[Results of a survey of the relationship between palatine tonsil and IgA nephropathy]

To investigate the relationship between palatine tonsil and IgA nephropathy, a survey was performed by questionnaire to 154 non-ENT medical doctors who had reported case of IgA nephropathy. The questionnaire was sent in February 1997, and answers were obtained within one month from 93 doctors (79 internal physicians, 12 pediatricians and 2 pathologists); a 60.4% response rate. A total of 72.0% of doctors answered that renal pathology was the most important prognostic factor for IgA nephropathy. A total of 73.1% of doctors thought that the administration of corticosteroid was the most effective therapy for IgA nephropathy, whereas only one doctor answered that tonsillectomy was most effective. Urine protein was the most useful factor for the estimation of the treatment, according to 37.6% of doctors. The majority of doctors who replied to the questionnaire thought that palatine tonsil seemed to be involved in the pathophysiology of IgA nephropathy in less than half of patients with IgA nephropathy. In addition, they answered that the rate of patients with IgA nephropathy to whom tonsillectomy was effective was also less than 50%. The tonsillar provocation test was rarely performed for the diagnosis of tonsillar focal infection in IgA nephropathy. Furthermore, 51.6% doctors answered that urine protein was the most important factor in any estimation of the provocation test.

Modulation of glycine-induced currents by zinc and other metal cations in neurons acutely dissociated from the dorsal motor nucleus of the vagus of the rat

Effects of Zn2+ and other polyvalent cations on glycine-induced currents in the freshly dissociated rat dorsal motor nucleus of the vagus neurons were investigated under voltage-clamp conditions by the use of the nystatin-perforated patch recording configuration. Glycine evoked a Cl- current in a concentration-dependent manner with a half-maximum effective concentration (EC50) of 3.3x10-5 M. Strychnine inhibited the 3x10-5 M glycine-induced current in a concentration-dependent manner with a half-maximal inhibitory concentration (IC50) of 6.8x10-7 M. At low concentrations (3x10-8 M-3x10-6 M), Zn2+ potentiated the current elicited by 3x10-5 M glycine. On the other hand, at concentrations higher than 10-5 M, Zn2+ inhibited the glycine response. The biphasic action of Zn2+ was mimicked by Ni2+, but La3+ and Co2+ had only potentiating effect. Zn2+ shifted the concentration-response curve for the glycine-induced current without changing the maximum response, and the EC50 values for the glycine response in the absence and presence of 10-6 M and 10-4 M Zn2+ were 3.3x10-5 M, 1.3x10-5 M and 1.3x10-4 M, respectively. These results suggest that the biphasic modulation of glycine response by Zn2+ results from changes in apparent glycine affinity.

Prognosis of tonsillectomy in patients with IgA nephropathy

IgA nephropathy (IgAN) is a type of chronic glomerulonephritis characterized by IgA deposits mainly in the mesangial area. It does not have so favourable a prognosis as was initially thought. This nephropathy is one of the diseases affected by tonsillar focal infections, and there have been patients in whom tonsillectomy has been effective. In this study, 24 patients with IgAN were followed for more than 2 years after tonsillectomy and studied clinicopathologically. Remission of proteinuria was observed in 41.7% of the patients 6 months after surgery and in 50.0% 2 years after surgery. At 2 years after surgery, patients with minor and focal segmental renal lesions showed a significantly higher rate of remission of proteinuria than patients with diffuse renal lesions. There was no statistically significant difference between positive and negative patients in the rate of remission of proteinuria based on any parameter of the tonsillar provocation test at any time after surgery.

Cardiac death prediction and impaired cardiac sympathetic innervation assessed by MIBG in patients with failing and nonfailing hearts

BACKGROUND

Although cardiac sympathetic nerve dysfunction is related to poor clinical outcome, a critical sympathetic dysfunction level for predicting cardiac death is still unclear. The current study was designed to investigate which indices derived from metaiodobenzylguanidine (MIBG) imaging have prognostic value compared with clinical and cardiac function variables, and to determine the threshold of cardiac MIBG activity for identifying patients likely to suffer cardiac death in both failing and nonfailing hearts.

