Phosphatidylinositol-3 kinase in fission yeast: a possible role in stress responses

A DNA fragment coding for a part of a putative phosphatidylinositol 3 kinase was cloned from Schizosaccharomyces pombe by cross-hybridization with Saccharomyces cerevisiae VPS34 gene, a yeast homologue of mammalian PI-3 kinase. The clone contained an open reading frame of 797 amino acids but lacked the initiation codon, ATG. The predicted amino acid sequence was homologous to those of S. cerevisiae VPS34 and mammalian PI-3 kinase genes. Disruption of the gene resulted in extremely low levels of PI-3-P and higher levels of PI-4-P, supporting the idea that the gene codes for the PI-3 kinase of S. pombe. The disruptants harbored large vacuoles and were sensitive to stresses such as high temperature or high concentration of monovalent and divalent cations.

[Evaluation of anastomosis between intrahepatic or extrahepatic vessels by intra-arterial digital subtraction angiography using carbon dioxide]

Carbon dioxide (CO2) intraarterial subtraction angiography (IADSA) was performed in 31 patients with various hepatobiliary diseases. The injection sites of CO2 were proper hepatic artery (10/31; group A), segmental hepatic artery (18/31; group B), and peripheral inferior phrenic artery (3/31; group C), respectively. In group A, only the third order branches of the portal venous system were visualized anterogradely in 8 of 10 patients. In group B, the microcatheter was placed coaxially through a 5 French guiding catheter at the main arterial supply of the tumor in 7 patients and at the peripheral segmental branch of the hepatic artery in 11 patients. The portal venous system was visualized retrogradely in all of the patients regardless of the injection site. The injected CO2 may flow back into the portal vein through the anastomosis known as the peribiliary or periportal plexus. In group C, not only the portal vein but also the pulmonary artery or pericardial vein were visualized by this method. CO2-IADSA was useful to image the minute communications between the various vessels, which have been not hitherto visualized by iodinated contrast medium.

[Relationship between regional flow reserve supplied by the great saphenous vein graft and regional left ventricular wall motion: a Doppler guide wire study]

The relationship between regional flow reserve supplied by a great saphenous vein graft and myocardial infarction and anterior wall motion assessed by left ventriculography was studied in 28 patients with no stenosis in the great saphenous vein graft and the peripheral site of the recipient left anterior descending coronary arteries. The proximal segment to the anastomosis was totally or subtotally occluded. The resting graft blood flow velocity was measured using a Doppler guide wire, then 0.56 mg/kg of dipyridamole was injected for 4 minutes intravenously and the resultant increase in graft blood flow velocity was recorded. The regional flow reserve of the anterior wall supplied by great saphenous vein grafts in 11 patients with anterior myocardial infarction (MI group) was significantly lower than that in 17 patients without myocardial infarction (non-MI group) (1.5 +/- 0.3 vs 2.6 +/- 0.7, p < 0.01). The flow reserve supplied by great saphenous vein grafts in 11 patients with normal anterior wall motion was 2.8 +/- 0.7, 10 with hypokinesis 1.9 +/- 0.3, and with akinesis 1.3 +/- 0.3. Reduced anterior wall motion induced a significant decrease in the flow reserve of the anterior wall supplied by the great saphenous vein graft (p < 0.01). The anterior wall motion score of four segments assessed by left ventriculography showed a significant correlation with the flow reserve of the anterior wall supplied by the great saphenous vein graft (y = -0.24 x + 3.7, r = 0.75, p < 0.001). The results show infarcted myocardium was an important influence on coronary flow reserve.

Increment of CD8S6F1 cells in synovial fluid from patients with rheumatoid arthritis

OBJECTIVE

To investigate the role of CD8 cell subsets in the pathogenesis of rheumatoid arthritis (RA) and the phenotypes of T cells adherent or non-adherent to the target cells (endothelial cells and synovial cells) pre-treated with IL-1 beta.

METHODS

The expression of S6F1 on CD8 cells and that of an activation marker on CD8 cells and CD8 cell subsets was evaluated in specimens of peripheral blood and synovial fluid obtained from 15 patients with RA and 10 with osteoarthritis (OA) using a two- or three-colour immunofluorescence method for analysis.

RESULTS

The percentage of CD8S6F1 cells among CD8 cells in synovial fluid was significantly greater than that of peripheral blood. Synovial fluid from RA patients had a greater percentage of CD8S6F1 cells compared with either peripheral blood of matched patients or synovial fluid of OA patients. The percentage of CD8HLA-DR cells in synovial fluid was markedly greater than that in paired samples of peripheral blood in patients with RA. In the CD8S6F1 cells from both groups of patients, synovial fluid showed an increased percentage of HLA-DR cells compared with peripheral blood. Similar results were observed in CD8 cells lacking S6F1 expression (CD8S6F1-) from both groups of patients. There was no significant difference in the percentage of HLA-DR cells between CD8S6F1 and CD8S6F1- cell populations in peripheral blood. In contrast with peripheral blood, in synovial fluid of RA patients the percentage of HLA-DR cells in the CD8S6F1 cell population was markedly greater than that in the CD8S6F1- population. However, the percentage of HLA-DR cells in both cell populations was similar in synovial fluid of OA patients. In both the endothelial and the synovial cell adhesion assays, the percentage of CD8S6F1 among CD8 cells and the mean fluorescence intensity of S6F1 antigen on CD8S6F1 cells were significantly greater in the adherent T cell population than that in the non-adherent T cell population.

CONCLUSION

These results suggest that increased expression of S6F1 antigen and the increased percentage of HLA-DR cells on CD8 cells in synovial fluid may be responsible for the migration of these cells into inflamed synovial tissues, and for cellular interactions between these cells and synovial cells or the extracellular matrix.

Staging hepatic tumors with CT and carbon dioxide

OBJECTIVE

Carbon dioxide (CO2) intraarterial dynamic CT (CO2-IADCT) was used to observe the micro- and macrocirculation of hepatic tumors and hepatic parenchyma.

MATERIALS AND METHODS

A total of nine patients with hepatic nodular mass [five patients with hepatocellular carcinoma (HCC), three with metastatic liver cancer originated from colon cancer, and one with cysts] were included in this study. Thirty to fifty milliliters of CO2 was injected into the proper or right hepatic artery, in approximately 15 s, using a manually operated syringe. Consecutive CT scans were performed with a slice thickness of 1 cm, using a TCT 900s (Toshiba Co., Tokyo, Japan), to evaluate visualization of hepatic arteries and portal veins around tumors, tumor vessels, and CO2 bubbles in tumors.

