animals treated with Fe-NTA for the longest duration (12 weeks). These findings suggest that the intranuclear production and propagation of free radical reactions are prevented by the trapping of iron in a chemically inert iron form of ferritin.

Contralateral deafness following unilateral suboccipital brain tumor surgery in a patient with large vestibular aqueduct--case report

A 68-year-old female developed contralateral deafness following extirpation of a left cerebellopontine angle epidermoid cyst. Computed tomography showed that large vestibular aqueduct was present. This unusual complication may have been caused by an abrupt pressure change after cerebrospinal fluid release, which was transmitted through the large vestibular aqueduct and resulted in cochlear damage.

Combined hyperactive dysfunction syndrome of the cranial nerves: trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia: 11-year experience and review

OBJECTIVE

A pathological condition caused by vascular compression at the root entry/exit zone of the cranial nerves is designated hyperactive dysfunction syndrome (HDS) of the cranial nerves. Patients with HDS who exhibited a combination of trigeminal neuralgia (TN), hemifacial spasm (HFS), and/or glossopharyngeal neuralgia were retrospectively reviewed, to study the incidence, etiological factors, and demographic characteristics for this combined HDS group.

METHODS

Medical and surgical records were analyzed for 41 patients with combined HDS, of 1472 consecutive patients with HDS who were treated between 1984 and 1994.

RESULTS

The combined HDS group accounted for 2.8% of all patients with HDS; 19 patients (1.3%) exhibited bilateral symptoms, i.e., 14 cases of TN, 3 of combined TN and HFS, and 2 of HFS. Twenty-two patients (1.5%) exhibited ipsilateral symptoms, i.e., 19 cases of TN and HFS and 3 of TN and glossopharyngeal neuralgia. Excluding three patients whose symptoms were associated with brain tumors or arteriovenous malformations, this patient group was older (63.2 versus 55.3 yr, P = 0.0009) and exhibited an increased percentage of associated hypertension (47.4 versus 17.5%, P = 0.000008), with a female predominance (86.8 versus 71.3%, P = 0.07), compared with the single HDS group. Thirty-six of these patients underwent a total of 61 microvascular decompression procedures, with favorable outcomes. The offending vessels were similar to those in single HDS, which were usually conventional and multiple.

CONCLUSION

The associated etiological factors for vascular compression syndromes were more evident in the combined HDS group than in the single HDS group. Progressive arteriosclerotic vasculoarchitectural changes of the vertebrobasilar system, accelerated by aging and hypertension, bring about the development of combined HDS, with a remarkable female predominance.

Neuroradiological characteristics of ecchordosis physaliphora. Case report and review of the literature

An extremely rare case of ecchordosis physaliphora is presented in which the authors focus especially on its radiological characteristics. The patient complained of a headache with no other neurological abnormalities. A thorough radiological examination revealed a small intradural prepontine mass with no bone destruction of the clivus. Magnetic resonance imaging was very useful in visualizing this mass as a low signal intensity lesion on T1-weighted images and as a high signal intensity lesion on T2-weighted images without any contrast enhancing effects. At surgery, a cystic gelatinous nodule was found ventral to the pons; the nodule was connected to the dorsal wall of the clivus via a delicate stalk. Histological studies proved that this was an ecchordosis physaliphora. Review of the literature demonstrates that the reported cases of ecchordoses have many common radiological features that would suggest the diagnosis of this rare disease.

Morphology of intraepithelial corpuscular nerve endings in the nasal respiratory mucosa of the dog

Corpuscular nerve endings in the nasal respiratory mucosa of the dog were investigated by immunohistochemical staining specific for protein gene product 9.5 by light and electron microscopy. In the nasal respiratory mucosa, complex corpuscular endings, which displayed bulbous, laminar and varicose expansions, were distributed on the dorsal elevated part of the nasal septum and on the dorsal nasal concha. The endings were 300-500 microm long and 100-250 microm wide. Some axons gave rise to a single ending while others branched into 2 endings. Cryostat sections revealed that the corpuscular endings were located within the nasal respiratory epithelium. On electron microscopy, immunoreactive nerve terminals that contained organelles, including mitochondria and neurofilaments, were observed within the epithelial layer near the lumen of the nasal cavity. Some terminals contacted the goblet cell. Such terminal regions were covered by the cytoplasmic process of ciliated cells and were never exposed to the lumen of the nasal cavity. These nerve endings are probably activated by pressure changes.

[Significance of serum surfactant protein-D (SP-D) level in patients with pulmonary tuberculosis]

Elevated levels of serum surfactant protein-D (SP-D) have been previously reported in patients with idiopathic pulmonary fibrosis (IPF) and pulmonary alveolar proteinosis. To determine whether the same change is seen in other pulmonary diseases, especially pulmonary tuberculosis (TB), we measured the serum SP-D levels in active pulmonary TB (smear and/or culture: positive), acute interstitial pneumonia (AIP), IPF, acute exacerbation of IPF, hypersensitivity pneumonitis (HP), pneumoconiosis, bronchiectasis, and bacterial pneumonia by an enzyme-linked immunosorbent assay using monoclonal antibodies to human lung SP-D, and compared them with those of healthy elderly subjects over 50 years of age. The SP-D level in the healthy elderly subjects was 57.6 +/- 38.4 ng/ml (mean +/- SD, n = 287). The levels in patients with active pulmonary TB (140.6 +/- 18.2 ng/ml, n = 49), AIP (1,021 ng/ml, n = 1), IPF (307.0 +/- 180.7 ng/ml, n = 42), acute exacerbation of IPF (817.7 +/- 283.6 ng/ml, n = 3), and HP (716.6 +/- 548.8 ng/ml, n = 4) were significantly higher than those in the healthy elderly controls (p < 0.05), whereas those of pneumoconiosis, bronchiectasis, and bacterial pneumonia, 121.9 +/- 92.8 ng/ml (n = 8), 93.9 +/- 72.9 ng/ml (n = 11), and 72.7 +/- 3.4 ng/ml (n = 4), respectively, showed no significant difference with the controls. In active pulmonary TB, the percentage of patients whose serum SP-D levels were over 134.6 ng/ml (mean + 2SD of healthy elderly controls) was 34.7%, and therefore we considered the serum SP-D level was not useful for the diagnosis of pulmonary TB. However, it was significantly higher in the patients with cavity formation than in those without (p < 0.05), and there was a significant positive correlation between the serum SP-D level and the number of tubercle bacilli in the sputum (r = 0.416, p = 0.00165), erythrocyte sedimentation rate at 1 hr (r = 0.489, p < 0.01), and CRP level (r = 0.383, p = 0.003). These findings suggest that the serum SP-D level is a useful indicator of the disease activity in pulmonary TB.

