Permeability of gadolinium-DTPA through two types of hemodialysis membrane

RATIONALE AND OBJECTIVES

Gadolinium diethylenetriamine penta-acetic acid (Gd-DTPA) was injected intravenously for magnetic resonance imaging in patients with impaired renal function, and the permeabilities of two types of general hemodialysis (HD) membrane to this agent were compared.

METHODS

One of the HD membranes, Nipro FB-210-U membrane (U membrane), has a larger pore size than the other, Nipro FB-210-M membrane (M membrane). On the same day as magnetic resonance imaging was performed, the patient underwent a 4-hour HD session. Blood was sampled before and at five points after the start of HD.

RESULTS

Mean dialysance of Gd-DTPA was 175.8 to 185.8 mL/min with the U membrane and 120.5 to 130.1 mL/min with the M membrane. The elimination rate was 91.1% with the U membrane and 81.1% with the M membrane 4 hours after the start of HD. The permeability was significantly higher with the U membrane than with the M membrane.

CONCLUSION

Although it is more expensive, the U membrane should be chosen rather than the M membrane for HD to remove Gd-DTPA from the body as efficiently as possible.

Modulation of leukocyte transendothelial migration by integrin-associated glycosyl phosphatidyl inositol (GPI)-anchored proteins

Leukocyte transendothelial migration is an essential process in inflammation and the immune response. The mechanisms involved in leukocyte adhesion to the endothelium, forming the first step in leukocyte extravasation, have been fairly well documented. However, subsequent steps, which include de-adhesion, coupled with locomotion, remain largely unknown. As part of our efforts to study leukocyte transendothelial migration, we previously established a monoclonal antibody (mAb) that sequentially up-regulates and down-regulates beta2 integrin-dependent adhesion of human neutrophils, as well as transendothelial migration in vitro. The molecule recognized by this mAb is a glycosyl phosphatidyl inositol, (GPI)-anchored glycoprotein. This protein may prove to be a new member of the family of integrin-associated, GPI-anchored proteins, which includes urokinase-type plasminogen activator receptor (uPAR), lipopolysaccharide (LPS)/LPS binding protein (LBP) receptor (CD14), and Fcgamma receptor IIIB (CD16b); all of which are regulators of integrin function. The mechanisms involved in beta2 integrin regulation by this new GPI-anchored glycoprotein are discussed.

Functional outcome of double-stapled and transanal ileal pouch-anal anastomosis after proctocolectomy

Improvement of functional outcome after proctocolectomy for ulcerative colitis and familial adenomatous polyposis was compared between transanal ileal pouch-anal anastomosis (T-IAA group, n = 29) and double-stapled ileal pouch-anal anastomosis (DS-IAA group, n = 8). Clinical functions were evaluated using a functional scoring system, and physiologic functions by anorectal manometry after one year postoperatively. Although in the T-IAA group 4 of the 29 patients (13.8%) displayed partial incontinence (< 9 points), all of 8 patients in the DS-IAA group showed good results referring to continence (> 10 points). The maximum resting pressure was 44.3 +/- 5.2 cmH2O in the T-IAA group vs. 56.6 +/- 5.8 cmH2O in the DS-IAA group, and postoperatively the maximum squeezing pressure was 96.8 +/- 9.2 cmH2O in the T-IAA group vs. 106.3 +/- 8.1 cmH2O in the DS-IAA group. There was a significant difference of maximum resting pressure and no significant difference of maximum squeezing pressure between the two groups. The length of the high pressure zone in the anal canal was significantly shorter in patients of the T-IAA group (2.1 +/- 0.8 cm) than in those of the DS-IAA group (3.5 +/- 1.1 cm) (p < 0.05). The DS-IAA is associated with excellent objective physiologic and subjective functional results. This reflects the sacrifice of the internal anal sphincter 1.5 cm cephalad necessary to effect this anastomosis at a mean of 1.4 cm from the dentate line.

Clinical aspects of total colectomy--laparoscopic versus open technique for familial adenomatous polyposis and ulcerative colitis

Clinical aspects of laparoscopy combined total colectomy (LTC) (n = 10) and open total colectomy (OTC) (n = 29) with ileorectal anastomosis for familial adenomatous polyposis and ulcerative colitis are compared in a retrospective study. The mean operative time was 282 (range, 169 to 420) minutes in the LTC group and 274 (range, 139 to 570) minutes in the OTC group. The mean volume of operative blood loss was 321 (range, 52 to 728) ml and 471 (range, 48 to 1040) ml for the LTC and OTC groups, respectively. Nasogastoric tube could be removed after POD 1.2 vs. 5.8 (p < 0.05), the mean time to passage of stool was 1.9 (range, 1 to 3) vs. 5.2 (range, 3 to 7) days (p < 0.01), and in the LTC group watery stool was soon made solidification after POD 23.4 vs. 84.1 (p < 0.01). Laparoscopy combined total colectomy may prove to have one-stage restorative total colectomy without a temporary ileostomy due to early solidification of watery stool and more benefits than conventional open surgery.