RESULTS

The hepatic arteries and portal vein were revealed in all patients. The tumor vessels were observed in all patients with HCC except one patient who received chemoembolization before this procedure and one of three patients with metastatic liver cancer. The spotty CO2 deposits in the tumor were revealed in all patients, except in two patients with hepatic cysts and embolized HCC. No spotty deposits were seen in the normal liver tissue.

CONCLUSION

Thus, CO2-IADCT provided visualization of tumor vessels, spotty deposits of CO2 in tumors, and retrograde visualization of the portal vein. This method seems to be useful for the precise evaluation of the staging of liver tumors.

Identification of collagen and laminin receptor integrins on murine T lymphocytes

In this study we investigated the receptors by which murine lymphocytes bind to collagen and laminin. To identify the collagen and laminin receptors, we generated three monoclonal antibodies, two of which (HM alpha 1 and HM alpha 2) could inhibit adhesion of activated T cells to collagen and laminin and one of which (HM alpha 6) could inhibit that to laminin. Biochemical studies showed that the antigens recognized by HM alpha 1, HM alpha 2, and HM alpha 6 are the mouse homologues of human VLA-1, VLA-2, and VLA-6, respectively. Finally, we demonstrated that both VLA-1 and VLA-2 contribute to the functional interaction between collagen and activated T cells, since HM alpha 1 and HM alpha 2 specifically inhibited collagen-induced TNF secretion from activated T cells. These results indicate that VLA-1 and VLA-2 play an important role in regulating adhesion and cytokine production of activated T cells.

[Metastasis of an adenocarcinoma of unknown origin to mediastinal lymph nodes, and transient regression]

A 67-year-old woman was admitted to our hospital because of fever. Chest roentgenogram showed an enlargement of mediastinal lymph nodes. Despite thorough examination, no definite diagnosis could be made. The mediastinal lymph nodes got smaller over the next 3 weeks and a chest roentgenogram taken 4 months later showed no mediastinal lymphadenopathy. The mediastinal lymphadenopathy and fever recurred 5 months later. She underwent thoracotomy and the mediastinal lymph nodes were excised. Microscopic examination of pretracheal lymph node specimens showed invasion of poorly differentiated adenocarcinoma associated with abundant tumor-infiltrating lymphocytes. The other lymph nodes showed sarcoid reaction. Although she has been followed for one year and 11 months, no primary site of the cancer has been found. Metastasis of cancer of unknown origin to mediastinal lymph nodes is extremely rare. It is also interesting that the lymph node swelling diminished spontaneously. The tumor-infiltrating lymphocytes and sarcoid reactions may have been immunological responses to the cancer and may have caused the transient regression.

[Effects of infarcted myocardium on coronary flow reserve: a study by transesophageal Doppler echocardiography]

Myocardial disorder or microvascular disorder can cause impairment of coronary flow reserve in patients without epicardial coronary artery stenosis. This study investigated whether infarcted myocardium influences the coronary flow reserve using transesophageal echocardiography. The coronary flow reserve was examined in 15 patients with anterior myocardial infarction without residual coronary artery stenosis in the chronic phase. The patients underwent 201Tl scintigraphy and were classified into two groups. Group I included six patients without salvaged myocardium and group II included nine patients with salvaged myocardium. The coronary blood flow velocity at the proximal part of the left anterior descending coronary artery (LAD) was evaluated by transesophageal echocardiography before and after dipyridamole administration (0.56 mg/kg/4 min). The ratios of the diastolic peak and mean velocities at hyperemia versus baseline were used as indices of coronary flow reserve (P-CFR and M-CFR, respectively). P-CFR and M-CFR were 1.7 +/- 0.3 and 1.5 +/- 0.4 in group I, and 2.9 +/- 0.5 and 2.7 +/- 0.6 in group II, respectively. Control subjects (n = 7) had P-CFR and M-CFR of 3.8 +/- 0.9 and 3.9 +/- 1.7, respectively. Coronary flow reserve decreased in patients with myocardial infarction, especially in patients without salvaged myocardium in the infarcted area. Infarcted myocardium has an important influence on coronary flow reserve, and transesophageal echocardiography is useful for evaluating coronary flow reserve.

Focal hepatocellular necrosis and portal lymphocytic infiltration of the liver in chronic alcoholics: histopathological study of 40 liver biopsies

Forty liver biopsies of hepatitis B surface antigen negative chronic alcoholics were histologically studied to assess the influence of hepatitis C virus (HCV)-infection. A moderate degree of focal hepatocellular necrosis and/or portal lymphocytic infiltration (FHN-PLI) was observed in 28% of the specimens, being especially prevalent in advanced cases of fibrosis and cirrhosis, and significantly correlated with HCV-infection. Eleven of these cases were examined in detail: HCV-infection was detected in eight and lymphocytic infiltration was apparent in the portal area, accompanied by formation of lymph follicles. The FHN-PLI was ascribed to alcoholic hepatitis in two HCV-negative cases and was concluded to be of unknown etiology in the remaining one HCV-negative case. This study thus indicated that over two-thirds of cases of chronic hepatitis in alcoholics can be attributed to HCV-infection, with the remainder being at least partly related to alcoholic hepatitis. The prevalence of alcohol-induced chronic hepatitis based on immunopathological findings was unclear, but was probably less frequent than previously reported.

Effects of RS-2135, a novel class I antiarrhythmic agent, on sustained ventricular tachycardia after coronary embolization in conscious dogs

To assess the ability of RS-2135, a novel class I antiarrhythmic agent to suppress ischemia-induced ventricular arrhythmias, we produced myocardial infarction (MI) by introducing a glass bead into the coronary artery of the dog (bead model). Ventricular arrhythmias after coronary embolization were as severe and long-lasting as those that occur after two-stage coronary artery ligation as described by Harris. RS-2135 (1.25 and 2.5 mg/kg intravenously, i.v.) suppressed sustained ventricular tachycardia (SVT) 24 h after coronary embolization in the bead model. The antiarrhythmic effects of i.v. administration of RS-2135 were more potent and more long-lasting than those of lidocaine (5 and 10 mg/kg i.v.), mexiletine (5 and 10 mg/kg i.v.), disopyramide (2.5 and 5 mg/kg i.v.), and flecainide (2.5 and 5 mg/kg i.v.). The antiarrhythmic effects of oral (p.o.) administration of RS-2135 were evaluated 48 h after coronary embolization. RS-2135 (10 mg/kg p.o.) was equipotent to flecainide (10 mg/kg p.o.) and twice as potent as disopyramide (20 mg/kg p.o.) and mexiletine (20 mg/kg p.o.). Onset of antiarrhythmic effects after p.o. RS-2135 was slower than that of other drugs. These data suggest that the bead model is as useful as the Harris model for evaluation of the antiarrhythmic potential of chemicals and that RS-2135, either i.v. or p.o., is effective against SVT after acute MI.