Single-step purification and characterization of MBP (maltose binding protein)-DnaJ fusion protein and its utilization for structure-function analysis

DnaJ is a molecular chaperone, which contains a zinc finger-like motif and cooperates with DnaK to mediate the folding of newly synthesized and denatured proteins. DnaJ was overproduced and purified using the maltose binding protein (MBP) fusion vector. The fusion protein (MBP-DnaJ) was expressed in a soluble form in Escherichia coli and purified to homogeneity using amylose resin in a single step. The UV-visible absorption spectrum of MBP-DnaJ showed peaks at 355 and 475 nm. Moreover, these absorption peaks disappeared upon treatment with ethylenediaminetetraacetic acid (EDTA) or p-hydroxymercuriphenylsulfonic acid (PMPS). Inductively coupled plasma (ICP) spectrometry demonstrated that MBP-DnaJ contains Fe ions as well as Zn ions. MBP-DnaJ mediated the replication of the lambda phage in vivo, stimulated the ATPase activity of DnaK and prevented the aggregation of denatured rhodanase, indicating that fusion of MBP to the N-terminal of DnaJ does not affect the functions of DnaJ. To study the roles of bound metal ions, metal-free MBP-DnaJ, and MBP-DnaJ containing 2 Zn ions were prepared. MBP-DnaJ containing Fe and Zn ions, and MBP-DnaJ containing 2 Zn ions stimulated the ATPase activity of DnaK, prevented the aggregation of denatured rhodanase and bound to DNA to similar extents. On the other hand, metal-free MBP-DnaJ showed much lower DNA-binding ability and lower ability to prevent rhodanese aggregation. Therefore, the bound metal species do not affect the function of the zinc finger-like motif of DnaJ, whereas removal of the metal ions from DnaJ diminishes its binding ability as to DNA and denatured proteins.

Possibility of different cancer development between the proximal and distal colon: comparison of the distribution between adenomatous polyps and cancer

BACKGROUND/AIM

The aim of this study was to compare the distribution of adenomatous polyps with that of cancer in the colon by using adenomatous polyps removed by colonoscopy.

METHODOLOGY

1223 adenomatous polyps removed by an endoscopic polypectomy were compared with 226 colon cancers with regard to their distribution, size and age.

RESULTS

With patients over 65 years of age, the incidence of adenomatous polyps was lower in the proximal colon than in the distal colon, however, the incidence of cancer was higher in the proximal colon than in the distal colon (p<0.05). The distribution of adenomatous polyps according to size was also significantly different between the proximal and distal colon (p<0.05).

CONCLUSION

These results thus suggest that some difference may exist in cancer development between the proximal and distal colon.

The Stamey and Gittes procedures: long-term followup in relation to incontinence types and patient age

PURPOSE

We report the long-term results of needle suspension of the bladder neck for stress incontinence.

MATERIALS AND METHODS

A total of 382 patients with stress incontinence underwent either the Stamey (group 1, 342 women) or Gittes procedure (group 2, 40) in a nonrandomized trial. Surgical outcomes and patient satisfaction were assessed by questionnaires. Surgical outcomes were then analyzed in relation to surgical procedures, McGuire incontinence types and patient age. Followup averaged 8.1 years for group 1 and 5.0 years for group 2.

RESULTS

Kaplan-Meier cumulative continence rates were 71.5% for the Stamey at 14 years and 37.0% for the Gittes at 6 years postoperatively (p < 0.0001). Patients with type III incontinence attained a 10-year cumulative continence rate of 38.3%, which was significantly inferior to those with type I (76.4% at 11 years) or II (73.9% at 13 years). Older patients had an 11-year cumulative continence rate of 61.4%, which was not statistically different from the younger women (68.9% at 14 years). Of the patients 79% were extremely satisfied or satisfied with surgical results, and urge incontinence developed de novo in 12% of the patients.

CONCLUSIONS

We conclude that the Stamey is superior to the Gittes operation, needle bladder neck suspension is as effective in older as in younger adults and women with type III incontinence should not undergo either operation.

The structures of asparagine-linked oligosaccharides of rat liver cathepsin L reflect the substrate specificity of lysosomal alpha-mannosidase

We have studied the structures of asparagine-linked oligosaccharides of cathepsin L purified from rat liver in detail. The oligosaccharides released from rat liver cathepsin L on glycopeptidase-F treatment were tagged with 2-aminopyridine at their reducing ends. The pyridylamino (PA) derivatives were separated into seven fractions according to molecular size by normal-phase HPLC. The structure of each oligosaccharide thus isolated was analyzed by reversed-phase HPLC and characterized by ion-spray mass spectrometry and high-resolution proton nuclear magnetic resonance (1H-NMR) spectroscopy. Our results indicate that the asparagine-linked oligosaccharides of rat liver cathepsin L are of the oligomannose type, having two to six mannose residues. Among them, the five major ones are Manalpha1-6Manbeta1-4-GlcNAcbeta1-4GlcNAc, Manalpha1 -6Manalpha1-6Manbeta1-4GIcNAcbeta1-4GlcNAc, Manalpha1-6(Manalpha1-3)-Manalpha1-6Manbeta1- 4GlcNAcbeta1-4GlcNAc, Manalpha1-6(Manalpha1-3)Manalpha1-6(Manalpha1-3) Manbeta1-4Glc-NAcbeta1-4GlcNAc, and Manalpha1-6(Manalpha1-3)Manalpha1-6(Manalpha1-++ +2Manalpha1-3)Manbeta1-4GlcNAcbeta1-4Glc-NAc. Their structures are shown to be products of Man6GlcNAc2 hydrolysis with lysosomal alpha-mannosidase.

