Cytodiagnostic clues to primary retinoblastoma based on cytologic and histologic correlates of 39 enucleated eyes

In 39 cases undergoing ocular enucleation, cytologic characteristics of primary intraocular retinoblastomas were examined in relation to histologic findings. Retinoblastoma cells occurred singly or in clusters within the associated necrotic debris. Calcific deposits were present in both cytologic and histologic specimens. Portions of capillaries with perivascular tumor infiltrates were identified as pseudorosettes. Wright rosettes were occasionally seen in poorly differentiated retinoblastomas. Flexner-Wintersteiner rosettes were uncommon; however, "mirror ball-like" clusters in cytologic materials correlated well with the rosettes and were a diagnostic clue. Cytomorphologically, the tumor cells could be divided into two types that reflected their histologic grading of differentiation. These findings are cytodiagnostic clues to the presence of retinoblastomas and can be helpful in the cytologic diagnosis.

A ruptured thymic branch aneurysm mimicking a ruptured aortic aneurysm, with associated bronchial artery aneurysms: report of a case

A 57-year-old woman who went into shock following an acute left hemothorax was operated on after stabilization under the diagnosis of a ruptured aortic aneurysm. A left fifth intercostal thoracotomy was done which revealed approximately 500 ml of bloody effusion in the extrapleural space and 2,000 g of clotted blood in the pleural cavity. While the aneurysm was initially thought to have originated in the isthmic or descending aorta, intraoperative findings revealed a swollen hematomatous thymus adherent to the aorta. A ruptured thymic branch aneurysm, 3 cm in diameter, was subsequently found in the resected hematomatous thymus. Histological examination also revealed several small aneurysms in the tortured bronchial arteries. Postoperative angiography showed a saccular aneurysm, 1.5 cm in diameter, and several smaller aneurysms in the bronchial artery of the left lung. The aneurysm was successfully treated by a transcatheter arterial embolization, and the patient has had no further symptoms since then. To our knowledge, there has been no other case of a ruptured thymic artery aneurysm reported in the literature, and only a few cases of bronchial artery aneurysms have been documented.

Isolation and properties of a protein complex containing flagellar movement-initiating phosphoprotein from testes of a white salmon

Phosphorylation of a tyrosine residue within a 15-kDa protein has been found to play a role in the initiation of flagellar movement of quiescent spermatozoa of the rainbow trout, Salmo gairdneri [Morisawa & Hayashi (1986) Biomed. Res. 6, 181-184; Hayashi et al. (1987) J. Biol. Chem. 262, 16692-16698]. In order to find a more accessible source of the 15-kDa protein for biochemical studies, phosphorylation of proteins was studied in other organs from other species. Cell-free extracts from spermatozoa and testes of Salmonidae were prepared and all catalyzed the cAMP-dependent, Mg(2+)-requiring, but Ca(2+)-independent phosphorylation of the 15-kDa proteins. Protein from the testes of a white salmon, Oncorhynchus keta, was isolated by conventional purification methods. The 15-kDa protein in the cell-free extract was found to be complexed with several other proteins such that the 15-kDa protein and its phosphorylating activity were copurified. Isolation of a sufficient amount of the complex for the preparation of antibodies against the various constituents is now possible.

Characteristics of Ki1769, a novel vasodilator, in isolated rat aorta

The vasorelaxant mechanism of a newly synthesized vasodilator, Ki1769 [N-cyano-N'-(2-phenethyl)-3-pyridinecarboximidamide], was studied in isolated rat aorta in comparison with cromakalim. Ki1769 (10(-8)-10(-5) M) and cromakalim (10(-8)-10(-5) M) produced a concentration-dependent relaxation and the EC50 values for Ki1769 and cromakalim were (8.60 +/- 1.90) x 10(-7) M and (1.36 +/- 0.18) x 10(-7) M, respectively. Ki1769- and cromakalim-induced relaxations were competitively antagonized by glibenclamide with pA2 values of 6.83 and 6.93, respectively. Charybdotoxin, apamine, atropine, propranolol and indomethacin did not affect the Ki1769-induced relaxation. An increase in 86Rb efflux was induced by Ki1769. Glibenclamide attenuated the increase in 86Rb efflux produced by Ki1769. These results suggest that the vasorelaxant effect of Ki1769 is based on the glibenclamide-sensitive K channel-opening action.