[Residual, recurrent mitral regurgitation after mitral valve reconstruction: differences in lesion and operation method]

Patients developing residual or recurrent mitral regurgitation (MR) increased to moderate or severe grade after mitral valve reconstruction for MR were investigated by correlating the lesion and operation method with the echocardiographic course of postoperative MR. Postoperative moderate or severe grade MR [more than 4.0 cm2 color Doppler flow area on postoperative transesophageal echocardiography (TEE)] occurred in 21 of 80 mitral valve reconstruction patients. If residual MR caused more than 2.0 cm2 color Doppler flow area on intraoperative TEE, the MR increased to moderate or severe grade during the follow-up period. Postoperative moderate or severe MR occurred more frequently in lesions of the anterior mitral leaflet than the posterior mitral leaflet (45.8% vs 6.5%, p < 0.001), and in elongated chordae than in torn chordae (52.9% vs 14.3%, p < 0.005). Chordal shortening for elongated chordae could correct MR at operation but MR recurred and increased gradually to moderate or severe grade in half of these cases. Chordal reconstruction with polytetrafluorethylene suture is expected to achieve better results than chordal shortening. The causes of postoperative MR could usually be identified by comparative investigation of echocardiographic course, lesion, and operation method. Postoperative moderate or severe MR occurs more often in lesions of the anterior mitral leaflet or cases of elongated chordae. Residual MR should be suppressed to less than 2.0 cm2 color Doppler flow area on intraoperative TEE.

Combined therapy with arbekacin and fosfomycin for methicillin-resistant Staphylococcus aureus infections

We examined the clinical efficacy of a combination of arbekacin and fosfomycin in the treatment of various methicillin-resistant Staphylococcus aureus (MRSA) infections. The combination of arbekacin plus fosfomycin displayed 65.4% (17/26) clinical efficacy and 65.4% (17/26) bacteriological efficacy. This combination thus appeared to be an effective regimen for the treatment of MRSA infections. However, its bacteriological efficacy against concomitant Pseudomonas aeruginosa strains was only 16.7% (1/6). In addition, in 4 episodes of superinfection involving P. aeruginosa strains developed during the combination therapy.

Point mutations and allelic deletion of tumor suppressor gene DCC in human esophageal squamous cell carcinomas and their relation to metastasis

Since tumor suppressor gene DCC exhibits amino acid sequence homology to the neural cell adhesion molecule, there is a possibility that DCC might be related to tumor metastasis. In the present study, we examined 51 cases of primary esophageal carcinomas with regard to point mutations and loss of the DCC gene. We detected point mutations in two cases by screening using polymerase chain reaction-single strand conformation polymorphism analysis. When we determined the sequences, one case with lymph node metastasis showed an ATG (Met) to ACG (Thr) missense mutation in codon 168. Another case showed a CGA (Arg) to GGA (Gly) mutation in codon 201, which might be a polymorphic change, and two other mutations resulting in no amino acid change. We also examined loss of heterozygosity of the DCC gene. Forty-four of the 51 cases (86%) were informative, and among them 10 cases (23%) showed allelic deletion. The further away the lymph node metastasis was from the primary tumor, the higher the frequency of allelic deletions became. We also found allelic deletions in moderately and poorly differentiated squamous cell carcinomas but not in well differentiated ones. These results indicate that alterations of the DCC gene are related to the degree of lymph node metastasis and the degree of differentiation.

Increase in adhesion molecules on CD4+ cells and CD4+ cell subsets in synovial fluid from patients with rheumatoid arthritis

OBJECTIVE

To elucidate the role of adhesion molecules in the pathogenesis of rheumatoid arthritis (RA).

METHODS

We evaluated their expression and that of an activation marker on CD4+ cell populations and CD4+ cell subsets in specimens of peripheral blood (PB) and synovial fluid (SF) obtained from 10 patients with RA and 7 with osteoarthritis (OA). A 2 or 3-color immunofluorescent method was used for analysis.

RESULTS

The SF from both groups of patients showed a greater density of adhesion molecules including LFA-1 alpha, LFA-1 beta, CD2, VLA-4 alpha and VLA-5 alpha on CD4+ cells, and a higher percentage of CD4+HLA-DR+ cells compared with their PB. IN PB-CD4+ cell subsets from the arthritic and healthy subjects, the CD4+CD45RO+ cell population showed an increased expression of adhesion molecules compared with CD4+CD45RA+ cell population. The expression of adhesion molecules on circulating CD4+ cell population and CD4+ cell subsets from the patients with RA and OA was comparable to that from healthy subjects. SF from both groups of patients showed a higher percentage of CD4+CD45RO+ cells and a lower percentage of CD4+CD45RA+ cells. In SF-CD4+ cell subsets from patients with RA, the CD4+CD45RO+ cell population had an increased expression of VLA-4 alpha compared to the CD4+CD45RA+ cell population; however, there was no significant difference in other adhesion molecule expression and the percentage of HLA-DR+ cells between the 2 cell subsets. Furthermore, the expression of VLA-4 alpha on the CD4+CD45RO+ cell population in SF from patients with RA was significantly higher than that in matched PB. In CD4+CD45RA+ cell population from both groups of patients, SF showed an enhanced expression of adhesion molecules and an increased percentage of HLA-DR+ cells compared with matched PB.

CONCLUSION

Our results suggest that increased expression of adhesion molecules and increased percentage of HLA-DR+ cells on CD4+ cells in SF may be responsible for cellular interactions between these cells and synovial cells or extracellular matrix.

Primary directional coronary atherectomy for acute myocardial infarction

The effectiveness of primary coronary angioplasty for acute myocardial infarction (AMI) is now widely recognized. However, the reocclusion rate is as high as 10%. Directional coronary atherectomy (DCA), now used widely in the treatment of stable and unstable angina pectoris, has not been recommended as the primary reperfusion therapy for AMI. This report describes the first preliminary study of primary DCA for AMI without any antecedent thrombolytic therapy or balloon coronary angioplasty. Five patients received primary DCA. The initial results were very good, but further study is necessary to determine the efficacy, particularly the long-term results, of primary DCA in the treatment of AMI.