Laparoscopic treatment of duodenal carcinoid tumor. Wedge resection of the duodenal bulb under endoscopic control

A 46-year-old man with epigastralgia and slight elevation of urinary 5-hydroxyindole acetic acid (5HIAA) was found to have a well-demarcated carcinoid tumor in the duodenal bulb. The tumor measured 8 mm in size, and showed submucosal involvement but no metastasis to the liver and regional lymph nodes. After laparoscopic exposure and lifting of the duodenal wall around the tumor, wedge resection of the duodenal bulb including the tumor was performed successfully with a laparoscopic endostapler under direct endoscopic control. The postoperative course of the patient was uneventful. Laparoscopic wedge resection of the duodenum would be an appropriate minimally invasive treatment of selected duodenal neoplasms with special preoperative assessments and intraoperative considerations.

Molecular cloning, expression, and characterization of a novel mouse liver SULT1B1 sulfotransferase

A mouse liver homogenate was shown to contain enzymatic activities catalyzing the sulfation of 3,4-dihydroxyphenylalanine (Dopa) and tyrosine isomers with a pH optimum of 8.25. Western blot analysis revealed a 34 kDa protein exhibiting immunologic cross-reactivity to antiserum against rat liver SULT1B1 sulfotransferase. By employing the reverse transcriptase-polymerase chain reaction (RT-PCR) technique, a 910-base pair product encoding the putative mouse liver SULT1B1 sulfotransferase was obtained. Using this PCR product as a probe, a cDNA containing the entire open reading frame of the mouse liver SULT1B1 sulfotransferase was cloned from a mouse liver Lambda ZAP cDNA library. The nucleotide sequence indicated it is a new enzyme. The deduced amino acid sequence exhibited 87.6, 72.3, 55.9, 54.2, 52.8, 51.1, and 49.4% identity to the amino acid sequences of the rat liver SULT1B1 sulfotransferase, human thyroid hormone sulfotransferase, mouse phenol sulfotransferase, rat liver phenol sulfotransferase, rat liver hydroxyarylamine sulfotransferase, mouse estrogen sulfotransferase, and rat estrogen sulfotransferase. Upon transfection of COS-7 cells with an expression vector (pcDNA3) harboring the cDNA encoding this new enzyme, a 34 kDa protein exhibiting immunologic cross-reactivity to antiserum against the rat liver SULT1B1 sulfotransferase was expressed. The recombinant sulfotransferase exhibited enzymatic activities toward Dopa and tyrosine isomers, as well as dopamine and 3,3',5-triiodo-L-thyronine. Northern blot analyses indicated the SULT1B1 sulfotransferase was predominantly expressed in liver, but not in the other ten mouse organs examined. Furthermore, the enzyme was found to be expressed in a developmental stage-dependent manner, being at a very low level in liver samples from 1-day-old mice and then gradually increasing to the maximum level in liver samples from 4-week-old mice.

MR imaging of meniscal tears with discoid lateral meniscus

OBJECTIVE

To study MR findings of meniscal tears with discoid lateral menisci (DLMs) and to evaluate the incidence and accuracy of MRI compared to arthroscopical surgery.

MATERIAL AND METHODS

MR appearances of surgically proved torn discoid lateral menisci (DLM) were studied in 57 knees (40 patients). They were all performed with a 1.5T MR before surgery. MR sequences included T1- and T2* weighted images on both coronal and sagittal planes and 3D-axial images with a slice thickness of 0.7 mm.

RESULT

Of 57 DLMs, there were 32 complete DLMs and 25 incomplete DLMs. Twenty-five of 32 complete DLMs had tears; including seven with intrasubstance tear, five with radial tear, five with other kinds of tears and eight with severe tears involving whole meniscus. On the other hand, 13 of 25 incomplete DLMs had tears; including two with intrasubstance tear, six with radial tear, four with other kinds of tears and one with severe tears. All DLMs were correctly diagnosed on MR images. Twenty-seven of 38 tears with DLM were correctly identified on conventional 2D MR images. This yielded 71.1% sensitivity, 100% specificity and 80.7% overall accuracy. When adding axial 3D MR images to 2D MR images, 36 of 38 tears were correctly diagnosed. A combination of both techniques yielded a sensitivity of 94.7% and a specificity of 100%. Ten of 11 radial tears with DLM were correctly identified on 3D axial images, where only three of them could be diagnosed on conventional 2D images. Eight of nine intrasubstance tears were correctly identified on 3D axial images, where six of them could be diagnosed on conventional 2D images.

CONCLUSION

DLMs had a much higher incidence of meniscal tears than normally shaped lateral menisci and MR is the only modality of choice to evaluate them before surgery. Especially 3D axial MR images were quite useful in the detection of intrasubstance and radial tears often associated with DLMs.