Effects of ligation of the internal iliac artery on blood flow to the bladder and detrusor function in rat

Ischaemia induced by atherosclerosis is a common cause of disorders in the elderly, including impairment of bladder function. To evaluate experimentally the effects of ischaemia on detrusor function, we performed infusion cystometry and evaluated the morphologic findings in the bladder of the rat. Blood flow to the bladder of the rat was evaluated with a Doppler flowmeter before and after the unilateral or bilateral ligation of the internal iliac arteries. Reevaluation was done at one and two weeks after surgery. Bladder function was studied by infusion cystometry performed in vivo under urethane anaesthesia. Finally, histological examination was performed. Blood flow at mid-dorsal wall of the control bladder was inversely related to intravesical volume. Unilateral or bilateral ligation of the internal iliac arteries decreased blood flow to the bladder, which showed a complete recovery two weeks postoperatively. Infusion cystometry of the ischaemic bladder with bilateral ligation of the internal iliac arteries demonstrated a decrease in voiding pressure, an increase in bladder capacity, and an increase in pressure at which micturition was initiated vs. the control. The bladder with unilateral ligation of the artery showed a decrease in voiding pressure, with no change in the other parameters. Histological examination indicated that the bilateral ischaemia and ischaemic side of unilateral ischaemia led to a degeneration of the mucosa, and severe oedema in submucosal and muscle layers one week postoperatively. Degeneration of smooth muscle was predominant at 2 weeks. Contralateral side of the unilaterally ischaemic bladder showed oedema and congestion of the submucosa and smooth muscle. Ligation of the internal iliac artery decreased blood flow to the bladder significantly, which resulted in smooth muscle degeneration. Consequently, in vivo voiding pressure was impaired in the ischaemic bladder.

Pemphigus vulgaris associated with transient acanthosis nigricans like lesion

A patient with pemphigus vulgaris was treated with predonisolone and cyclosporin. At the sites of healing erosions, hyperkeratotic, hyperpigmented plaques developed; they were clinically and histologically similar to acanthosis nigricans. These lesions regressed after a few months. This case and others described in the literature suggest that such dermatoses might be caused by immunologically as well as mechanically mediated epidermal injury.

Synthesis of a high-mannose-type glycopeptide analog containing a glucose-asparagine linkage

The title compound was prepared by enzymatic transfer of oligosaccharide to a synthetic pentapeptide containing the Glc-Asn linkage. The compound was not hydrolyzed by glycoamidases from plant and bacterial sources, but it inhibited both enzymes in the micromolar range. Its activity is compared to other potential inhibitors.

Does potassium induce the release of nitric oxide in the rabbit corpus cavernosum?

We investigated the effects of increases in the extracellular potassium concentration on the function of the rabbit corpus cavernosum. The resting tissue tension increased as the potassium concentration was increased from 4.7 mM to 20 mM or 30 mM. The maximum contraction induced by 200 microM phenylephrine was significantly decreased in the presence of 30 mM potassium compared with 4.7 mM potassium. After precontraction was induced with 200 microM phenylephrine, the magnitude of field-stimulated relaxation increased significantly as the potassium concentration was increased from 4.7 mM to 10 or 20 mM, but was almost completely abolished at 30 mM potassium. There was no difference in the suppressive effect of L-NAME on field-stimulated relaxation between specimens treated with 4.7 mM or 20 mM potassium. ATP- and bethanechol-induced relaxation was not affected by increases in the extracellular potassium concentration. A high-dose potassium solution (124 mM) induced contraction of the corpus cavernosum. In tissue precontracted with phenylephrine, a high-dose potassium solution that contained phenylephrine induced relaxation of corpus cavernosum; this relaxation was completely suppressed by L-NAME. These findings suggest that small increases in the extracellular potassium concentration increase field-stimulated relaxation of the corpus cavernosum and that this relaxation is not related to the effects of nitric oxide. Relaxation induced by high-dose potassium in tissue precontracted with phenylephrine is probably the result of release of nitric oxide.

Coexpression of GTP cyclohydrolase I and inducible nitric oxide synthase mRNAs in mouse osteoblastic cells activated by proinflammatory cytokines

Proinflammatory cytokines, a combination of IL-1beta, TNF-alpha, and IFN-gamma, caused mRNA expression of GTP cyclohydrolase I (GTP-CH), the rate-limiting enzyme in tetrahydrobiopterin (BH4) biosynthesis, and of inducible nitric oxide synthase (iNOS) in a well-characterized osteoblastic clone MC3T3-E1 cell line. We found the expression of the GTP-CH gene in osteoblasts for the first time. The expression of GTP-CH and iNOS mRNAs was found to be maximal at 3 and 9 h, respectively. The expression of both genes elicited increases in BH4 and NO levels. Pharmacological studies using 2,4-diamino-6-hydroxypyrimidine, an inhibitor of GTP-CH activity, showed that BH4 is involved in the activity of iNOS, but not in the induction of iNOS mRNA. The results using an inhibitor of nuclear factor (NF)-kappaB and activating protein-1 (AP-1) activation suggested that coinduction of the two genes in response to cytokines occurred via activation of NF-kappaB and AP-1. In MC3T3-E1 cells BH4 and sepiapterin, producing BH4, could protect against apoptosis, i.e. the degradation of nuclear DNA in the cells, induced by NO derived from S-nitroso-N-acetyl-D-L-penicillamine. These results suggest that the induction of BH4 together with NO by proinflammatory cytokines could protect against NO-induced apoptosis in MC3T3-E1 cells.