[Improvement of transthoracic pulsed Doppler imaging of pulmonary venous flow by intravenous injection of sonicated albumin]

Enhancement of pulmonary venous Doppler flow signals by intravenous injection of sonicated albumin was evaluated in 200 patients. Baseline pulsed Doppler signals were strong in 153 (77%) patients and weak in 47 patients. After injection of sonicated albumin, adequate pulsed Doppler flow signals were recorded in 44 (94%) of the 47 patients. Pulsed Doppler recordings could therefore achieve quantitative analysis in 197 patients (98%, p < 0.01). Signals were enhanced in proportion to the sonicated albumin dose (p < 0.01). No remarkable symptoms or complications were seen during and after examinations. Intravenous sonicated albumin improves transthoracic pulsed Doppler imaging of pulmonary venous flow. This simple and safe technique will obviate transesophageal recordings of pulmonary venous flow in adult patients and facilitate further studies of its diagnostic and monitoring value.

[A case of crescentic glomerulonephritis associated with anti-myeloperoxidase antibody presenting as alveolar hemorrhage]

A 77-year-old man was admitted because of hemoptysis. Chest roentgenograms initially showed progressive infiltrative shadows, which improved spontaneously in 3 months. Transbronchial lung biopsy specimens obtained during the first admission revealed alveolar hemorrhage with neither granuloma nor vasculitis. Alveolar hemorrhage associated with renal dysfunction recurred 9 months later. Serum creatinine level was elevated to 3.5 mg/dl. No other organ than lungs or kidneys was involved. Renal biopsy was performed to confirm the pathological diagnosis of crescentic glomerulonephritis. Anti-basement-membrane antibody was negative, whereas anti-neutrophil-cytoplasmic antibody was positive for perinuclear pattern (P-ANCA) by indirect immunofluorescent (IF) method. He was diagnosed as having idiopathic crescentic glomerulonephritis complicated with alveolar hemorrhage, and the presence of anti-myeloperoxidase (MPO) antibody in serum was anticipated. Anti-MPO antibody level in his serum evaluated by ELISA was markedly elevated. Although myeloperoxidase has been considered as a common antigen to P-ANCA and anti-MPO antibody, the determination of P-ANCA has been clinically unreliable because of equivocal results. In contrast, the presence of anti-MPO antibody is highly specific for idiopathic crescentic glomerulonephritis complicated with alveolar hemorrhage or its incomplete variant case. Also, it is a better index of disease activity. Therefore, there is a possibility that those patients diagnosed as having idiopathic pulmonary hemosiderosis or pulmonary-renal syndrome may be categorized into the one disease, anti-MPO antibody-associated disease, and the measurement of anti-MPO antibody may lead to prompt treatment prior to the histological diagnosis.

Estimation of the kinetics of iodized oil injected into the feeding artery of hepatocellular carcinoma using dynamic computed tomography

The distribution of iodized oil (Lipiodol) after its injection in hepatocellular carcinoma (HCC) was evaluated by dynamic computed tomography (CT) in 10 patients. Following the injection of Lipiodol into the hepatic artery, two patterns were observed. In type I (4/10 tumors) Lipiodol retention began at the tumor periphery and then spread contiguously towards the central portion. In type II (6/10 tumors), the accumulation began at the periphery, but then skipped directly to the central portion of the tumor. Hypervascular tumors were predominantly type I, and avascular or hypovascular tumors were all type II. This difference in Lipiodol kinetics suggests that lipid-based intra-arterial (i.a.) chemoembolization should precede the i.a. infusion of water-soluble chemotherapeutic agents or injection of solid embolic materials in hypervascular tumors.

DNA alterations in cells from hereditary non-polyposis colorectal cancer patients

To determine if the MCC, DCC or p53 gene is associated with susceptibility to hereditary non-polyposis colorectal cancer (HNPCC), these genes in normal cells from 12 HNPCC patients were analysed by polymerase chain reaction-single strand conformation polymorphism analysis. No changes which may alter the amino acid sequences of these genes were detected, suggesting that these genes are not associated with the susceptibility to HNPCC. Only one of nine HNPCC cancers showed mutations in the MCC and p53 genes on the same analysis. Loss of heterozygosity in chromosomes 5q, 17p, 18q and 22 was detected in four of the nine cancers, all of them being positive as to metastasis to lymph nodes. Abnormalities of the (CA)n repeat were found in six cancers, including all four without metastasis. These data indicate that tumor suppressor genes in chromosomes 5q, 17p, 18q and 22 are associated with the late stage of colorectal tumorigenesis in HNPCC, whereas the (CA)n repeat abnormalities are an early event of tumorigenesis and more essential to HNPCC.

Mapping of a transcription element critical for expression of the fibroblast growth factor receptor 1 gene

The fibroblast growth factor receptor 1 (FGFR1) gene has no TATA or CCAAT-elements. To examine its mechanism of expression, we characterized the transcription element of this gene. The basal promoter element was mapped to the 5'-flanking region from -89 to -43. The DNase I protection assay and gel shift analysis revealed that a nuclear protein extracted from FGFR1-expressing cells (NIH3T3 and SC-3), but not from FGFR1-nonexpressing cells (P3U1), could bind to the nucleotide sequence from -62 to -42. The molecular weight of this protein was approximately 100 kDa by Southwestern analysis. In addition, both the promoter activity and the nuclear protein binding activity were markedly impaired by the substitution of two bases within this footprint site. Interestingly, this footprint site appeared to lack the consensus sequence of the currently reported transcription factors. These results indicate that the 5'-flanking region from -62 to -42 plays a pivotal role in FGFR1 gene expression.

Acquisition of color opponent representation by a three-layered neural network model

This paper discusses color representation in the visual system by analysis of a three-layered neural network model. The model incorporates physiological knowledge of color representation at the sensor level (broad-band trichromatic representation by cones) and the higher level (narrow-band color representation by color-coded cells in V4). We trained the model to perform a mapping between these color representations by the back propagation algorithm and analyzed the acquired characteristics of the hidden units. It turned out that the hidden units learned characteristics similar to those of the color opponent cells found in the visual system. It was concluded that the R-G and Y-B color opponent representations reflect the efficiency of the color representation in the visual system from investigations on the efficiency of color representation in the hidden layer and on the capability of the color recognition task of the model.