METHODS AND RESULTS

Myocardial I-123-MIBG activity was quantified as a heart-to-mediastinum ratio in 414 consecutive patients, 173 (42%) of whom had symptomatic heart failure. After cardiac function measurements, patients were followed up with an end-point of cardiac or noncardiac death. During a mean follow-up period of 22 months, 37 cardiac deaths occurred: 23 resulted from heart failure, 9 were sudden cardiac deaths, and 5 were fatal myocardial infarctions. Multivariate analysis using the Wald chi2 and the Cox proportional hazard model revealed that late heart-to-mediastinum ratio, the use of nitrates, early heart-to-mediastinum ratio, and left ventricular ejection fraction were independent predictors of cardiac death; late heart-to-mediastinum ratio, New York Heart Association (NYHA) class, the presence of previous myocardial infarction, and age were independent predictors of heart failure and sudden cardiac death. Late heart-to-mediastinum ratio was the most powerful predictor of overall cardiac death among the variables. The Kaplan-Meier analysis showed that a late heart-to-mediastinum ratio of 1.74 or less, age greater than 60 years, the presence of myocardial infarction, and NYHA functional class 3 or 4 strongly indicated poor clinical outcomes. Furthermore, the more powerful incremental prognostic values were obtained by using MIBG imaging in combination with conventional clinical variables.

CONCLUSIONS

Impaired cardiac sympathetic innervation assessed by MIBG activity has the greatest potential for predicting cardiac death and may be useful for identifying a threshold level for selecting patients at risk for death by heart failure, sudden cardiac death, and fatal myocardial infarction.

Molecular cloning of the cDNA encoding A + U-rich element RNA binding factor

Using the differential display method, a new cDNA clone, termed laAUF1, encoding the human A + U-rich RNA-binding motif was isolated and sequenced. Analysis of the protein sequence of laAUF1 indicates 73% homology between the deduced polypeptide sequences of laAUF1 and AUF1 in the region encoding a consensus motif for two non-identical RNA recognition motifs (RRMs) and Gln-rich motif. We suggest that the similar affinities of laAUF1 and AUF1 for particular A + U-rich elements (ARE) sequences are related to their potencies as mRNA destabilizers.

[Two cases of subarachnoid hemorrhage associated with neurofibromatosis type I: a case of multiple cerebral aneurysms and arteriovenous malformation, and another case of an anterior communicating artery aneurysm]

Two cases of subarachnoid hemorrhage associated with neurofibromatosis type I (von Recklinghausen's disease) are reported. A 30-year-old male patient (case 1) had been diagnosed as having neurofibromatosis type I due to neurofibroma and café-au-lait spot. He suffered from subarachnoid hemorrhage and angiography showed multiple aneurysms in the right and left middle cerebral arteries and left internal carotid artery. He also had arteriovenous malformation in the left temporal lobe. Case 2 was that of a 62-year-old female patient with neurofibroma and café-au-lait spot. She suffered from subarachnoid hemorrhage and angiography showed an aneurysm in the anterior communicating artery. Both patients were discharged with no deficits after neck clipping, however they both suffered from large-sized hematoma in the punctured site of the femoral artery after angiography. The cerebral aneurysms associated with neurofibromatosis type I are often multiple and may coexist with arteriovenous malformation.

[A case of intradural xanthogranuloma in the upper cervical spine]

An 18-year-old female patient suffered from posterior neck pain and gait disturbance. The neurological examination revealed left hemiparesis, general hyperreflexia and hypoalgesia on the right neck and upper limb, and left trunk and lower limb. MRI showed a large mass lesion in the right side of the spinal canal at the level of the C1 cervical spine, which was obviously compressing the spinal cord. An operation was performed through a right suboccipital craniectomy and right hemilaminectomy of the first vertebra. Though the mass lesion in the subarachnoid space compressed the spinal cord, it adhered neither to the spinal cord nor to the nerve roots. However, as it clearly adhered to the dura mater, the attachment site was also completely removed. In the pathological examination, lymphocyte, foamed macrophage and the giant cell of Touton type were shown. The immunohistochemical study with CD68 (Kp1) was positive, but it was negative for the lysozyme, neuron specific enolase and S-100 protein. The diagnosis was xanthogranuloma. The patient recovered completely after the operation. This is a rare case of juvenile type xanthogranuloma. This lesion in the spinal canal has usually its onset in the adult age.