Apo A-I and apo E concentrations in cerebrospinal fluids of patients with acute meningitis

It has been demonstrated that apolipoproteins found in cerebrospinal fluid (CSF) play an important role in lipid metabolism in the central nervous system (CNS). Previously we reported that CSF apo A-I levels increased with the severity of neurological damage in poliovirus-infected macaques. In the present study, apo A-I was quantitatively analysed in CSF from patients with or without neurological diseases. In controls, CSF apo A-I level was significantly higher in males; 3.83 (0.40) mg/L, mean (SEM) (n = 19) compared with females, 2.42 (0.26) mg/L (n = 23, P < 0.05). CSF apo A-I concentrations in patients with acute meningitis increased at the active stage, 7.74 (1.78) mg/L (n = 10), but returned to basal concentrations at the convalescent stage 2.72 (0.38) mg/L (n = 10), while the CSF apo A-I level in patients with other neurological diseases remained in the same range as in controls. By contrast, CSF apo E was consistently elevated at either stage of acute meningitis. Furthermore, it was found that the levels of CSF apo A-I, but not of apo E, correlated positively with CSF albumin concentrations. These findings suggest that the CSF apo A-I and apo E have different origins and may play different roles in the lipoprotein metabolism in CNS.

Production of WTC.ZI-zi rat congenic strain and its pathological and genetic analyses

A new rat congenic strain, WTC.ZI-zi, was produced after eleven generations of backcrossing between ZI strain as a donor strain and WTC strain as an inbred partner. WTC.ZI-zi/zi homozygous rats generally exhibit more conspicuous body tremor and much earlier occurrence of flaccid paresis than the original ZI strain. The average life span of the congenic strain is approximately nine months, which is also much shorter than that of the original ZI strain. Pathological analysis of the central nervous system of the congenic strain revealed more aggravated vacuolation and hypomyelination than in the original ZI strain. Establishment of the genetic profile with microsatellite markers showed that the congenic strain was genetically almost identical to the WTC strain except for a small chromosome segment bearing the zitter gene. Analysis of markers in this region implied that the length of the donor segment was approximately 13.4 centimorgans which corresponded to 0.65% of the total genome. Thus, these results suggested that expressional alterations of zitter gene were due to replacement of the genetic background from the original ZI strain to the WTC strain. Furthermore, the WTC.ZI-zi congenic strain could provide a refined tool for the analysis of zitter mutation, because the congenic strain has a strict control strain, WTC, and the length of the donor chromosome is genetically defined.

Several common HLA-DR types share largely overlapping peptide binding repertoires

The peptide binding specificities of HLA-DRB1*0401, DRB1*0101, and DRB1*0701 have been analyzed by the use of large collections of synthetic peptides corresponding to naturally occurring sequences. The results demonstrated that nearly all peptides binding to these DR molecules bear a motif characterized by a large aromatic or hydrophobic residue in position 1 (Y, F, W, L, I, V, M) and a small, noncharged residue in position 6 (S, T, C, A, P, V, I, L, M). In addition, allele-specific secondary effects and secondary anchors were defined, and these parameters were utilized to derive allele-specific motifs and algorithms. By the combined use of such algorithms, peptides capable of degenerate DRB1*0101, DRB1*0401, and DRB1*0701 binding were identified. Additional experiments utilizing a panel of quantitative assays specific for nine additional common DR molecules identified a large set of DR molecules, which includes at least the DRB1*0101, DRB1*0401, DRB1*0701, DRB5*0101, DRB1*1501, DRB1*0901, and DRB1*1302 allelic products, characterized by overlapping peptide-binding repertoires. These results have implications for understanding the molecular interactions involved in peptide-DR binding, as well as the genetic and structural basis of MHC polymorphism. These results also have potential practical implications for the development of epitope-based prophylactic and therapeutic vaccines.

Enzymatic synthesis of a neoglycoconjugate by transglycosylation with Arthrobacter endo-beta-N-acetylglucosaminidase: a substrate for colorimetric detection of endo-beta-N-acetylglucosaminidase activity

The transglycosylation activity of endo-beta-N-acetylglucosaminidase from Arthrobacter protophormiae was used for the enzymatic synthesis of a novel oligosaccharide, Man6GlcNAc-p-nitrophenyl-alpha-D-glucose (Man6GlcNAc-Glc-pNP). The reaction was efficiently induced in aqueous solution containing dimethyl sulfoxide. In the medium containing 20% (v/v) dimethyl sulfoxide with 0.1 M Glc-pNP as an acceptor, the transglycosylation attained yields of 75% by high-performance anion-exchange chromatography. The structure of Man6GlcNAc-Glc-pNP was confirmed by ion mass spectrometry and 400 MHz 1H NMR spectrometry. Various endo-beta-N-acetylglucosaminidases hydrolyzed this oligosaccharide and Man6GlcNAc and Glc-pNP were released from the oligosaccharide by endo-beta-N-acetylglucosaminidase digestion. We have established a new procedure for the colorimetric detection of endo-beta-N-acetylglucosaminidase activity using Man6Glc-NAc-Glc-pNP, which is simple as that for other exoglycosidase assays with pNP-glycosides as substrates.

Selective expression of Ser 199/202 phosphorylated tau in a case of frontotemporal dementia

We examined a 65-year-old patient with clinicopathological features that met the criteria of frontotemporal dementia (FTD), particularly frontal lobe degeneration (FLD). He came from a family with concentrated occurrence of dementia symptoms in the presenium. Neuropathological examination disclosed brain atrophy locally pronounced on the frontotemporal lobes with characteristic neuronal loss, microvacuolation and astrocytic gliosis. There were no pathological hallmarks such as senile plaques, Pick bodies (PBs), achromatic cells and neurofibrillary tangles. Precise separation of FTD from Pick disease (PD) and motor neuron disease with dementia (MNDD) has not yet been established, and they are included in one spectrum. Antibodies against paired helical filament tau protein demonstrated immunopositive cytoskeletal structures within the neurons as well as the glial cells in the brain of the present case. They were selectively stained with tau 199/202 but not tau 396, which were provided newly to recognize phosphorylation at Ser 199/202 or Ser 396 in tau, respectively. We investigated tau pathology in the present case in comparison to 8 cases with PD that were clinicopathologically confirmed. Neither tau 199/202 nor tau 396 stained the CNS structures in PD cases with few PBs, while both stained evidently those as well as PBs in PD cases associated with many PBs; so that the present case could be distinguished from PD on the basis of the immunoreactivity to site-specific phosphorylated tau. Our result suggests that FTD, especially familial FLD type might involve unique tau pathology, no matter whether FLD is a distinct entity from PD, or a variant form in the wide FTD spectrum including PD and MNDD and other related disorders.