Phasic coronary flow characteristics in patients with hypertrophic cardiomyopathy: a study by coronary Doppler catheter

Abnormal patterns of coronary flow velocity have been observed in patients with symmetric left ventricular hypertrophy in conditions such as aortic stenosis and systemic hypertension. However, phasic coronary flow characteristics have not been investigated in patients with asymmetric left ventricular hypertrophy in hypertrophic cardiomyopathy. The purpose of this study was to assess phasic coronary flow characteristics and their relation to echocardiographic and hemodynamic parameters in patients with hypertrophic cardiomyopathy. Coronary flow velocity was recorded in the left anterior descending artery with a 20 MHz Doppler catheter in eight patients with hypertrophic nonobstructive cardiomyopathy and eight control subjects with normal coronary arteries. Flow reversals observed in systole in all patients with hypertrophic cardiomyopathy, and the time velocity integrals of systolic flow were significantly smaller in patients with hypertrophic cardiomyopathy than in control subjects (-1.5 +/- 1.7 versus 4.3 +/- 1.2 cm; p < 0.01). The time from the beginning of diastole to peak diastolic velocity corrected by the square root of R-R interval (square root of RR) was prolonged significantly, and the velocity half-time from peak diastolic velocity corrected by square root of RR was shorter in the patients with hypertrophic cardiomyopathy compared with those in the control subjects (6.8 +/- 2.0 msec versus 4.0 +/- 0.6 msec [p < 0.01] and 9.2 +/- 4.9 msec versus 13.9 +/- 2.0 msec [p < 0.05], respectively). Peak velocity and time velocity integral of flow reversal showed significant correlations with anterior ventricular septal thickness (y = -0.5x + 13.5, r = 0.8, and p < 0.01; y = -1.3 +/- 16.8, r = 0.8, and p = 0.024, respectively), the septal/free wall thickness ratio (y = -0.1x + 1.1, r = 0.8, and p < 0.01; y = -0.2x + 1.4, r = 0.9, and p < 0.01, respectively), and the degree of narrowing of the first septal perforator arteries (y = 1.9x + 91.6, r = 0.8, and p = 0.012; y = 6.1x + 80.6, r = 0.9, and p < 0.01, respectively). In conclusion, flow reversal in systole and slow acceleration and rapid deceleration in diastole were characteristics in patients with hypertrophic cardiomyopathy. Flow reversal might be related to the degree of left ventricular asymmetry and compression of the septal perforator arteries.

Plasma thrombomodulin as a marker of vascular injuries in collagen vascular diseases

Thrombomodulin, a thrombin receptor on the vascular endothelial cell surface, is released into circulating blood. The plasma concentrations in patients with collagen vascular diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis, juvenile rheumatoid arthritis, Sjögren's syndrome, systemic sclerosis, polymyositis and/or dermatomyositis (PM/DM), Behçet's disease, and Wegener's granulomatosis, were measured and compared with those of healthy persons. The mean plasma thrombomodulin concentrations in patients with juvenile rheumatoid arthritis, systemic sclerosis, PM/DM, Wegener's granulomatosis, and active states of SLE, rheumatoid arthritis, and Beçhet's disease were significantly higher than those in the control group. Patients with Wegener's granulomatosis showed the highest mean value. The mean values in patients with inactive states of the diseases and Sjögren's syndrome were not significantly different from the values in the control group. In cases of juvenile rheumatoid arthritis, systemic sclerosis, PM/DM, and Wegener's granulomatosis, patients with active interstitial pneumonitis or extensive pulmonary lesions frequently showed higher values of plasma thrombomodulin than those without overt pulmonary involvement. Elevated plasma thrombomodulin values were decreased along with amelioration of the diseases by treatment. These results may indicate that plasma thrombomodulin measurement may be helpful for evaluating vascular injury in patients with collagen diseases.

A novel insertional mutation at exon VII of the myelin proteolipid protein gene in Pelizaeus-Merzbacher disease

Pelizaeus-Merzbacher disease (PMD) is an X-linked neurological disorder characterized by dysmyelination in the central nervous system (CNS). Recently mutations of the myelin proteolipid protein (PLP) gene which encodes both PLP and its isoform, DM-20 generated by alternative splicing, have been demonstrated in PMD patients. We analyzed the seven exons of the PLP gene of a Japanese boy affected with PMD by direct sequencing and identified an insertion event in exon VII of the PLP gene. This mutation was also present in his carrier mother, but was absent in ninety-five X chromosomes of normal Japanese. The frame-shift mutation leads to the production of truncated PLP with altered carboxyl terminal amino acid sequences, resulting in considerable change of the structure of PLP and DM-20 necessary for functional purposes. This is the first report of a mutation in exon VII of the PLP gene associated with PMD.

Philadelphia-chromosome-positive, monosomy 7 biphenotypic acute mixed lineage leukemia in adults: a pluripotent stem cell disorder

Two adult patients with acute mixed lineage leukemia (AMLL) having combined Philadelphia chromosome (Ph1) positivity and monosomy 7 are presented. The phenotypes of leukemic blasts from both cases were almost same (early B-lymphoid lineage and myeloid lineage); CD10+, CD13+, CD19+. HLA-DR+, and dual-color analysis showed simultaneous expression of CD10 (CD19) and CD13 antigens in individual blasts (biphenotypic) in both cases. On molecular analysis, the leukemic blasts showed rearrangement in the first intron of the BCR gene with breakpoint just outside of 3' end of m-BCR-2 (bcr 3) in case 1, and in the M-BCR in case 2. Immunoglobulin heavy chain gene (IgH) rearrangement was noted in both cases, but rearrangement of the T-cell receptor beta-chain gene (TCR beta) was detected only in case 1. Clinically, both cases achieved complete remission by the combination chemotherapy consisting of L-asparaginase, doxorubicin, vincristine, and prednisolone (L-AdVP). In remission, all these molecular abnormalities disappeared in both patients. These results suggest that the Ph1-positive and monosomy 7 AMLL in adults is de novo acute leukemia with both early B-lymphoid and myeloid phenotypes and may arise from malignant transformation of pluripotent stem cell, and expresses a heterogenous rearrangement pattern of the BCR gene.

Fission yeast genes nda1+ and nda4+, mutations of which lead to S-phase block, chromatin alteration and Ca2+ suppression, are members of the CDC46/MCM2 family

Fission yeast cold-sensitive mutants nda1-376 and nda4-108 display a cell cycle block phenotype at the restrictive temperature (cell elongation with the single nucleus) accompanied by an alteration in the nuclear chromatin region. DNA content analysis shows that the onset of DNA synthesis is blocked or greatly delayed in both mutant cells, the block being reversible in nda4-108. Upon release to the permissive temperature, nda4-108 cells resumed replicating DNA, followed by mitosis and cytokinesis. The nda4 phenotype was partly rescued by the addition of Ca2+ to the medium; Ca2+ plays a positive role in the nda4+ function. The predicted protein sequences of nda1+ and nda4+ isolated by complementation are similar to each other and also, respectively, to those of the budding yeast, MCM2 and CDC46, both of which are members of the gene family required for the initiation of DNA replication. The central domains of these proteins are conserved, whereas the NH2- and COOH- domains are distinct. Results of the disruption of the nda1+ and nda4+ genes demonstrates that they are essential for viability.