Increased A beta 42(43)-plaque deposition in early-onset familial Alzheimer's disease brains with the deletion of exon 9 and the missense point mutation (H163R) in the PS-1 gene

Cerebral amyloid deposition is a neuropathological hallmark for Alzheimer's disease (AD). Immunohistochemical analysis of two A beta species (A beta 42/43 and A beta 40) deposition was undertaken using the carboxyl end-specific antibodies to determine the molecular alteration of these species in the brains of patients whose presenilin 1 (PS-1) gene, the major causative gene for the early-onset familial AD, bears the point mutation (H163R) and the deletion of exon 9. We found a marked increase in A beta 42-plaque deposition in brains of patients with PS-1 mutations compared with that in brains of those with sporadic AD. The results of immunohistochemical analysis indicate that both mutation and deletion in the PS-1 gene promote deposition of A beta 42-plaques indicating the pathological association of PS-1 and betaAPP/A beta 42 in early-onset familial AD.

Pharmacokinetics of enrofloxacin in the red pacu (Colossoma brachypomum) after intramuscular, oral and bath administration

The intramuscular (i.m.), oral (p.o.), and bath immersion disposition of enrofloxacin were evaluated following administration to a cultured population of red pacu. The half-life for enrofloxacin following i.m. administration was 28.9 h, considerably longer than values calculated for other animals such as dogs, birds, rabbits, and tortoises. The 4 h maximum concentration (Cmax) of 1.64 micrograms/ml, following a single 5.0 mg/kg dosing easily exceeds the in vitro minimum inhibitory concentration (MIC) for 20 bacterial organisms known to infect fish. At 48 h post i.m. administration, the mean plasma enrofloxacin concentration was well above the MIC for most gram-negative fish pathogens. The gavage method of oral enrofloxacin administration produced a Cmax of 0.94 microgram/mL at 6-8 h. This Cmax was well above the reported in vitro MIC. A bath immersion concentration of 2.5 mg/L for 5 h was used in this study. The Cmax of 0.17 microgram/mL was noted on the 2 hour post-treatment plasma sample. Plasma concentrations of enrofloxacin exceeded published in vitro MIC's for most fish bacterial pathogens 72 h after treatment was concluded. Ciprofloxacin, an active metabolite of enrofloxacin, was detected and measured after all methods of drug administration. It is possible and practical to obtain therapeutic blood concentrations of enrofloxacin in the red pacu using p.o., i.m., and bath immersion administration. The i.m. route is the most predictable and results in the highest plasma concentrations of the drug.

Fisher syndrome after Campylobacter jejuni enteritis: human leukocyte antigen and the bacterial serotype

We describe two children who had Fisher syndrome subsequent to Campylobacter jejuni enteritis. The C. jejuni isolates from both patients, who lived in different areas, belonged to PEN 2: LIO 4. One patient had the following human leukocyte antigens (HLAs): HLA-A24, 33; B44, 52; DQ1; and DR2, 6 antigens. Another had the HLA-A24, 33; B44, 54; Cw1; DQ1, 4; and DR4, 6. An effort should be made to isolate C. jejuni from patients with Fisher syndrome and to perform HLA typing so that the pathogenesis of this syndrome can be clarified.

[An autopsy case of primary central nervous system lymphoma with diffuse intracerebral lesion]

A case of primary central nervous system lymphoma (PCNSL) who initially showed clinical pictures like encephalitis and diffuse lesions on MRI was reported, including postmortem pathologic examinations. A 68-year-old woman was seen in March, 1990 with a 1-month history of the progressive gait disturbance. She was very unstable and could barely stand by herself, though she did not show any focal neurologic deficits. She showed no evidence of systemic diseases. The cerebrospinal fluid analysis was normal. T2-weighted image of MRI demonstrated the diffuse symmetric hyperintense lesions mainly in the periventricular white matter. The progressive intellectual decline and the spasticity of four limbs developed as the diffuse lesions on MRI gradually extended. Despite the administration of corticosteroids under the presumptive diagnosis of PCNSL, she rapidly fell into the apallic syndrome within two months. Her EEG showed periodic synchronous discharges. Three months later, she suddenly developed signs of right uncal herniation. CT showed a large mass lesion in the right hemisphere. After the anti-edema therapy, signs of herniation regressed. The serial CT scans demonstrated a gradual decrease in the mass effect, while another multi-nodular lesions appeared and then disappeared one after another bilaterally. Eventually, the diffuse low densities in the cerebral white matter and the ventricular enlargement had remained. She died of bronchopneumonia eight month after the onset of symptoms. The clinical importance of the diagnosis of PCNSL which initially shows diffuse symmetric lesions without a mass is stressed. Postmortem examinations revealed PCNSL, diffuse, large cell type according to the Lymphoma Study Group classification. The lymphoma cells were proved to be B cell origin from the immunohistochemical study of frozen tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of FOY-305 on post-operative reflux esophagitis in rats (I). Effects of FOY-305 on reflux esophagitis after total gastrectomy in rats]