Detection of antitumor promoting activity in Raji cells carrying Epstein-Barr virus genome by immunoblotting analysis

Extract of Raji cells treated with sodium n-butyrate (1 mM) and a tumor promoter, 12-O-tetradecanoylphorbol-13-acetate (TPA, 40 ng/ml), was analyzed by immunoblotting using ten human sera with different antibody titers against Epstein-Barr virus early antigens. Two human sera reacted with one induced polypeptide of 48 kDa and its induction was inhibited by curcumin (4 micrograms/ml), an antitumor promoter from turmeric. A mouse antiserum against P3HR-1 cells treated with TPA and sodium n-butyrate also detected the 48-kDa polypeptide in Raji cells treated with TPA at concentrations of 2.5 to 80 ng/ml. These results indicate that the immunoblotting analysis can be used in a confirmation test for detection of antitumor promoting activity.

Follow-up results of using microvascular decompression for treatment of glossopharyngeal neuralgia

Glossopharyngeal neuralgia (GPN) is an uncommon disorder that is characterized by a severe lancinating pain commonly induced by swallowing. There has been some debate among various authors as to which surgical procedure should be adopted to treat cases of GPN: microvascular decompression (MVD) or partial rhizotomy. The latter necessitates the partial destruction of normal neural structures.

OBJECT

The purpose of this paper is to present follow-up results in patients with GPN who underwent MVD.

METHODS

Between 1980 and 1995, 20 patients underwent MVD for GPN. Results were studied to verify the effectiveness of MVD performed in 16 patients before 1991 who participated in follow-up evaluation for more than 5 years postoperatively. The follow-up period ranged from 5 to 16 years (mean +/- standard deviation 11.6 +/- 2.8 years). The method adopted for MVD was to reposition the offending vessel, such as a troublesome vertebral artery or posterior inferior cerebellar artery that is commonly ectatic and arteriosclerotic, by lifting the loop of the artery and using glue to affix it to the nearby dura mater of the petrous bone.

CONCLUSIONS

Pain was relieved in all cases. Two patients complained of persistent mild hoarseness, causing the inability to speak loudly, and two patients complained of occasional coughing episodes that occurred for a couple of years after the surgery. No other complications were reported and no recurrence of pain was noted during the follow-up period. This procedure provided satisfactory results by preserving important perforating arteries in this area and by repositioning offending arteries in a safer and surer fashion, thus reducing complications and recurrence of GPN.

Chordoid meningioma in a child. Case report

A case of chordoid meningioma occurring in a 15-year-old girl is presented. The patient manifested seizures as the initial symptom and subsequently exhibited subclinical microcytic hypochromic anemia. The tumor, located in the falcotentorial region and associated with diffuse edema, was totally resected. On histological examination of the surgical specimen, the clustering pattern of partly vacuolated cells in the mucoid stroma mimicked chordoma; however, positive staining of individual cells for vimentin and epithelial membrane antigen led to a diagnosis of meningioma. Interestingly, the tumor cells were surrounded by a periodic acid-Schiff- and type IV collagen-positive substance. Electron microscopy demonstrated a strikingly dense and thick basal lamina. The patient's microcytic hypochromic anemia disappeared after the tumor was removed. Both the clinical and pathological features of this case resemble those of chordoid meningioma, a rare meningioma variant.

Response of isolated human neurogenic bladders to tachykinins

Tachykinins act as stimulants of the isolated urinary bladder. However, the efferent role of tachykinins on detrusor function is controversial. We investigated the contractility of isolated human neurogenic bladders taken from patients with myelomeningocele or sacral agenesis, and tested the response to neurokinin A (NKA), neuromedin K (NKB), and substance P (SP). The contractile strengths were compared with normal controls. All tachykinins investigated induced significant contractions in both neurogenic and control bladders. The rank order of contractile potency was the same in both groups, namely, NKA > NKB > SP. The contraction induced by SP was not affected by atropine, but was completely blocked by [Sar9,Met(O2)11]-SP (a SP antagonist). Responses to electrical field stimulation were not changed by the SP antagonist. The contractile magnitude to field stimulation was also not altered by administration of 10(-6) M tachykinins. Responses of the neurogenic bladder to NKA and SP were significantly greater than the control. There were no differences in the response to KCl administration between the 2 groups. We conclude that hypersensitivity to NKA and SP in neurogenic bladders may contribute to bladder dysfunction in patients with sacral cord lesions.

Effects of partial outflow obstruction on bladder contractility and blood flow to the detrusor: comparison between mild and severe obstruction

Detrusor dysfunction secondary to partial outflow obstruction is caused in part by decreased blood flow to the detrusor. We investigated changes in blood flow to the bladder and in bladder function after inducing partial outflow obstruction. The urethras of male Sprague-Dawley rats were constricted by sutures to degrees representing either mild and severe obstruction. Blood flow to the bladder was measured by a Doppler flowmeter prior to and 7 days after obstruction. In vivo and in vitro experiments were performed 7 days after surgery. After cystometry was used to determine bladder capacity, the pressure at which micturition was induced, and maximum voiding pressure, the bladder was removed and placed in an organ bath where increases in intravesical pressure in response to field stimulation were evaluated. Finally, volume-pressure studies were performed in order to determine passive detrusor compliance and response to field stimulation at each specific capacity in vitro. Although blood flow to the bladder was significantly decreased by severe obstruction, no differences in blood flow between control and mildly obstructed bladders was observed. While maximum voiding pressure decreased in severely obstructed bladders, both the pressure at which micturition was induced and bladder capacity were increased. The response to field stimulation was increased by mild obstruction but decreased by severe obstruction, although bladder compliance was increased by both. The peak response to filled stimulation was observed at a larger capacity in severely obstructed bladders than the others. In conclusion, when outflow obstruction was mild, blood flow to the bladder remained unchanged and detrusor contractility increased. On the other hand, severe obstruction decreased bladder blood flow and induced deterioration of detrusor function.