A possible role of two hydrophobic amino acids in antigen recognition by synovial T cells in rheumatoid arthritis

Synovial T cells play a crucial role in the pathogenesis of rheumatoid arthritis (RA) synovitis. We have quantitatively analyzed the T cell receptor (TcR) variable (V) region gene repertoire of freshly isolated synovial fluid (SF) T cells, comparing it with that of peripheral blood (PB) T cells in RA. The TcR V gene repertoire of PB and SF T cells in RA and osteoarthritis was heterogeneous. In contrast, V alpha 11 in SF was expressed to a greater degree in three of five RA patients, and increased levels of V beta 6, 1-3 were found in the SF of four of six RA, compared with paired PB. Of note, V beta 6, 1-3 was universally used in four RA patients with a disease duration of less than 10 years, irrespective of their HLA-DR types. This was in contrast to two other RA patients, suffering for more than 20 years, who showed different V alpha and V beta usages. beta-chain sequence analysis in RA patients with a preference for V beta 6, 1-3 has shown that a few clones dominated in SF, whereas polyclonality was observed in PB. These findings suggest oligoclonal expansion of T cells in response to specific antigen(s) in the SF of these patients with RA of relatively short duration. Concomitant use of two hydrophobic amino acids, leucine and valine in the D beta region was noticeable among the predominant SF clones. These two amino acids might directly contact a peptide specific for the induction of synovitis in RA patients. TcR-directed therapy may, therefore, be useful for the treatment of early RA synovitis.

Optimization of nonradioisotopic single strand conformation polymorphism analysis with a conventional minislab gel electrophoresis apparatus

We have developed a means of nonradioisotopic single strand conformation polymorphism (nonRI-SSCP) analysis and applied it to the detection of a point mutation in the human tumor suppressor gene, p53. The method does not require any particular facilities or apparatus, such as a laboratory for radioactive materials, a large gel unit for sequencing, or a semiautomated electrophoresis system. This technique comprises amplification of DNA fragments by the PCR technique with specific oligonucleotide primers, denaturation, and electrophoresis on neutral polyacrylamide gels in a conventional minislab apparatus. The SSCP patterns on electrophoresis were detected with a commercially available silver stain method. We also evaluated various electrophoretic conditions for nonRI-SSCP analysis, such as the gel concentration and buffer components. A tris/glycine buffer system gave better resolution of SSCP bands. The SSCP patterns of different sized DNAs could be analyzed in a gradient polyacrylamide gel. Thus, nonRI-SSCP analysis with a conventional minislab gel electrophoresis apparatus can be satisfactorily substituted for a commonly used RI-SSCP technique.

Treatment of hepatocellular carcinoma by intraarterial injection of adriamycin/mitomycin C oil suspension (ADMOS) alone or combined with cis-diaminodichloroplatinum (CDDP)

We evaluated the effects of intraarterial injection of Adriamycin/Mitomycin C oil (Lipiodol) suspension (ADMOS) alone and ADMOS+cis-diaminodichloroplatinum (CDDP) in 135 patients with hepatocellular carcinoma (HCC). A total of 59 patients received ADMOS alone and 76 patients received ADMOS+CDDP (ADMOS/CDDP). Tumor size was reduced by over 25% in 13 (34%) of the evaluable 38 patients in the ADMOS-alone group and in 39 (51%) of the 76 evaluable patients in the ADMOS/CDDP group. Serum alpha-fetoprotein (AFP) levels decreased by more than 50% in 10 (59%) of 17 ADMOS-alone patients and in 23 (70%) of 33 ADMOS/CDDP patients whose pretreatment AFP levels were above 0.2 mg/l. The overall one- and 2-year survival rates were 68% and 41%, respectively. No severe complications and no significant changes in laboratory values were observed, except for one patient in the ADMOS/CDDP group who developed a liver abscess. Although the tumor response was significantly better in patients treated by ADMOS/CDDP than in those treated by ADMOS-alone (p < 0.05), there was no significant difference in the survival rates between the 2 groups. The intraarterial injection of ADMOS and CDDP was concluded to be effective in treating HCC judging by tumor response.

[Long-term hypertension control in a community--comparison of stroke incidence and hypertension control between participants and nonparticipants in health examinations]

Since 1969, community-based hypertension control program has been conducted for non-company-employed residents aged 40 and over (3,039: 70% of the residents) in Noichi town, Kochi prefecture. The program is composed of annual health examinations, health education and referral of hypertensives to local physicians. Incidence and mortality of stroke have declined along with a decrease in systolic blood pressure levels. However, during the period of 1982-84, stroke incidence was higher for nonparticipants in health examinations than in the participants of the same age group. For an understanding of the state of detection and control of hypertension in nonparticipants aged 40-69 of the 1982-84 health examinations, blood pressure was examined for 312 subjects randomly selected from the 2,062 nonparticipants. Blood pressure levels were significantly higher in nonparticipants than in participants. In addition, the proportion of hypertensives who were aware of their blood pressure levels was lower in nonparticipants than in participants. About 87% of residents aged 40-69 reported that they received blood pressure checkups at least once a year. Persons who were involved in manual labor, sales and services received blood pressure checkups less frequently. Among company employees, the proportion of persons who checked their blood pressures annually was progressively lower with decrease in size of companies. The community hypertension control appears to have contributed to a decline of blood pressure levels and stroke incidence. However, detection and control of hypertension was relatively poor in nonparticipants in health examinations, particularly for employees of small companies.

[A case of surgically resected primary pulmonary lymphoma with IgG-paraproteinemia: gene analysis was effective for establishing its diagnosis]

A 69-year-old woman was hospitalized because of abnormal lung shadow and IgG-lambda paraproteinemia. She was otherwise healthy and asymptomatic. Chest roentgenogram showed a consolidation in the right lower lobe. Chest CT showed a tumour in S8 and subpleural interstitial shadow in S10. No intrathoracic lymphadenopathy was found. Serum IgG was 6,109 mg/dl. The cell count obtained by bronchoalveolar lavage (BAL) was 44.5% plasma cells and 17.5% lymphocytes. CD19-positive lymphocytes were prominent. The IgG/albumin ratio was 13 times higher, and IL-6/albumin ratio was 29 times higher in lavage fluid than in serum. Transbronchial lung biopsy (TBLB) specimen showed interstitial infiltration of plasma cells and lymphocytes. Right lower lobectomy was performed, and serum IgG subsequently decreased to about 4,000 mg/dl. DNA was extracted from the surgical specimen, and analyzed by Polymerase Chain Reaction (PCR) method. A rearrangement band was amplified with Fr3a & VLJH primers (immunoglobulin heavy chain gene). The infiltrated cells were proved to be monoclonal B-cells. This case was diagnosed as small lymphocytic lymphoma, plasmacytoid. Most primary pulmonary lymphomas are well differentiated B-cell type, and the histopathological findings resemble those of LIP or pseudolymphoma. Gene analysis may thus be an effective procedure for the distinction between inflammatory and neoplastic cell proliferation, such as LIP and lymphoma.