Evaluation of chewing activity in the elderly person

In the present study, we examined the chewing performance of 70 elderly persons. Self-assessment of chewing problems and clinical classification using the modified Eichner index showed little correlation (Kappa value = 0.28; 95% confidence interval (CI) = 0.05-0.51). The sensitivity and specificity were 0.52 and 0.76, respectively. On the other hand, the mastication score determined by evaluation of a questionnaire on food intake and classification using the modified Eichner index showed high agreement (Kappa value = 0.73; 95% CI = 0.50-0.96). The sensitivity and specificity were 0.76 and 0.95, respectively. The mastication score showed significant correlation with other masticatory functions such as maximum biting force, occlusal contact area and the number of missing teeth (P < 0.01). These results suggest that the use of a questionnaire on food intake would be informative for epidemiological surveys of chewing activity in the elderly.

[Three-dimensional MR angiography of HCC and portal and hepatic veins using superparamagnetic iron oxide]

We examined a new MR technique for obtaining 3D-MRA images of the liver that simultaneously depicts HCC and the portal and hepatic veins. Five patients with clinically suspected HCC were studied with superparamagnetic iron oxide (SHU-555A) used as a negative contrast medium for the liver. In our study, a 3D-rotational display was provided on the CTR monitor from 2D-TOF images by computed reconstruction, clearly showing HCC and portal and hepatic veins on the same image. Our method was found to be of great value in planning surgery of the liver.

Partial characterization of the gametes and development of a successful in vitro fertilization procedure in the mastomys (Praomys coucha): a new species for reproductive biology research

The mastomys, a small African rodent, has been extensively used as a laboratory animal for cancer research. Previous preliminary studies have demonstrated that the animal has a relatively short estrous cycle and that superovulation can be induced. However, biological characterization of the gametes in this species has not been done. The purpose of this study is to determine requirements for fertilization and to devise a suitable method for in vitro fertilization (IVF). Data from these studies show that 1) cauda epididymal plasma (CEP) is required for maintaining sperm motility in vitro; 2) in a heterologous sperm penetration assay in vitro, optimal conditions for sperm capacitation and the acrosome reaction depend on time and CEP concentration; and 3) loss of the cortical granules is observed to occur spontaneously within 3-4 h after ovulation in superovulated eggs. On the basis of the data obtained from these studies, we have developed a method for preincubation of mastomys sperm and a successful mastomys IVF procedure. This species can now be used as a new laboratory animal for research in reproductive biology.

Iodine concentrations in the rat kidney measured by X-ray microanalysis. Comparison of concentrations and viscosities in the proximal tubules and renal pelvis after intravenous injections of contrast media

PURPOSE

To measure the iodine concentrations in the proximal tubules and renal pelvis after i.v. injections of contrast media (CM) at 1600 mg I/kg b.w., using a micropuncture technique and X-ray microanalysis.

MATERIAL AND METHODS

The correlation between the viscosity of each CM and its iodine concentration was evaluated and the viscosity of the fluid in the proximal tubule and renal pelvis was estimated in rats.

RESULTS

After iotrolan injection, the iodine concentration in the proximal tubular fluid had increased to values about three times higher than those reached with diatrizoate, iohexol and ioxaglate. Similarly, iotrolan tended to produce a higher iodine concentration in the renal pelvis than did the other CM. The urine viscosity in the renal pelvis was much higher after the iotrolan injection than after the other CM injections.

CONCLUSION

High urine viscosity after iotrolan injection can at least partly explain our previous findings of a prolonged increase in tubular hydrostatic pressure and a prolonged decrease in the single nephron glomerular filtration rate after administration of this CM.

A case of enlarged cavernous sinus mistaken for petrous apex tumor

We experienced a case of abnormally enlarged cavernous sinus extending into the petrous apex, which was confused with a petrous apex tumor or an enlarged Meckel cave. The CT and MR appearances were of expansile lesions in the petrous apex with water signal intensities on both T1- and T2-weighted MR images. Unfortunately, these findings were not specific. Cerebral angiography was only suggestive of enlarged cavernous sinus involving the petrous apex because of opacification of the petrous apex in the venous phase. Our case was confirmed by surgery as enlarged cavernous sinus involving the petrous apex.

[Home infusion therapy for cancer patients at a near-terminal stage--analysis of cases who died at home]

To improve the quality of life in cancer patients at a near-terminal stage, we assisted patients to stay home using a system for home infusion therapy (HIT) established at Osaka Prefectural Habikino Hospital in 1994. From April in 1995 to April in 1996, 25 patients were treated at home using the HIT system for longer than 7 days. Thirteen out of 25 patients still stayed at home even at a terminal stage and died in their residences. There was no difference either in the mean age or in the HIT duration between 13 patients who died at home and the remaining 12 patients who were readmitted to their hospitals before death. However, 47% of the patients who died at home had been told their diagnoses by doctors and realized their own prognoses, while only 17% of the patients who died in the hospital knew their diagnoses and prognoses. Seventy-seven percent of the patients who died at home were given home oxygen therapy (HOT), against 33% of the patients who died in the hospital. Furthermore, the patients who died at home were given more intensive care than the patients who died in the hospital, because the former had a larger family than the latter. In conclusion, HIT at a near-terminal stage and death at home may be more readily accepted by patients who know their diagnoses and prognoses and have a large family.