We investigated the effect of camostat mesilate (FOY-305), an oral protease inhibitor, on reflux esophagitis after total gastrectomy followed by an end-to-side esophago-jejunostomy (Billroth-II) in rats. Effects of FOY-305 were compared with those of sodium alginate (AL-Na) and cimetidine. On the basis that esophageal ulceration occurred from post-operative day 5 in this model, rodents were fed with special chows containing test drugs from day 2 for 5 or 12 days in order to examine the prophylactic effects (Exp. I) and from day 7 for two weeks in healing experiments (Exp. II). In Exp. I, FOY-305 significantly prevented esophageal ulceration on post-operative days 7 and 14. However, AL-Na significantly prevented esophageal ulceration on post-operative day 7 but not on day 14. In Exp. II, FOY-305 had a remarkable therapeutic effect on esophageal ulceration on day 21. Food intake and body weight of rodents in the FOY-305-treated group were higher than those in the control group. In pathohistological studies, FOY-305 elicited an inhibitory effect on ulceration and induced esophageal mucosal regeneration at the ulceration sites. In contrast, AL-Na and cimetidine did not have any significant therapeutic effect. These results suggest that FOY-305 is an effective agent for the treatment of reflux esophagitis after total gastrectomy.

Cloning and nucleotide sequence of the CDC23 gene of Saccharomyces cerevisiae

As a preliminary step for studying the function and intracellular behavior of the product of the CDC23 gene, a cell cycle gene of Saccharomyces cerevisiae, we cloned the CDC23 gene and determined its nucleotide (nt) sequence. The nt sequence contains an open reading frame (ORF) of 1878 nt coding for a protein of 626 amino acids (aa). The CDC23 gene is expressed as a 2.4- to 2.5-kb major transcript. The putative protein product of the CDC23 gene has a potential Ca2(+)-binding site near its N terminus, and has four contiguous repeats of a consensus sequence consisting of 34 aa near its C terminus. Regions that can be regarded as consisting of repeats of the same consensus sequence were found in the published aa sequences of the products of three other yeast genes.

[Pituitary hemorrhage extending into the third ventricle. Case report]

A case of pituitary apoplexy causing pituitary hemorrhage with extension into the third ventricle is reported. The patient was a 73-year-old, obese female admitted with sudden onset of vomiting and impaired consciousness. Neurological examination revealed that she was stuporous, with marked neck stiffness and a dilated left pupil. A plain skull X-ray showed sellar enlargement and destruction of the dorsum sellae. Computed tomography demonstrated a high-density area in the third and lateral ventricles and a round, high-density mass in the suprasellar cistern. The patient died the next day. Autopsy revealed a large tumor in the sellar and suprasellar areas. The tumor and the hematoma within it compressed the floor of the third ventricle and passed through the lamina terminalis and the hypothalamic region. Histological examination disclosed a basophilic adenoma. The pituitary hemorrhage appeared to be the result of ischemia and necrosis within the pituitary adenoma caused by its acute expansion. The extension of the hematoma into the third ventricle was attributable to the large size of the tumor and its close adhesion to the floor of third ventricle.

[A case of pseudohypoparathyroidism with intracerebral calcification]

Intracerebral calcifications, especially in the basal ganglia, are observed in many kinds of diseases. A 41-year-old man is reported, who suffered from an acute epidural hematoma and underwent surgery to remove the hematoma. We detected very extensive intracerebral calcification on CT. Laboratory findings revealed hypocalcemia and hyperphosphatemia. General physical examination revealed characteristics typical of pseudohypoparathyroidism. The patient was diagnosed as having pseudohypoparathyroidism type I by the Ellsworth-Howard test. Since the advent of CT, the incidence of basal ganglia calcification has increased. CT is 5 to 15 times more sensitive than skull radiography in the detection of intracerebral calcification. Although many pathological states can cause basal ganglia calcification, most of the calcifications which are recognized on CT scans are physiological. But in cases in which basal ganglia calcifications are recognized also on plain radiographs, various kinds of symptoms including ones of basal ganglia origin are often recognized, and calcifications often extend to regions other than basal ganglia, eg. cerebellum, thalamus, etc. Pseudohypoparathyroidism is a rare disease which presents hypocalcemia, some characteristic physical appearances, and dementia. It is important to decide whether further examinations are necessary or not, when basal ganglia calcification is recognized incidentally on CT scan.