Lymphocyte subsets in hemodialysis patients treated with recombinant human erythropoietin

We investigated whether recombinant human erythropoietin (rhEPO) therapy affected the lymphocyte subsets in patients on long-term maintenance hemodialysis (HD) with severe anemia. Before treatment, the numbers of peripheral blood lymphocyte, CD3+, CD4+, CD8+, and CD20+ cells were decreased in HD patients compared to those in healthy subjects, while the number of CD3+HLA-DR+ cells was increased in HD patients compared to that in healthy subjects. Furthermore, the number of CD4+CD45RA+ (naive T) cells was markedly decreased in HD patients (112 +/- 77 vs 241 +/- 146/microliters; P < 0.01). The number of CD8+S6F1+ (cytotoxic T) cells in HD patients was also less than that in healthy subjects (247 +/- 104 vs 122 +/- 83/microliters; NS). During a 6-month period of rhEPO therapy, we found that the low level of CD4+CD45RA+ cells gradually increased (from 112 +/- 18 to 163 +/- 24/microliters; P < 0.01) with the elevation of hematocrit values (from 21.5 +/- 1.7 to 28.2 +/- 3.5%; P < 0.05). The number of CD3+HLA-DR+ cells decreased after 1 month of rhEPO therapy (from 93 +/- 14 to 46 +/- 13/microliters) and gradually declined throughout the 6-month study period. In our in vitro study, we demonstrated that no effects were observed on [3H]thymidine uptake in the T cell subsets at various concentrations of rhEPO. These results suggest that rhEPO-induced immunoregulation is mediated by an indirect stimulatory effect on the immune system, this stimulation being accompanied by an improvement in physical condition.

[Report of three cases of purple urine bag syndrome which occurred with a combination of both E. coli and M. morganii]

Purple urine bag syndrome is a rare phenomenon in which bags turns purple or blue following catheterization. This phenomenon was reported to occur by Providencia stuartii in the presence of indicanuria. We reported herein three females above 75 years of age having a similar phenomenon. All were bedridden chronically and constipated. In these cases, no growth of P. stuartii was found on repeated urine culture, but Escherichia coli and Morganella morganii were concomitantly isolated during the blue bags. It is suggested that purple urine bag syndrome develops in a combination of E. coli and M. morganii besides P. stuartii.

Fukuyama-type congenital muscular dystrophy and the Walker-Warburg syndrome

We compared the neuropathological findings in two cases of the Walker-Warburg syndrome (WWS) with those in 6 of Fukuyama-type congenital muscular dystrophy (FCMD). Remarkable differences were noticed between the two conditions. The central nervous system (CNS) dysplasia in WWS, which involved diffuse agyria and hydrocephalus, was more severe than that in FCMD. In WWS the septum pellucidum was absent, and the corpus callosum, basal ganglia and thalami were markedly hypoplastic. The cerebellum was severely hypoplastic and the vermis was partly absent. The pyramidal tracts could not be identified. On the other hand, the general configuration of the CNS was well preserved in FCMD. The cerebral cortices exhibited diffuse or focal micropolygyria with or without a few pachygyric lesions, but the severity was variable. The cerebellum was not hypoplastic, but exhibited focal micropolygyria. The pyramidal tracts were aberrant. WWS and FCMD, however, did not show any distinct differences on microscopic analysis of the cerebral cortices. There was leptomeningeal glio-mesenchymal overgrowth, and the horizontal lamination of the nerve cells was distorted throughout by proliferating gliovascular bundles or septa. We found in this study that the CNS pathology in WWS was compatible with type II lissencephaly, and thus differed from that in FCMD. Hypoplasia of the cerebellum and a partial absence of the vermis also seemed to be predominant features of WWS, which can be used to differentiate WWS from FCMD. In this study, we concluded that FCMD and WWS are different disease entities because they differ in their clinical manifestations, including eye lesions and CNS pathology, and because no familial concomitance of FCMD and WWS has been reported.

Beta 1 integrin-mediated interaction with extracellular matrix proteins regulates cytokine gene expression in synovial fluid cells of rheumatoid arthritis patients

Inflammatory cytokines have been implicated in the pathogenesis of rheumatoid arthritis (RA), whereas the mechanisms for constitutive production of inflammatory cytokines in affected joints are largely unknown. Recently, integrin-mediated interaction with extracellular matrix (ECM) proteins has been demonstrated to play a role in regulating cytokine production in T cells and monocytes. In this study, we investigated the contribution of the beta 1 integrin-mediated interaction with ECM proteins to the persistent cytokine gene expression in RA synovial fluid mononuclear cells (SFMNC). We examined mRNA expression of 14 cytokines in the SFMNC of three RA patients, which were either fresh or cultured overnight in serum-free medium on ECM-coated plates, by polymerase chain reaction with a panel of oligonucleotide primers specific for each cytokine. The persistent expression of various cytokine mRNA found in fresh SFMNC was maintained after overnight culture in serum-free medium on ECM proteins, especially on laminin (LM), but not on serum albumin. This effect of LM was inhibited by an anti-integrin beta 1 chain (CD29) mAb, as well as by an anti-CD3 mAb, indicating an important role of the beta 1 integrin-mediated interaction with ECM proteins in regulating persistent cytokine gene expression in RA SFMNC, and a key role of T cells in regulating inflammatory monokine production.

Penetration of cefpirome into sputum in chronic respiratory infections: comparison of administration of 0.5 g and 1.0 g in the same patient

This study evaluated the sputum penetration of cefpirome following slow intravenous infusion of 0.5 and 1.0 g using a comparative cross-over design to reduce variability. Five patients with chronic respiratory tract infections were randomized to receive either 0.5 g followed by 1.0 g, or by 1.0 g followed by 0.5 g cefpirome, by slow intravenous infusion over 1 h, with a 24-h wash-out period between each treatment. With the exception of one patient, sputum concentration correlated well with plasma concentration. Higher sputum levels of cefpirome were achieved following the higher dose.