Mapping of eight testis-specific genes to mouse chromosomes

We previously identified eight testis-specific genes using antibodies raised against testicular germ cells. They are expressed during spermatogenesis and are presumed to be involved in testicular germ cell differentiation and sperm formation. We have mapped the genomic loci for these testis-specific genes using restriction fragment length variants in interspecific backcross mice. The calmegin gene (Clgn) was mapped to Chr 8. The synaptonemal complex protein gene 1 (Sycp1) probe hybridized with two sequences on different chromosomes; Sycp1-rs2 was mapped to Chr 3, whereas Sycp1-rs3 was mapped to Chr 7. The relaxin-like factor gene (Rlnl) was mapped to Chr 8, and collapsin response mediator protein 1 (Crmp1) was mapped to Chr 5. Three novel genes encoding testis-specific proteins A2 (Tsga2), A8 (Tsga8), and A12 (Tsga12) were mapped to chromosomes 3, X, and 10, respectively.

A case of Meckel's diverticulum complicated by stenosis of the colon

Meckel's diverticulum is a common anomaly of the GI tract that is known to cause small intestinal obstruction. A 17-yr-old male who had no history of previous surgery was admitted with intermittent abdominal pain. A barium enema showed extraintestinal compression of the ascending colon, suggesting the existence of a congenital band. Laparoscopy revealed that the ascending colon was lifted up and compressed by the intestinal end of a Meckel's diverticulum with a fibrous band connecting to the umbilicus. The portion of the ileum including the Meckel's diverticulum was resected. This is the first case of stenosis of the colon caused by a Meckel's diverticulum.

Urine viscosity after injections of iotrolan or iomeprol

PURPOSE

Previous observations in rats caused us to speculate whether the injection of iotrolan, a nonionic dimeric contrast medium (CM), would increase urine viscosity enough to obstruct urine outflow in the collecting duct.

MATERIAL AND METHODS

The urine viscosity in dogs was measured directly with a viscosimeter after injections of iotrolan or of iomeprol, a nonionic monomeric CM.

RESULTS AND CONCLUSION

The injection of iotrolan increased urine viscosity considerably whereas iomeprol had little effect on this variable. The osmolality-dependent adverse reactions of CM have previously been emphasized but viscosity-dependent adverse reactions must also be considered when the CM is a polymer with a low osmolality.

Structural abnormalities of autosomal chromosomes in the male partner do not influence fertilization and early development of embryos after intracytoplasmic sperm injection

The objective of this study was to determine whether or not abnormalities in the autosomal structure of the male partner have any influence on fertilization and early embryo development after intracytoplasmic sperm injection (ICSI). Thirty-seven couples in whom the male partners were examined by the same andrologist were included in this study. Six couples (group I) in whom the male partner possessed autosomal structural abnormality underwent seven ICSI cycles. As a control group, 31 couples (group II) in which the male partner was karyotypically normal underwent 41 ICSI cycles. Although the normal fertilization rates seen in group I were significantly higher than those in group II (P < 0.05), there was no significant difference in the cleavage rates between the two groups. We did not perform the analysis of the female partner's chromosomes, but we surmise that structural autosomal abnormalities in the male partner do not adversely influence fertilization at ICSI and early development of embryos.

Determination of methylation specificity of sequence-specific DNA methyltransferases using matrix assisted laser desorption/ionization time-of-flight mass spectrometry

We describe here a sensitive and straightforward method for characterizing the methylation specificity of type II DNA methyltransferase (MTase) using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. DNA substrate, prepared by ligation of a commercially available oligonucleotide, was modified by the subject MTase, and was derivatized to a mixture of single-stranded oligonucleotides through endonuclease treatment, heat-denaturation and limited digestion by 3'-terminus-specific phosphodiesterase I. MALDI-TOF mass spectrometry was used to determine the mass differences between the digestion products, and the methylated nucleotide was explicitly identified by the mass increase of 14 Da due to the base modification. The method was applicable to the three representative MTases M. Eco RI, M. Bam HI and M. Hae III.

Expression of the placenta-specific, 100 kDa ras GTPase activating protein in several human cancer cell lines and normal human tissues

The ras GTPase activating protein (ras GAP), a regulator of Ras activity, has two isoforms; ras GAP 120 and ras GAP 100. The latter, whose molecular size is about 100 kDa, is generated alternative splicing from the ras GAP 120 gene and is considered placenta-specific, while the former is expressed ubiquitously. As point mutations of ras are frequently observed in human tumors, we investigated the expression of ras GAP in several human cancer cell lines and samples of human colon cancer using immunoprecipitation and immunoblot analysis with an anti-GAP monoclonal antibody, B4F8, as well as reverse transcription-polymerase chain reaction (RT-PCR). ras GAP 100 protein was detected in 4 of 9 colonic, 1 of 6 gastric and 1 of 4 lung cancer cell lines as well as ras GAP 120, but not in colon cancer specimens. In contrast, ras GAP 100 mRNA was present in all tested cell lines and colon cancer specimens. Then, we investigated ras GAP 100 expression in normal tissues, ras GAP 100 protein was not detected in human normal tissues except placenta. Contrary, ras GAP 100 message was expressed in normal tissues derived from liver, stomach, colon and lymphocyte although the level of which was smaller than that in placenta. These findings demonstrate that ras GAP 100, reportedly placenta-specific, is distributed in other normal tissues at least at mRNA level and its expression is augmented in some cancer cell lines.