[Vesicoureteral reflux and urinary incontinence in myelodysplastic patients: a comparison between those who had anti-reflux surgery alone and those who were treated by anti-reflux surgery combined with bladder augmentation with or without sling operation]

BACKGROUND

Vesicoureteral reflux and urinary incontinence are frequently observed among myelodysplastic patients. Since the conservative therapy is not always effective to improve these pathologies, surgical intervention is necessary for some of the patients.

METHODS

Thirty-eight myelodysplastic patients were divided into 2 groups: Group A comprised 17 patients who had been operated by anti-reflux surgery (crossover method) alone and Group B 21 patients who had undergone anti-reflux surgery (Orikasa's method) and augmentation enterocystoplasty with or without sling operation. Cessation rate of reflux, bladder capacity, bladder compliance and operative complications were analyzed in the 2 groups. A questionnaire was sent to the patient asking to answer frequency of clean intermittent catheterization (CIC), severity of urinary incontinence, satisfaction rate for operation and so on. Mean followed-up periods were 11.7 (5.3-13.6) years for Group A and 3.7 (0.6-6.9) years for Group B, respectively.

RESULTS

Reflux was successfully eradicated in 19 of 24 ureters (79%) of Group A and in 25 of 29 ureters (86%) of Group B, which was not significantly different. In Group A, bladder capacity and compliance slightly improved. The latter, however, remained less than 10 ml/cmH2 O. Bladder capacity and compliance of Group B increased more than twice the original value with statistical significance. Operative complication in Group A was ureteral obstruction in 1 patient, which eventually necessitated peritoneal dialysis. In Group B revision of ventriculoperitoneal shunt was necessary in 4 patients, incomplete ileus was conservatively treated in 3, and a bladder stone was formed in 1. The patients assessed that frequency of pyelonephritis was less in Group B compared to Group A. Other subjective parameters, however, such as frequency of CIC, severity of urinary incontinence, postoperative changes in the amount of urinary incontinence, and satisfaction rate for operation, were not different between the 2 groups.

COMMENTS

Though operation-related complications occurred more frequently in those of Group B, these patients enjoyed significant improvement in bladder capacity and bladder compliance. We conclude when the conservative therapy fails to cure and improve vesicoureteral reflux and urinary incontinence, surgical interventions including anti-reflux surgery and augmentation cystoplasty with or without sling operation are recommended as a treatment option.

Familial multiple system degeneration associated with iron deposition: determination of subcellular localization of elementary iron by energy-dispersive X-ray analysis

We report an autopsy case characterized by iron deposition associated with multiple system degeneration. Although iron deposition was distributed as in Hallervorden Spatz syndrome, no spheroid was detectable. On the other hand, multiple system degeneration was observed mainly in the pallido-nigral and dentato-rubral systems which resembled pallido-nigro-luysian degeneration. However, the clinical course and manifestations, and the neuropathology of this case were not completely consistent with any previous report. Differential diagnosis and classification of the case are discussed, and the genetic diagnostic procedures are presented. We also investigated the subcellular localization of elemental iron in glial cells using energy-dispersive X-ray spectral analysis. A small amount of elementary iron was clearly demonstrated in some regions of membrane-bound electron-dense material presumably derived from lysosomes. Further accumulation of clinical and neuropathological data in such cases will provide some clues to discover the etiology and classification of multiple system degeneration that occurs in association with iron deposition.

A progressive postoperative increase in the serum level of soluble receptors for interleukin-2 is an indicator of a poor prognosis in patients with gastric cancer

Activated T lymphocytes release a soluble form of IL-2R (SoIL-2R) into the bloodstream, which can be detected by CD25 monoclonal antibody. Perioperative changes of serum levels of SoIL-2R and the number of CD25-positive cells were monitored simultaneously to clarify the clinical implications of SoIL-2R in patients with gastric cancer (n=91). Preoperative levels of SoIL-2R were significantly higher than in normal controls and levels were a useful indicator of possible lymph node involvement. Postoperative levels of SoIL-2R increased independently of the number of CD25-positive cells. Patients with progressive postoperative increases in levels of SoIL-2R had both a significantly high frequency of postoperative relapse and a poor prognosis. Increased SoIL-2R may reduce the availability of IL-2 by binding to it. Postoperative progressive increases in SoIL-2R appear to be a good indicator for a poor prognosis in patients with gastric cancer.

Comparison of cellular characteristics between human hepatoma cell lines with wild-type p53 and those with mutant-type p53 gene

Characteristics of human hepatoma cell lines with the wild-type p53 were compared with those of human hepatoma cell lines with the mutant-type p53. The p21 protein located downstream of p53 was expressed in cell lines with the wild-type p53 but was not expressed in cell lines with the mutant-type p53. As to other tumor suppressor genes such as p16 and p27, there was no difference in their expression between both types of cell lines. In addition, no marked difference was observed in the activities of CDK2 and CDK4 between cell lines with the wild-type and the mutant-type p53. Phosphorylated Rb protein was detected in all cell lines except the HLE line, indicating that this cell line may have a deletion of and/or a mutation of the Rb gene. These results indicate that abnormalities of tumor suppressor genes other than p53, p16, p27, and Rb may be involved in hepatocarcinogenesis. The population doubling time of the wild-type p53 cells was significantly longer than that of the mutant p53 cells. Neither type of cell line showed a specific chromosome distribution which would indicate karyotype instability. The cell lines expressing the wild-type p53 produced tumors at lower frequency than those with the mutant p53 gene. Although there was no significant difference in effects of TGF-beta 1, EGF, cholera toxin, and db-cAMP on cell growth between the two types of cells, all three cell lines with the wild-type p53 were resistant to cytotoxicity of TNF-alpha, while two of the three with the mutant p53 were very sensitive to its cytotoxic effects.