Demonstration of cathepsins B, H and L in xenografts of normal and Duchenne-muscular-dystrophy muscles transplanted into nude mice

The activities and contents of the lysosomal cysteine proteinases cathepsins B, H and L were examined in xenografts of biopsied muscles transplanted from age-matched normal subjects and Duchenne-muscular-dystrophy (DMD) patients into nude mice. The activity of cathepsin B increased 9-fold and that of B-plus-L increased 24-fold in the first week after transplantation in normal muscle xenografts. By the third week, the activity of cathepsin B increased a total of 20-fold and B-plus-L increased to 36-fold the original level. The activity levels of cathepsin B, B-plus-L, H and D, and acid phosphatase in normal and DMD xenografts were not significantly different when compared 2 weeks after transplantation. However, the protein content of cathepsin B in DMD muscle xenografts was more than 3-fold that of normal xenografts at 2 weeks. The profile of cathepsin H activity in normal muscle xenografts was different than those of cathepsins B and B-plus-L. In the first week, the cathepsin H diminished sharply to about one-third of the biopsied muscle level and then, by 3 weeks after transplantation, it had increased slightly to about half the original level. The amount of endogenous cysteine-proteinase inhibitor changed in parallel with the activity of cathepsins B and B-plus-L. Cathepsins B and H, but not cathepsin L, were found immunohistochemically in regenerating muscle fibres of normal and DMD xenografts 2 weeks after transplantation. Staining of cathepsin B in DMD xenografts was slightly stronger than that in normal subjects. There was no immunostaining in degenerating or necrotic muscle fibres 2 weeks after transplantation. Western-blot analysis revealed that the cathepsin B band at 29 kDa was increased in normal xenografts 2 and 3 weeks after transplantation. Also, 2 weeks after transplantation the staining intensity of this band was slightly stronger in DMD xenografts than in normal xenografts. These results suggest that cathepsin B participates in the regeneration of transplanted muscle, both normal and DMD, and in the DMD muscle fibre-wasting processes, during regeneration.

Removable magnetic dental attachment that permits magnetic resonance imaging

Magnetic dental attachments cause magnetic resonance image (MRI) degradation. A new magnetic dental attachment that allows removal of magnetic parts to exchange them for nonmagnetic parts was developed and tested. It allows high quality MRI with no change in occlusal vertical dimension. A volunteer test subject with combinations of attachments in place was examined by MRI. The images produced showed no degradation or distortion. Magnetic attachments for overdentures or maxillofacial prostheses should be removable to permit use of MRI.

[Detection of dystrophin with anti-peptide antibodies]

The analysis of dystrophin in skeletal muscles was performed to identify Duchenne and Becker muscular dystrophy (DMD and BMD) by means of immunohistochemical stain and Western blotting with antisera against synthetic dystrophin peptides. The control muscle specimens derived from normal healthy persons, and patients without DMD and BMD revealed clearly continuous stains of dystrophin at surface membrane. A band with 400 kDa of molecular size by Western blotting was positively stained by anti-dystrophin antibodies. The muscle specimens from eleven DMD patients showed no observation both in the band on Western blotting and in the immunohistochemical staining of dystrophin on frozen-thin sections. BMD muscle specimens showed patchy and faint stains, but no detection of any band on Western blotting except a 380 kDa minor band with anti-peptide IX antibody in one patient muscle. The immunohistochemical procedure was found to be more sensitive than Western blotting for the detection of dystrophin. These results indicate that the dystrophin analysis by both methods is an useful tool for the differential diagnosis of patients with DMD and BMD.

Power spectral analysis of heart rate variability in Type As during solo and competitive mental arithmetic task

It has been reported that there are differences in autonomic balance between Type As and Type Bs. This study evaluated the sympathovagal interaction in Type A (N = 10) and Type B (N = 10) male students during mental arithmetic task in a solo and a competitive condition by the spectral component analysis of heart rate variability (HRV). The low-frequency (LF) component to high-frequency (HF) component ratio was significantly greater in Type As than in Type Bs, though no significant differences were found in task performance, heart rate change, and blood pressure between the two subject groups in both conditions. The present findings indicate that there was a significant difference in sympathovagal balance between Type As and Type Bs, and that Type As showed dominant sympathetic activity. The results suggest that the power spectral analysis of HRV, which is convenient and non-invasive, has enough sensitivity to discriminate differences in autonomic balance between Type A subjects and Type B subjects, not only during the solo and competitive task period but also during the resting period.

Power spectral analysis of heart rate variability in Type As and Type Bs during mental workload

Recently several studies have suggested that there are differences in autonomic balance between Type As and Type Bs. This study evaluates a sympathovagal interaction in Type A (n = 8) and Type B (n = 11) male students during a mental arithmetic task by power spectral analysis of heart rate variability. The low-frequency component to high-frequency component ratio was significantly greater in Type As than in Type Bs during a resting period. No significant differences were found in heart rate changes and blood pressure between the two kinds of subject groups. The present findings indicate that there was a significant difference in sympathovagal balance between Type As and Bs. Type As showed dominant sympathetic activity.

Pigmentary dysplasias and chromosomal mosaicism: report of 9 cases

Chromosomes were studied in 9 individuals with pigmentary dysplasias of the skin and other abnormalities. Of the 9 individuals, 5 were chromosomal mosaics in both blood lymphocytes and skin fibroblasts (46,XY/47,XY, + 13;46,XX/47,XX, + 14;46,XY/47,XY, + 18;46,XX/47,XX, + 18;46, XX/47,XX, + mar), while the other 4 individuals were chromosomally normal in both tissues studied. The pigmentary dysplasias involved hypo- or hyperpigmented patches/flecks or lines/whorls. The latter ran along Blachko lines on the back, abdomen and the limbs. These patterns varied not only between individuals but also between different regions of an individual. The possibility of chimerism was studied but ruled out (1/32 to 1/256) in 7 individuals, using chromosomal heteromorphisms in the patients and their parents as markers.

[An autopsy case of Fahr disease (infantile form)]

A 13-year-old girl with Fahr disease (infantile form) was reported. Her parents were consanguineous. Her elder sister had mental retardation and spasticity of the lower limbs, and died at 23 years of age. The patient suffered from infantile spasms at 3 month. She was bed-ridden, nonverbal, microcephalic and blind. Cranial CT revealed massive calcifications in the basal ganglia, periventricular white matter, dentate nucleus and cerebellar white matter. EEG showed a suppression-burst pattern. At 13 years, she died of pneumonia and hyperammonemia. Microscopic examination of brain showed perivascular non-arteriosclerotic ferro-calcinosis. The periventricular granules are 1-4 mu or 12 mu in diameter. This pathological change was observed only in the central nervous system above midbrain. No calcifications were found in the pituitary and the vessels of pia mater. Also a reduced ornithine transcarbamylase activity was found in the liver, which was probably not related with cerebral calcifications. Infantile form of Fahr disease is rare and may be heterogeneous in etiology. However, clinical manifestations and pathological findings were similar to those in previous reports of Fahr disease in childhood. It is one of the disorders causing infantile spasms.