[Successful treatment of myocardial infarction of left main trunk by emergent CABG under IABP and PCPS support]

We experienced a successful treatment of acute myocardial infarction which was due to left main trunk obstruction. A 54-year-old man with no history of angina was transported by a rescue squad in cardiogenic shock, and diagnosed by electrocardiography with a wide range of myocardial infarction. Emergent coronary arteriography was performed under IABP support, revealing 99% stenosis in the left main trunk. Percutaneous transluminal coronary recanalization (PTCR) was performed, but suddenly cardiac arrest was happened. He was put on emergency percutaneous cardiopulmonary support (PCPS). A Palmaz-Schatz stent was implanted for reperfusion, but the patient was hemodynamically unstable with frequent ventricular arrhythmia and pulmonary edema. 24 hours later he underwent coronary artery bypass grafting and CPB could be terminated intraoperatively. His cardiac function was very low and LVEF was 20%. All grafts were patent. On the rehabilitation he was discharged on postoperative day 162 and has returned to work in his office one year postoperatively.

Dicentric Y chromosome in an azoospermic male

We describe a 28 year old male with a pseudodicentric Y chromosome who suffered from azoospermia attributed to maturation arrest of the primary spermatocyte, as diagnosed by testicular biopsy. Chromosome analysis, using G, Q and C banding techniques, revealed an abnormal karyotype of 45,X[7]/46,X,psu dic (Y)(pter-->q11.2::q11.2-->pter)[33]. Polymerase chain reaction (PCR) DNA analysis did not detect the absence of DAZ and RBM1 which are candidates for azoospermic factor (AZF) genes. Therefore, it is suggested that the maturation arrest of the primary spermatocyte in this patient was caused either by a pairing dysfunction between the X and Y chromosomes during meiosis or by deletions in the autosomal or the Y chromosomal spermatogenesis controlling genes, excluding DAZ and RBM1.

FLAIR appearance of Wernicke encephalopathy

We performed MR imaging of the brain with both conventional spin-echo (SE) and fluid-attenuated inversion-recovery (FLAIR) sequences in a case of Wernicke encephalopathy. Lesion conspicuity was found to be better with FLAIR imaging.

[A case of primary pulmonary intimal sarcoma of the pulmonary artery]

We report the pulmonary intimal sarcoma of the pulmonary artery which is encountered infrequently. The patient, a 67-year-old man, was admitted with right heart failure. Diagnosis was not established completely by computed tomography of the thorax, pulmonary angiogram and pulmonary scintigram, therefore chronic pulmonary thromboembolism was suspected. Palliative resection was performed with cardiopulmonary bypass and total circulatory arrest. Pathologic examination of the resected tumor revealed pulmonary intimal sarcoma, which originated from the pulmonary artery. The patient died four months postoperatively. The cause of death was determined by autopsy to be recurrent pulmonary intimal sarcoma invading the left atrium and multiple metastasis of the brain, pancreas, adrenal glands and right lung.

[A case report on mitral valve replacement associated with antiphospholipid syndrome in systemic lupus erythematosus]

Mitral valve replacement (MVR) was performed on a 36-year-old woman for mitral valve regurgitation. The patient suffered from antiphospholipid syndrome (APLS) with systemic lupus erythematosus (SLE). The patient required 4 times plasma exchanges to prevent embolization to the cerebral arteries. A decrease in the anticardiolipin beta 2-glycoprotein I complex level was achieved and MVR was performed with a relatively good postoperative course. Anticoagulation therapy had been continued, but one year postoperatively the patient fell down a staircase and suffered acute epidural hematoma. Emergency operation was performed. The patient, however, died due to cerebral hemorrhage.

Chewing activity and activities of daily living in the elderly

The present study was conducted in order to determine the statistical relationship between chewing activity and activities of daily living (ADL) in the elderly. Subjects which took part were 79 elderly individuals (37 males, 42 females) ranging in age from 65 to 74 years. Based on questionnaires regarding diet, a mastication score was determined to evaluate chewing activity in each subject. This score was scaled from 0 to 100%. ADL levels were determined using two indices: the guidelines of the Ministry of Health and Welfare of Japan and the Tokyo Metropolitan Institute of Gerontology (TMIG) index. The TMIG index is a multidimensional 13-item index of competence in which scores range from 0 to 13 points. According to the guidelines of the Ministry of Health and Welfare, the independence level of each subject was evaluated as independent, home-bound, or bedridden. These independence levels showed a significant correlation with the mastication score (P < 0.01). The mastication score also significantly correlated with the TMIG index, showing a Spearman coefficient of correlation of 0.63 in males (P < 0.01) and 0.71 in females (P < 0.01). These results suggest that chewing activity is related to ADL levels in elderly subjects.