A possible role for calmodulin in Ca2+-induced swelling of mitochondria

Ca2+-induced mitochondrial swelling was inhibited by a low concentration of calmodulin antagonists. Two affinities of Ca2+ to mitochondrial swelling were observed: high (2-5 microM) and low (more than 100 microM) systems. The high-affinity change was inhibited by micromolar level of trifluoperazine and W-7, but not by W-5. The possible mechanism of this inhibition and the role of CaM in mitochondria are discussed.

[Two cases of percutaneous transluminal angioplasty (PTA) for the treatment of subclavian steal syndrome]

Recently percutaneous transluminal angioplasty (PTA) has been used to treat atherosclerotic lesion of the brachiocephalic arteries. We treated two patients with subclavian steal syndrome successfully by PTA. The first patient was a 52-year-old man complaining of vertigo and ischemic symptoms of the left arm. Blood pressure was 110/90 mmHg in the left arm and 140/92 mmHg in the right. On the angiogram, about 80% stenosis was found in the proximal portion of the left subclavian artery, and retrograde filling of the left vertebral artery was observed. At first, a carotid-subclavian bypass surgery was performed, but unfortunately failed because of obstruction of the artificial arterial graft. Then we performed PTA using Grüntzig balloon dilatation catheter. The dilatation was carried out successfully. Immediately after PTA, to-and-fro and antegrade flow of the vertebral artery was observed, and one month later it became normal flow. Neurological symptoms gradually disappeared within two months. The second patient was a 57-year-old man suffering from vertigo on effort and TIA. Blood pressure was 130/78 mmHg in the left arm, and 152/82 mmHg in the right. Angiogram showed more than 95% stenosis of the left subclavian artery, and retrograde filling of the left vertebral artery. We also observed bilateral severe stenosis of the MCA. Carotid-subclavian bypass was dangerous because of the low perfusion of the ipsilateral MCA area. PTA was performed as the first choice, and the dilatation of the stenosis was sufficient. In two months natural antegrade filling of the left vertebral artery was obtained. We followed these patients for 12 months and no restenosis was observed neurologically and radiologically. We performed PTA with the Grüntzig balloon catheter using the Seldinger's method through the right femoral artery. Diameter of the balloon was 6 mm and its length was 4 cm. After setting the balloon to the stenotic lesion, we inflated the balloon with 5atm (75 psi) pressure for 30 minutes. Monitoring the blood pressure and arterial pressure wave at the tip of the catheter, we repeated inflation of the balloon 4 times. We used continuous venous infusion of low molecular dextran and heparin during PTA procedures. No complication occurred and neurological symptoms disappeared gradually. PTA is a safe and effective method, so it should be the first choice in the treatment of subclavian steal syndrome caused by severe stenosis of the subclavian artery.

Immunohistochemical localization of calcineurin, calmodulin-stimulated phosphatase, in the rat hippocampus using a monoclonal antibody

Immunohistochemical localization of calcineurin, a calmodulin-stimulated phosphatase, was examined in the rat hippocampus by using a monoclonal antibody VD3 which is specific for the A subunit (61 kDa) of calcineurin. The stratum lucidum, where the mossy fiber terminal forms giant synaptic boutons, showed strong immunoreactivity.

Cloning and expression in Escherichia coli of the gene for an Arthrobacter beta-(1----3)-glucanase

When inserted in the correct orientation at the BamHI site of plasmid YRp7, an 8.6-kilobase BamHI fragment of Arthrobacter sp. strain YCWD3 DNA gave Escherichia coli HB101 cells harboring the recombinant plasmid pBX20 the ability to lyse bakers' yeast cell walls or bakers' yeast glucan in agar medium. An extract of the transformed E. coli cells contained an endo-beta-(1----3)-glucanase with the same activity pattern as that of glucanase I produced by Arthrobacter sp. strain YCWD3. Although part of the glucanase activity was contributed by apparently defective molecules, two protein species were found which had high lytic activity on yeast cell walls and adsorbed to microcrystalline cellulose, and both had a single constituent polypeptide with a molecular weight of about 55,000, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. In these properties the protein species were indistinguishable from those glucanase I protein species of Arthrobacter sp. strain YCWD3 which we believe are nearly the intact molecule. We conclude that the cloned fragment of Arthrobacter sp. strain YCWD3 DNA contains the structural gene for glucanase I. A recombinant plasmid obtained by subcloning a PstI fragment of pBX20 into pBR322 caused the transformed E. coli cells to produce apparently defective glucanase molecules only. This observation serves as additional supporting evidence for our conclusion.