Cloning of the Saccharomyces cerevisiae gene whose overexpression overcomes the effects of HM-1 killer toxin, which inhibits beta-glucan synthesis

A gene whose overexpression can endow Saccharomyces cerevisiae cells with resistance to HM-1 killer toxin was cloned from an S. cerevisiae genomic library. This gene, designated HKR1 (Hansenula mrakii killer toxin-resistant gene 1), contains a 5.4-kb open reading frame. The predicted amino acid sequence of the protein specified by HKR1 indicates that the protein consists of 1,802 amino acids and is very rich in serine and threonine, which could serve as O-glycosylation sites. The protein also contains two hydrophobic domains at the N-terminal end and in the C-terminal half, which could function as a signal peptide and transmembrane domain, respectively. Hkr1p is found to contain an EF hand motif of the calcium-binding consensus sequence in the C-terminal cytoplasmic domain. Thus, Hkr1p is expected to be a calcium-binding, glycosylated type I membrane protein. Southern and Northern (RNA) analyses demonstrated that there is a single copy of the HKR1 gene in the S. cerevisiae genome, and the transcriptional level of HKR1 is extremely low. Gene disruption followed by tetrad analysis showed that HKR1 is an essential gene. Overexpression of the truncated HKR1 encoding the C-terminal half of Hkr1p made the cells more resistant to HM-1 killer toxin than the full-length HKR1 did, demonstrating that the C-terminal half of Hkr1p is essential for overcoming the effect of HM-1 killer toxin. Furthermore, overexpression of HKR1 increased the beta-glucan content in the cell wall without affecting in vitro beta-glucan synthase activity, suggesting that HKR1 regulates beta-glucan synthesis in vivo.

Mechanisms for protective effects of free radical scavengers on gentamicin-mediated nephropathy in rats

Studies were performed to examine the mechanisms for the protective effects of free radical scavengers on gentamicin (GM)-mediated nephropathy. Administration of GM at 40 mg/kg sc for 13 days to rats induced a significant reduction in renal blood flow (RBF) and inulin clearance (CIn) as well as marked tubular damage. A significant reduction in urinary guanosine 3',5'-cyclic monophosphate (cGMP) excretion and a significant increase in renal cortical renin and endothelin-1 contents were also observed in GM-mediated nephropathy. Superoxide dismutase (SOD) or dimethylthiourea (DMTU) significantly lessened the GM-induced decrement in CIn. The SOD-induced increase in glomerular filtration rate was associated with a marked improvement in RBF, an increase in urinary cGMP excretion, and a decrease in renal renin and endothelin-1 content. SOD did not attenuate the tubular damage. In contrast, DMTU significantly reduced the tubular damage and lipid peroxidation, but it did not affect renal hemodynamics and vasoactive substances. Neither SOD nor DMTU affected the renal cortical GM content in GM-treated rats. These results suggest that 1) both SOD and DMTU have protective effects on GM-mediated nephropathy, 2) the mechanisms for the protective effects differ for SOD and DMTU, and 3) superoxide anions play a critical role in GM-induced renal vasoconstriction.

Reducing motion artifacts during hepatic DSA

In hepatic digital subtraction angiography, artifacts caused by diaphragmatic motion can interfere with the correct diagnosis of hepatic lesions. This article describes the feasibility of using the exhalation holding method in reducing diaphragmatic motion artifacts in hepatic DSA. The authors compared respiratory holding methods in 30 patients who underwent hepatic DSA. They performed a blind comparison of images to assess diaphragmatic motion artifacts. Results showed the images obtained by the exhalation holding method were superior to those obtained by the inhalation holding method in 20 out of 30 series (66.7%).

Histologic and biomechanical characteristics of the supraspinatus tendon: Reference to rotator cuff tearing

A bursal- or joint-side incomplete thickness tearing of the rotator cuff is clinically important, because it is known that this tearing has the potential to develop into a complete tendon disruption. Normal cadaveric supraspinatus tendons were analyzed histologically and biomechanically to clarify the differences in pathomechanical causation of bursal- and joint-side incomplete tears. Histologically, the bursal-side layer was composed of tendon bundles with a decreasing muscular component toward the insertion. The joint-side layer was a complex of tendon, ligament, and joint capsule without transitional areas. Biomechanically, the bursal-side layer had greater deformation and tensile strength. When each layer was divided into three portions of equal length, the middle segment of the bursal-side layer elongated the most, whereas the entire joint-side layer increased evenly in length. We conclude that the joint-side layer is more vulnerable to a tensile load than the bursal-side layer.