Tissue-specific and developmental stage-dependent expression of a novel rat Dopa/tyrosine sulfotransferase

Tissue-specific and developmental stage-dependent expression of a novel Dopa/tyrosine sulfotransferase in Sprague-Dawley rats was examined. Both immunoblot and Northern blot analyses showed that the enzyme was expressed predominantly in liver and to a lesser extent in kidney. Its expression could not be detected in nine other organs tested. Livers from different age groups of male or female rats were examined for the developmental regulation of the expression of the Dopa/tyrosine sulfotransferase. Results from immunoblot and Northern blot analyses revealed that the enzyme was present at a very low level in livers of 1-day-old to 2-week-old rats, and gradually increased to a maximum level in rats older than 2 months. Data from the enzymatic assays also showed a similar trend of expression in both male and female rats. The Dopa/tyrosine sulfotransferase activities detected in liver samples of the 8-week-old male and female rats were, respectively, 8.6 and 6.6 times that of the activities detected in liver samples of the 1-day-old male and female rats. These data provide a foundation for the future investigation of the cis- and trans-acting factors involved in the regulation of the tissue-specific and developmental stage-dependent expression of this enzyme.

MRI of head injury using FLAIR

We studied the utility of fluid-attenuated inversion-recovery (FLAIR) MRI in the investigation of head injury. We examined 56 patients with head injuries with T2-weighted spin-echo (SE) and FLAIR sequences. In all cases, the sensitivity of FLAIR images to equal or superior to that of conventional SE images to the traumatic lesions. In 9 cases, central diffuse axonal injury of the fornix and corpus callosum could be seen only on sagittal FLAIR images.

Intracytoplasmic injection with late spermatids: a successful procedure in achieving childbirth for couples in which the male partner suffers from azoospermia due to deficient spermatogenesis

OBJECTIVE

To investigate the feasibility of using late spermatids in intracytoplasmic sperm injection (ICSI) for patients in which there is a total lack of normal and testicular sperm.

DESIGN

Clinical study.

SETTING

Private fertility center with adjacent laboratory facilities.

PATIENT(S)

Thirty-six males diagnosed with azoospermia underwent testicular biopsy and the resulting spermatids from nine patients were used to fertilize oocytes retrieved from their respective wives by ICSI.

INTERVENTION(S)

Intracytoplasmic spermatid injection of oocytes with late spermatids obtained by testicular biopsy.

MAIN OUTCOME MEASURE(S)

Fertilization, pregnancy, and delivery rates.

RESULT(S)

Three of the cases resulted in pregnancies with childbirth occurring in all three, identical twins in one, and individual singletons in the other two cases.

CONCLUSION(S)

It is possible to achieve successful levels of pregnancy and childbirth in cases of azoospermia by intracytoplasmic injection of late spermatids.

Socioeconomic factors and dental caries in developing countries: a cross-national study

The purpose of the present study was to analyze statistically correlations between socioeconomic factors and the prevalence of dental caries in developing countries. The DMFT index, which evaluates the incidence of dental caries, showed a positive correlation (P < 0.01) with several socioeconomic factors, such as life expectancy, adult literacy rate, school attendance rate, population employed in the service sector, population aged 15-64 years, and urban population. According to multiple regression analysis, population aged 15-64 years, population employed in the service sector, and urban population were the most influential independent socioeconomic variables, in descending order, with a regression coefficient of 0.635 and a coefficient of determination of 0.404 (P < 0.001). This finding suggests that the prevalence of dental caries in developing countries increases with the degree of urbanization.

High signal intensity of the infundibular stalk on fluid-attenuated inversion recovery MR

PURPOSE

To determine the MR imaging characteristics of the pituitary stalk with a fluid-attenuated inversion recovery (FLAIR) technique.

METHODS

We retrospectively studied the prevalence of a high-signal infundibular stalk on FLAIR MR images of the brain in 133 patients and compared this finding with the patients' ages. To understand the cause of the high signal intensity of the pituitary stalk on FLAIR images, we calculated the T1, T2, and proton-density values in regions of gray matter, white matter, and the pituitary stalk in nine cases.

RESULTS

FLAIR images showed the pituitary stalk as having high signal intensity in 97 (73%) of 133 cases; however, in 11 of 16 patients less than 10 years old, the infundibular stalk was not of high signal intensity. In patients with a high-signal pituitary stalk on FLAIR images, the T2 value of the pituitary stalk was longer than that of gray or white matter.

CONCLUSION

High signal intensity of the infundibular stalk was frequently seen on FLAIR MR images of the brain at all ages. A prolonged T2 value of the pituitary stalk caused the high signal intensity, presumably reflecting the fluid component of the pituitary stalk.