Identification of calmodulin-binding proteins in pure mitochondria by photoaffinity labeling

Calmodulin-binding proteins (CaM-BPs) were identified in the submitochondrial fractions obtained from highly purified rat liver mitochondria. The matrix fraction contained five CaM-BPs with apparent molecular weights (MW) of 27K, 38K, 47K, 76K, and 84K Da in a Ca solution. Electron transfer particles also contained five CaM-BPs, but their MWs were 31K, 35K, 53K, 66K, and 73K in a Ca solution. Nonspecific calcium-independent CaM-BPs were also identified in matrix fractions, having MWs of 10K, 25K, and 49K Da.

Selective immunoglobulin M deficiency associated with disseminated molluscum contagiosum

A 16-year-old girl with disseminated molluscum contagiosum (MC) was found to have a very low level of serum IgM, elevated levels of IgG and IgA, and a high level of IgE. She had normal numbers of peripheral blood IgM+, IgG+ and IgA+ B-lymphocytes but their terminal differentiation into plasma cells could not be induced by pokeweed mitogen (PWM) in vitro. On the other hand, the patient's T-cells showed normal helper functions in the PWM system and normal interferon (IFN) production in vitro. However, the IgM+ B-cells can be induced to differentiate into IgM secreting cells by Epstein-Barr virus (EBV), suggesting that the genetic mechanism for synthesis of the component immunoglobulin proteins is present. T-cell functions were impaired, as shown by delayed type cutaneous hypersensitivity (DTH) and mitogen response. The data suggest that the selective IgM deficiency of the patient is due mainly to defects in B-cells at the terminal differentiation stage, but immunological abnormalities are present in both B and T-cell systems. Neutrophil functions examined were normal. MC was treated by intravenous injection of IFN without any side effects; however, no clinical improvement was achieved.

[A case of chronic subdural hematoma in a hemodialyzed patient]

In proportion to a rapid increase of dialysis patient, death caused by neurological complications is increasing annually among long-term hemodialyzed patients. A case of chronic subdural hematoma during long-term hemodialysis is presented. A 35-year-old male had undergone hemodialysis three times weekly for four years. He had marked changes in body-weight and blood pressure between hemodialysis. In March 1983, he had a headache, vomiting, and left hemiparesis. The CT scan showed a right subdural hematoma. He was admitted to our hospital 10 days later because of progressive hemiparesis and speech disturbance. The neurological examination showed left hemiparesis with sensory deficit and dysarthria. The CT scan showed an increase in the size of the subdural hematoma. Bleeding time was over 10 minutes. A right-sided burr hole was made and altered blood was removed and irrigated. After operation, headache and weakness rapidly subsided, but the next morning, attacks of convulsion occurred. The CT scan showed the rebleeding in the subdural space. After correcting the level of serum potassium by hemodialysis, a right parietal craniotomy was performed. Hematoma of about 100 g was removed and the capsule of the hematoma showed organized tissue histologically. Postoperatively, although attacks of convulsion occurred temporarily, he gradually improved. The levels of serum potassium and BUN were controlled by several treatments of hemodialysis. He was discharged with only mild hemiparesis. Subdural hematoma caused by hemodialysis is a very important complication. Chronic subdural hematoma is sometimes very difficult to differentiate from dysequilibrium syndrome or dialysis dementia. The CT scan is a very valuable examination to rule out subdural hematoma.