Amyloid beta-protein (Abeta) 1-40 but not Abeta1-42 contributes to the experimental formation of Alzheimer disease amyloid fibrils in rat brain

Two major C-terminal variants ending at Val40 and Ala42 constitute the majority of amyloid beta-protein (Abeta), which undergoes postsecretory aggregation and deposition in the Alzheimer disease (AD) brain. To probe the differential pathobiology of the two Abeta variants, we used an in vivo paradigm in which freshly solubilized Abeta1-40 or Abeta1-42 was injected into rat brains, followed by examination using Congo red birefringence, Abeta immunohistochemistry, and electron microscopy. In the rat brain, soluble Abeta 1-40 and Abeta1-42 formed aggregates, and the Abeta1-40 but not the Abeta1-42 aggregates showed Congo red birefringence. Electron microscopy revealed that the Abeta1-40 aggregates contained fibrillar structures similar to the amyloid fibrils of AD, whereas the Abeta1-42 aggregates contained nonfibrillar amorphous material. Preincubation of Abeta1-42 solution in vitro led to the formation of birefringent aggregates, and after injection of the preincubated Abeta1-42, the aggregates remained birefringent in the rat brain. Thus, a factor or factors might exist in the rat brain that inhibit the fibrillar assembly of soluble Abeta1-42. To analyze the postsecretory processing of Abeta, we used the same in vivo paradigm and showed that Abeta1-40 and Abeta1-42 were processed at their N termini to yield variants starting at pyroglutamate, and at their C termini to yield variants ending at Val40 and at Val39. Thus the normal rat brain could produce enzymes that mediate the conversion of Abeta 1-40/1-42 into processed variants similar to those in AD. This experimental paradigm may facilitate efforts to elucidate mechanisms of Abeta deposition evolving into amyloid plaques in AD.

Measurement of histidinohydroxylysinonorleucine and hydroxyproline in skin collagen by reversed-phase high-performance liquid chromatography after 9-fluorenylmethyl chloroformate labeling

A novel, highly sensitive method to quantify histidinohydroxylysinonorleucine (HHL), a trifunctional type of cross-link in skin collagen, was developed. HHL in skin hydrolysates labeled with 9-fluorenylmethyl chloroformate (FMOC-Cl) was separated by reversed-phase high-performance liquid chromatography. Mass spectrometric analysis revealed that two FMOCs were bound to two primary amino acid residues, histidine and hydroxylysine, but not to lysine residue in one HHL molecule. Hydroxyproline was simultaneously measured to express the molar ratio of HHL to collagen. The detection range of HHL was from 1 to 10 pmol and that of hydroxyproline from 1 to 50 pmol. A 6-mm punch-biopsied human skin sample contained 0.40 to 0.69 mol of HHL per one molecule of collagen. This sensitive method is useful as it is rapid and can be used to examine the aging process or the change of HHL content in skin collagens of various pathologic states.

Effect of mucosal resection on detrusor function in the disused rabbit bladder

A new rabbit model of disused bladder was developed. Disused bladders were created by sagittal splitting of the bladders along the midline and closure of one side (reservoir side), leaving the remaining side unclosed (disused). The mucosa was dissected from some of the disused sides. Tissue elasticity and the weight of the detrusor muscle were decreased by bladder disuse. The responsiveness to field stimulation, bethanechol, ATP, KCl, or isoproterenol, was decreased by disuse. Tissue elasticity and responsiveness to stimuli were decreased to a lesser extent in disused tissue with intact mucosa. Results suggest that the bladder mucosa helps to preserve the function of the disused bladder.

Molecular cloning, expression, and sequence analysis of the endoglycoceramidase II gene from Rhodococcus species strain M-777

Endoglycoceramidase (EGCase (EC 3.2.1.123)) is a hydrolase that hydrolyzes the linkage between the oligosaccharide and ceramide of various glycosphingolipids. This paper describes the molecular cloning and expression of EGCase II, one of the isoforms of EGCases. The gene encoding EGCase II was obtained by screening of a genomic DNA library from Rhodococcus sp. strain M-777 constructed in pUC19 with oligonucleotide probes deduced from a partial amino acid sequence of the enzyme protein. Recombinant Escherichia coli cells in which the EGCase II gene was expressed produced 14 units of the enzyme per liter of culture medium but did not produce sphingomyelinase. Recombinant EGCase II was a functioning enzyme with substrate specificity identical to that of the wild-type enzyme. Sequence analysis showed the presence of an open reading frame of 1470 base pairs encoding 490 amino acids. The N-terminal region of the deduced amino acid sequence had the general pattern of signal peptides of secreted prokaryotic proteins. Interestingly, the consensus sequence in the active site region of the endo-1,4-beta-glucanase family A was found in the amino acid sequence of EGCase II.

Reactivation of thermally inactivated enzymes by free and immobilized chaperonin GroEL/ES

Thermally inactivated bovine deoxyribonuclease I (DNase I) and yeast enolase were reactivated by GroEL/ES from Escherichia coli. In both cases, GroEL/ ES was found to have the ability to reactivate inactivated enzymes in an ATP-dependent manner. GroEL/ ES can interact with the enzymes that were denatured at high temperature and convert them to the active conformations. To test the applicability of GroEL/ES to the reactivation processes of thermally inactivated enzymes, GroEL/ES was immobilized using formyl-Cellulofine (GroEL/ES-Cellulofine) and its performance was studied. GroEL/ES-Cellulofine retained a sufficiently high ability to reactivate enzymes. Moreover, GroEL/ES-Cellulofine could be used repeatedly, indicating high durability. These results indicate that immobilized chaperonin is effective for reactivation of enzymes that are thermally inactivated in various bioprocesses.