A rare case of the right-sided aortic arch that has the right subclavian artery as the last branch

This report describes a rare case of the right-sided aortic arch with the right subclavian artery as the last branch, which was encountered in a Japanese male cadaver in the dissecting room at Kurume University School of Medicine in 1995. In this subject, the ascending aorta arose from the left ventricle and ascended obliquely, curving forward and to the right, and became the right-sided aortic arch. The aortic arch passed upwards, reaching a summit at the level of the third thoracic vertebral body, then curved dorsally. The left brachiocephalic, the right common carotid and the right subclavian arteries came off the aortic arch in that order. After the right subclavian artery, the aortic arch dilated and formed the aortic diverticulum behind the trachea and the esophagus. The right thoracic aorta, a continuation of the aortic arch, descended to the right of the vertebral column. This case is a type M anomaly according to the Adachi-Williams-Nakagawa's classification, and is the twelfth case with this type of vascular variation to be reported in Japan.

Evaluation of water durability at adhesion interfaces by peeling test of resin film

The water durability at adhesion interfaces was investigated by measurement of the peeled area of thin resin films bonded with 4-META resin on metal surfaces after imposing thermal stress using liquid nitrogen. Thermal stress at the adhesion interface was calculated by a computer-aided finite element method. On 18-8 stainless-steel specimens which bond strongly with 4-META resin, total interface failure occurs on specimens with resin thicker than 0.55 mm in dry condition. A resin layer of 0.25 mm was chosen to study degradation of the adhesion interface by water. The shearing stress was calculated as 16 MPa for a 0.25 mm thick resin layer. On mild-steel adherent interface with 4-META resin which degrades rapidly by water molecule, the relationship between water immersion time and degradation at the adhesion interface was discussed together with the amount of water penetrated at the interface. The method proposed in the present study is effective as a quick evaluation method for water durability at the adhesion interface.

In situ localization of messenger ribonucleic acid for an oviduct-specific glycoprotein during various hormonal conditions in the golden hamster

The oviductal epithelium secretes specific glycoproteins that associate with the egg after ovulation. Several published reports including our preliminary studies have suggested that ovarian steroids regulate the secretion of oviduct-specific glycoproteins in several mammalian species. The objective of this study, using golden hamsters, was to analyze the hormonal effects on gene expression of these molecules more precisely during various hormonal conditions (estrous cycle, ontogeny, pregnancy, GnRH analogue treatment, and ovariectomy) by in situ hybridization. The message for the hamster oviduct-specific glycoprotein (HOGP) was detected by a digoxigenin-labeled single-strand specific DNA probe in paraffin sections. Data from these studies show the following. 1) In the oviduct, the signal was detected in both the perinuclear region and the basal region in the ampulla but was predominantly detected in the basal region in the isthmus. 2) The signal intensity was high in the ampulla compared with the isthmus. 3) During a normal estrous cycle, the message level was significantly altered between the estrous and diestrous stages in the ampulla but not in the isthmus. In addition, the signal did not disappear at any stage in either the isthmus or ampulla. 4) The HOGP message was first observed from around 14 days of age and then decreased in parallel with serum estradiol levels during aging. 5) The signal was also observed in the oviductal epithelium of pregnant animals at term and of postpartum animals. 6) When we treated the animals with TAP-144-SR (GnRH analogue) or performed an ovariectomy, which caused diminution of serum estradiol and progesterone levels, the message of HOGP was significantly decreased. Moreover, the message expression was greatly induced after estradiol administration to GnRH analogue-treated animals, whereas a high level of serum progesterone slightly inhibited HOGP message expression. These results suggest that elevation of the serum estradiol/ progesterone level affects the HOGP gene expression in the ampulla. However, a high serum estradiol level did not induce the gene expression rapidly, suggesting that an adequate serum hormonal level over a given period of time may be important for the HOGP gene expression.

MR FLAIR imaging of herpes simplex encephalitis

We performed MRI of the brain with both conventional spin-echo (SE) and fluid-attenuated inversion-recovery (FLAIR) sequences in two cases of herpes simplex encephalitis. The lesion conspicuity in the gray and white matter was found to be the greatest with FLAIR imaging.

Elimination of iomeprol by hemodialysis

Iomeprol is commercially a relatively new type of contrast medium. There have been no reports concerning its dialysability and safety when administered to patients with end-stage renal failure undergoing regular therapeutic hemodialysis (HD). One hundred milliliters of iomeprol (350 mgl/ml) was injected intravenously at computed tomography in 10 patients suffering from chronic renal failure. HD was then performed within 30 min after the start of iomeprol injection. The duration of HD was 4 h and blood samples were taken at 15, 30 min, 1, 2 and 4 h after its start. Mean dialysance of urea was 176.0-182.9 ml/min, compared to 131.4-133.3 ml/min for iomeprol. Elimination rate of iomeprol was 821.4 +/- 4.6% 4 h after the start of HD. Two of the 10 patients had side effects. One of them complained of a heat sensation and the other of sneezing and rash. As 4-h HD effectively removed iomeprol from the body and there were no severe side effects, it is concluded that iomeprol is suitable for HD patients.