[Effects of 4-(o-benzylphenoxy)-N-methylbutylamine hydrochloride (MCI-2016, bifemelane hydrochloride) on coagulation, fibrinolysis, hemolysis, hemorheological properties and platelet aggregation]

MCI-2016 showed little influence on coagulation (APTT) and fibrinolysis (plasma clot lysis activated by urokinase) at doses (concentrations) as high as 300 mg/kg, p.o. or 8.6 X 10(-4) M. Hemolytic action of MCI-2016 was only observed at the concentrations above 2 mM. The drug also showed no influence on blood glucose level (30-300 mg/kg, p.o.). Effects of MCI-2016 on hemorheological properties were studied either in vitro or ex vivo. Above the doses (concentrations) of 100 mg/kg, p.o. and 10 microM, MCI-2016 suppressed the mechanical hemolysis and accelerated the membrane filtration rate. These effects of MCI-2016 were superior to those of cinepazide, Ca-hopantenate, meclofenoxate and pentoxyfylline. MCI-2016 also inhibited platelet aggregation induced by collagen with the IC 50 of 35 to 60 microM (rabbit and human platelets). Secondary aggregations of ADP and epinephrine were also inhibited by MCI-2016. As for reference drugs, bencyclane showed inhibitory patterns similar to MCI-2016. Other drugs examined exhibited little effect. In summary, it may be suggested that MCI-2016 exhibits beneficial influences in the clinical fields of cerebrovascular diseases.

A direct evidence of the localization of mitochondrial calmodulin

The presence and localization of mitochondrial calmodulin was directly proved immuno-electron microscopically by the protein A-gold technique. In the ultra-pure mitochondria the complexes of anti-calmodulin antibody and protein A-gold clearly showed the localization of mitochondrial calmodulin on the inner membrane and in the matrix space.

Cell-cycle-dependent changes of the negative surface charges in L929 cells

The negative charges of cell surface were studied by the adsorption method of methylene blue in the synchronized cultures of L929 cells and its spontaneously transformed cell strain. The negative surface charges of the transformed cells were twice those of the original cells through all cell cycle phases. The surface charges cell-cycle-dependently changed in both cell systems and there were two maximum peaks at early G1 and S phase.

Fluorescence spectral studies on the specific interaction between sulfated glycosaminoglycans and potato lectin

On excitation at 280 nm, Solanum tuberosum agglutinin (STA) produced a fluorescence emission spectrum with a maximum at 347 nm, which is typical of tryptophanyl residues. The fluorescence emission maximum was shifted toward shorter wavelength and quenched by the addition of specific sugars. The changes were analyzed precisely and quantitatively by measuring the fluorescence difference spectra. This method required far smaller amounts of samples than UV-difference spectroscopy to obtain the binding parameters. The binding constants of chitin sulfate, keratan sulfate, and highly sulfated keratan sulfate were calculated to be 1.8 X 10(5) M-1, 3.4 X 10(5) M-1, and 5.2 X 10(5) M-1, respectively. The results indicate that consecutive and non-consecutive, alternating (1 leads to 4)-N-acetyl-beta-D-glucosaminyl residues in the glycosaminoglycans can interact freely with STA in spite of the existence of the sulfate groups at C-6 of the N-acetyl-D-glucosaminyl residues and extra sulfate groups at C-6 of the galactosyl residues linked with N-acetyl-6-O-sulfo-beta-D-glucosamine.

[Clinical evaluation of cefmetazole in the dermatologic field]

The therapeutic efficacy and safety of cefmetazole, a cephamycin-derived antibiotic in an injectable form were evaluated in patients with pyogenic infection in the dermatological field. Especially, it was found to be extremely effective for the skin diseases due to staphylococci or streptococci. The results obtained were the following; marked improvement in 18 cases and moderate improvement in 34 cases out of 61 cases, attaining efficacy of 86.7%. Side effects were noted as the rise of GOT and GPT in 3 cases, which were normalized by ceasing its further administration. The MIC of cefmetazole against Staphylococcus aureus isolated out of foci was 0.39-6.25 microgram/ml, while those of CEZ, CXM and ABPC used as the controls exceeded 50 microgram/ml in some cases. It is considered thus, that cefmetazole, is superior to these other antibiotics also in terms of MIC.

Serial observations of brain stem function by auditory brain stem responses in central transtentorial herniation

Changes in auditory brain stem responses were serially investigated in a patient with downward transtentorial herniation due to acute obstructive hydrocephalus to correlate the neurological signs with the results of computerized tomography. Neurological deterioration correlated highly with disruption of auditory brain stem responses, especially with that of the components of waves V to VII. A noninvasive technique, the measurement of auditory brain stem responses is thought to be useful in detecting the severity of downward transtentorial herniation and in estimating the recovery of brain stem function after surgical treatment of intracranial hypertension.