Endoscopic transvesico-transurethral approach for repair of vesicovaginal fistula: initial case report

Through an endoscopic transvesico-transurethral approach, we closed a vesicovaginal fistula that occurred after hysterectomy in a patient with uterine leiomyoma. The 3-mm fistula, located in the midportion of retrotrigone, was resected transurethrally and sutured in two layers through two 5-mm suprapubic trocars placed into the bladder and the urethral route under pneumobladder. The patient had no urine leakage from the vagina after surgery.

Choroid plexus papilloma in the posterior third ventricle: case report

OBJECTIVE AND IMPORTANCE

The case of a 42-year-old woman with a choroid plexus papilloma (CPP) arising from the posterior wall of the third ventricle is described. This case is very unusual because the tumor did not have any connection with the choroid plexus but was attached to the normal brain parenchyma.

CLINICAL PRESENTATION

The patient presented with the symptoms of increasing intracranial pressure. Magnetic resonance imaging revealed hydrocephalus related to a small mass in the posterior third ventricle, occluding the aqueduct.

INTERVENTION

Surgery confirmed that the tumor was located at the surface of the posterior commissure without having any connection to the normal choroid plexus. A histopathological examination revealed a CPP with no attachment to the choroidal tissue.

CONCLUSION

A review of the literature demonstrates that CPPs without any connection to the choroid plexus are very unusual. To our knowledge, this is the first reported case of such a CPP that developed on the posterior wall of the third ventricle in which no choroid plexus was present. Furthermore, this tumor, to our knowledge, is also the smallest intraventricular CPP to be verified at surgery.

Effects of ethanol on responses of isolated rabbit urinary bladder and urethra

BACKGROUND

Acute ethanol ingestion increases the risk of urinary retention in patients with benign prostatic hyperplasia (BPH). To elucidate the mechanism of this effect, we investigated the in vitro effects of ethanol on lower urinary tract function in rabbits.

METHODS

The responses to various stimuli of muscle strips isolated from male rabbit bladder and urethra were determined in the presence of 0%, 0.5%, 1.0%, and 3.0% ethanol.

RESULTS

Basal tension of tissue strips taken from the bladder and the urethra was reduced by ethanol in a dose-dependent manner, as were bladder contractions induced by field stimulation, bethanechol, and ATP. Ethanol also reduced phenylephrine-induced contractions of the prostatic urethra. A high (3%) concentration of ethanol significantly reduced KCl-induced contraction of both the bladder and urethra, as well as urethral relaxation induced by field stimulation following contraction with 200 mumol/L phenylephrine.

CONCLUSION

Responsiveness of the rabbit lower urinary tract was significantly reduced by exposure to ethanol. A similar decrease in tonus and contractility of the detrusor and inhibition of relaxation in the prostatic urethra may lead to urinary retention in men following acute ingestion of ethanol.

Subpial amyloid plaques in the cerebellum in a case of Alzheimer's disease

We studied the morphological and immunohistochemical characteristics of subpial amyloid plaques (SAPs), which were found particularly in the cerebellum of an Alzheimer's disease (AD) patient, and compared them to the senile plaques (SPs) and amyloid angiopathy in AD cerebrum. The case presented herein exhibited a variety of amyloid deposition including SAPs and amyloid angiopathy. SAPs were visualized most intensely with antibodies to amyloid-beta protein (A beta), compared with the conventional staining methods including silver impregnation techniques. The most unique feature of the SAPs consisted in their morphology and location, which was between the pia mater and brain parenchyma, occasionally bulging outside the brain surface. Immunostaining with monoclonal antibodies against the carboxyl termini of A beta showed that SAPs were invariably positive for A beta 42/43, two-thirds of which were associated with A beta 40. Ultrastructurally SAPs appeared either fibrillar or amorphous and were separated originally from the brain parenchyma by sheets of glia limitans. The chronological relationships in the evolution of the SAPs are discussed with relevance to their morphology and location.

[Pneumonitis induced by the herbal medicine Sho-saiko-to in Japan]

We studied the clinical characteristics of pneumonitis induced by Sho-saiko-to (SST). Of 94 cases reported to a drug maker, 72 were judged to be SST-induced pneumonitis (52 men and 20 women, mean age 63.7 years). Most patients took SST for chronic liver diseases due to infection with the hepatitis C virus. The mean duration of SST therapy before the onset of pneumonitis was 50.2 +/- 42.1 days. Most patients presented with coughing, dyspnea, and fever of acute onset. Chest X-ray films showed diffuse ground-glass shadows and infiltration. Abnormally high levels of C-reactive protein and lactate dehydrogenase were common, as was hypoxia. Analysis of bronchoalveolar lavage fluid revealed abnormally high percentages of lymphocytes and neutrophils and a low CD4/CD8 ratio. Although 64 of 72 patients survived after cessation of SST only or steroid therapy, 8 died of respiratory failure despite high-dose steroid therapy. Compared with patients who survived those who died were more likely to have an underlying lung disease, had been taking SST longer after the onset of pneumonitis, and had more severe hypoxemia.

Adrenoleukodystrophy protein-deficient mice represent abnormality of very long chain fatty acid metabolism

We have generated a line of mice deficient in adrenoleukodystrophy protein (ALDP) by gene targeting in order to clarify the pathophysiology of adrenoleukodystrophy (ALD). ALDP-deficient male and female mice appeared normal clinically at least up to 12 months. Western blot analysis showed the absence of ALDP in the brain, spinal cord, lung, and kidney and normal expression of PMP70 in the liver, lung, and kidney. The amounts of C26:0 increased by 73-240% in the brain, spinal cord, lung, and kidney. beta-Oxidation of very long chain fatty acids (VLCFA) in cultured hepatocytes and fibroblasts was reduced to 35-50% of normal. Light and electron microscopy did not show demyelination in the brain, spinal cord, and peripheral nerve. Thus, the deficiency of ALDP in mice impairs the peroxisomal fatty acid beta-oxidation but does not duplicate the clinical and pathological abnormalities of the human ALD. These observations suggest that the accumulation of VLCFA alone is not sufficient to cause demyelination in the nervous system.