[Assessment of thalamic regional cerebral blood flow in patients with cerebrovascular disease]

The thalamus is believed to play an integrative role in the central nervous system. In the present study, thalamic rCBF was measured in 65 CVD patients and 15 normal volunteers by stable Xe/CT scanning. ROIs were chosen in the thalamic slice at a level 5cm over the OM line, and mean CBF was 7 cm over the OM line. The clinical factors focused on in multiple regression analysis were: age (A), sex (Se), stage from onset (St), lesion side (Sd); unilaterality or bilaterality, size (Sz) thalamic lesion (Tl). GCS (G), HDS-R (H); Hasegawa dementia score (revised), symptoms (Ss) such as anxiety, dizziness, head-headed feeling and headache, and neurological deficits (N). Each factor was graded and scored. Statistically, there was a significant correlation between thalamic rCBF (Y) and mean CBF (X) in the less affected hemisphere: Y = 1.82X + 2.2, r = 0.801, p < 0.001, n = 65. Multiple regression analysis of the thalamic rCBF revealed that the Sz factor was significant (p < 0.0001) on the lesion side: Y = 76.7-10.2Sz, r = 0.644, p < 0.001, n = 51, while the Se, Sd and St factors were significant (p < 0.005) on the less affected side: Y = 71.9 + 9.7Se-6.8Sd-5.0St, R = 0.585, p < 0.001, n = 65. The thalamic index (X), an indicator of thalamic atrophy, and thalamic rCBF were significantly correlated: Y = 28.7X + 10.2, r = 0.386, p < 0.001, n = 80. In conclusion, thalamic rCBF appeared to reflect the degree of organic changes and time course in the cerebral hemisphere, because factors such as size, sex and stage were statistically significant.

Case report: MR appearance of hemangiopericytoma of the thigh

We report a case of hemangiopericytoma in the thigh of a 42-year-old woman. CT examination depicted a peripherally enhanced, multicystic mass without calcification. On T1-weighted images of MRI, the mass showed slightly high signal intensity relative to muscle, with the exception of the lower pole, which showed high signal intensity. On T2*-weighted images, the mass showed high signal intensity and cystic appearance. The lower pole showed low signal intensity on T2*-weighted images and was thought to be intratumoral hemorrhage. Low signal intensity structures on both T1- and T2*-weighted images were observed within and around the mass. They were thought to be dilated vessels, although this was not confirmed at surgery. Hemangiopericytoma should be considered in the differential diagnosis of a tumor in the thigh when MR images show the mass with slightly high signal intensity on T1-weighted images, intratumoral hemorrhage, and flow voids within or adjacent to the tumor.

Arterial embolization to control renal hemorrhage in patients with percutaneous nephrostomy

Two patients with renal hemorrhage treated by arterial embolization are reported. In one patient, one kidney was injured and the another had poor function. The other patient had one kidney. Although both patients had hematuria and underwent percutaneous nephrostomy, the bleeding location was not detected angiographically. Repeated embolization and irrigations through a nephrostomy catheter following each embolization arrested the bleeding.

Temporal surge of glycosyltransferase activities in the genital tract of the hamster during the estrous cycle

Mammalian spermatozoa must undergo maturational changes between the events of mating and fertilization. These biochemical and functional alterations, collectively termed capacitation, take place as spermatozoa traverse the female reproductive tract. The preparatory biochemical changes include removal, modification, and reorganization of sperm surface molecules. Although details of all the changes are not known, lectin binding studies have provided evidence suggesting that carbohydrate moieties of sperm surface glycoproteins are modified during capacitation. In an attempt to gain insight into the potential modifications of sperm plasma membrane glycoproteins, we quantified glycoprotein-modifying enzyme activities in the uterine and oviductal fluid of the hamster during the 4 days of the estrous cycle. These enzymes are known to modify existing glycoproteins, either by adding sugar residues (glycosyltransferases) or by removing terminal sugar residues (glycosidases). Data from these studies showed that 1) levels of all glycosyltransferase activities assayed (sialyltransferase, fucosyltransferase, galactosyltransferase, and N-acetylglucosaminyltransferase) were negligible in the uterine fluid at the onset of ovulation (Day 1) but sharply increased preceding ovulation (Day 4); 2) levels of the four glycosyltransferase activities assayed were higher in the oviductal fluid at the onset of ovulation (Day 1) and then gradually decreased through the remainder of the estrous cycle (Day 2 to Day 4); 3) levels of all glycohydrolase activities (acidic alpha-D-mannosidase, beta-D-galactosidase, beta-D-glucuronidase, beta-D-glucosaminidase, and alpha-L-fucosidase) and protein in the uterine and oviductal fluids did not vary widely during the 4 days of the cycle. These results demonstrate a temporal surge of glycosyltransferase activities in the genital tract fluids of the hamster. The temporal changes in the glycoprotein-modifying enzymes may have an effect on the glycosylation of sperm plasma membrane and zona pellucida glycoproteins at the site of fertilization or may alter the surface glycoproteins of the fertilized egg in the uterus prior to implantation.