Interaction of sulfated glycosaminoglycans with lectins

The sulfated glycosaminoglycans, such as keratan sulfate and chitin sulfate having 3-hydroxy free N-acetyl-beta-D-glucosaminyl residues as constituents, reacted with wheat germ agglutinin and Solanum tuberosum agglutinin by sugar-specific interaction. The glycosaminoglycans showed different inhibitory activities to the hemagglutination reaction of these lectins and keratan sulfate and its modified products formed insoluble complexes with both of the lectins at pH 7.0 in physiological saline solutions (0.15 M NaCl). S. tuberosum agglutinin was precipitated within a particularly narrow concentration range of keratan sulfate, and the formation of a soluble complex was observed by gel chromatography. These interactions were specifically inhibited by N,N'-diacetylchitobiose but not by 2 M NaCl. The specific interactions of the glycosaminoglycans with S. tuberosum agglutinin were confirmed by their ultraviolet difference spectra with two peaks at 285 and 298 nm attributable to the tryptophan residues in the binding site of the agglutinin. It was also found that S. tuberosum agglutinin and wheat germ agglutinin have different binding specificities. The presence of sulfate groups in either keratan sulfate or chitin sulfate did not interfere with their specific interactions with S. tuberosum agglutinin as strongly as with wheat germ agglutinin. The N-acetylneuraminic acid residues in keratan sulfate were found to be receptor sites for wheat germ agglutinin but not for S. tuberosum agglutinin.

Heat stable cell growth inhibiting factor isolated from rat liver microsomes

A heat stable cell growth inhibiting factor was isolated from rat liver microsomes by hot salt extraction, ethanol fractionation and the hot phenol method. The factor was contained in the RNA fraction (designated as mhRNA). mhRNA inhibited the growth of mouse fibroblast (L-929) cells at a relatively low concentration (55 microgram/ml of culture medium). The molecular weight of mhRNA was about 27,000 and the base composition was guanine and cytosine rich.

Primary intracranial malignant lymphomas with particular reference to their pathogenesis

During the past 6 years we have experienced a total of 6 cases of malignant lymphomas, which originated primarily in the central nervous system. The most reliable diagnostic criteria will be a "perivascular cuffing" by silver impregnation with further spreading of tumor cells to the periphery, a "starry-sky" appearance consisting of numerous histiocytes with foamy cytoplasm intermingled with tumor cells, and cytological features of the imprint preparation. Since there is a close histologic similarity to extracerebral malignant lymphomas, we would like to propose that these tumors should be regarded as primary malignant lymphomas of the central nervous system instead of mere reticulum cell sarcoma-microglioma, and also would like to regard the brain to be not an exceptional site other than visceral lymphomas for occurrences of malignant lymphomas. For the pathogenesis of primary intracranial malignant lymphomas, the hypothesis, proposed by FEIGIN, of the possible existence of multipotential stem cells in the brain was discussed.

Purification and some characteristics of liver cytosol cornin, an antimitotic substance from rat liver cytosol

Further purification and characterization are reported on rat cytosol cornin (RLCC), an antimitotic substance. Fraction I (purified RLCC) was purified more than 10-fold from crude RLCC with Sephadex G-50 column chromatography and showed a remarkable inhibitory effect on division of inseminated sea urchin eggs and mouse fibroblast cells. Fraction I was observed as one spot, and the molecular weight was estimated to be about 25,000 by thin layer gel filtration. Fraction I contained protein (92%) and RNA (8%), but the antimitotic activity was scarcely affected by treatment by pancreatic RNase. The protein of Fraction I was separated into two bands by SDS-polyacrylamide gel electrophoresis, and the molecular weight was estimated as 10,000 and 15,000, respectively. The 50% inhibition dose of Fraction I on the first division of inseminated sea urchin eggs and on proliferation of mouse L cells was about 2.5 X 10(-5) g/ml and 5 X 10(-4) g/ml, respectively. The yield of fraction I was about 35 mg from 100 g rat liver.

ANTIBODY TITER AND CLINICAL COURSE OF PEMPHIGUS

The relationship between the titer of pemphigus antibody and the clinical course of the disease was investigated in 15 patients with various types of pemphigus. Although antibody titers generally ran parallel to fluctuations of the clinical course, the elevation of antibody titer appeared to follow the re-appearance or exacerbation of the lesions on 10 occasions in 6 patients, while it appeared to precede the latter only on 2 occasions in 2 patients. In addition, the disappearance of the antibody was considerably delayed after disappearance of skin lesions in 2 cases. These findings suggest that the pemphigus antibody is the result of skin damage, rather than the cause of pemphigus itself.