An interleukin-6 secreting myxoma in a hypertrophic left ventricle

We describe a patient who had both a left ventricular myxoma and left ventricular hypertrophy; the myxoma was subsequently excised and revealed to produce interleukin-6. The combination of left ventricular myxoma and ventricular hypertrophy is uncommon. Interleukin-6 secreted from the myxoma may be an important factor in the pathogenesis of ventricular hypertrophy in this patient.

A novel synthetic phyllolitorin analogue [desTrp3,Leu8]phyllolitorin inhibits scratching behavior induced by neuromedin C in rats

[DesTrp3,Leu8]phyllolitorin (DTP) (pGlu-Leu-Ala-Val-Gly-Ser-Leu-Met-NH2) was synthesized as an analogue of phyllolitorins, a new member of bombesin family, and examined if it antagonized neuromedin C (NMC)-induced scratching. DTP inhibited dose-dependently the scratching behavior by NMC (1 microgram), whereas it did not alter any element of other grooming behaviors. DTP (6 micrograms) alone was found to be neither toxic nor active in inducing both scratching and grooming, which were comparable to vehicle alone. Assuming that the scratching behavior is commonly and specifically elicited by bombesin family peptides, DTP might be classified as a new type of bombesin antagonist.

Slow abnormal conduction in the low right atrium: its anatomic basis and relevance to atrial reentry

To characterize slow abnormal conduction in the low right atrium, which is known to be responsible for atrial flutter, electrophysiologic findings were correlated with anatomic features in a canine model of atrial flutter with ligation of the crista terminalis in the midright atrium. Activation in the low right atrium was mapped with a patch electrode containing 52 bipolar electrodes and a multiplexing system. A particular region in the low right atrium showed atrioventricular node-like electrophysiologic properties, a rate-dependent conduction delay, and Wenckebach periodicity. This area coincided with an area responsible for slow conduction during atrial flutter and unidirectional block at its initiation. Both pilsicainide and E-4031 preferentially blocked conduction in the specific area, leading to the termination of atrial flutter. Although refractoriness could not explain the abnormal conduction, anatomic studies consistently found the specific region to be in or around a thick muscle bundle, that is, the crista terminalis, or a thick pectinate muscle branching from the crista, located perpendicular to the wavefront of the pacing impulse and atrial flutter. These electrophysiologic and anatomic findings suggest that slow abnormal and atrioventricular node-like conduction over a thick muscle bundle, which is a normal anatomic feature of the low right atrium, plays a role in the initiation, maintenance, and termination of atrial reentry.

A study on the metabolism of spermidine in mammals: purification and identification of a newly identified metabolite, 2-oxo-1-pyrrolidinepropionic acid, in rat urine

In order to study the metabolism of spermidine in mammals, radioactive spermidine was injected intraperitoneally into a rat and urine was collected for analysis. Incorporation of radioactivity into putreanine, isoputreanine, spermidic acid, and N-aminopropylpyrrolidin-2-one was confirmed by ion-exchange chromatography, thin layer chromatography, and paper electrophoresis, the highest radioactivity being observed in the non-polar and acidic fraction of the collected urine. A radioactive compound was purified from the non-polar and acidic fraction, and identified as 2-oxo-1-pyrrolidinepropionic acid by comparison of its behavior on ion-exchange chromatography and thin layer chromatography with that of authentic 2-oxo-1-pyrrolidinepropionic acid, and recrystallization with the authentic compound. Acid hydrolysis of the radioactive compound produced radioactive spermidic acid, confirming the identification. To examine the interconversion between isoputreanine and N-aminopropylpyrrolidin-2-one, these compounds were deuterated and then intraperitoneally injected into a rat. Analysis of 24-h urine by gas-chromatography-mass-spectrometry indicated no interconversion between the two metabolites of spermidine under these conditions. An intracerebroventricular injection of radioactive spermidine into a rat showed that radioactivity was also incorporated into the metabolites of spermidine in the brain, and oxidative deamination of the aminopropyl moiety of spermidine was thought to be dominant in the central nervous system and vice versa in peripheral organs.

A 1,2-alpha-D-mannosidase from a Bacillus sp.: purification, characterization, and mode of action

A 1,2-alpha-D-mannosidase was purified to homogeneity from the culture supernatant of Bacillus sp. M-90, which was isolated from soil by enrichment culture on baker's yeast mannan. The purified enzyme had M(r) 380,000 Da, and was comprised of two apparently identical 190,000 Da subunits. It had a neutral optimum pH (7.0) and an isoelectric point of 3.6. The enzyme was highly specific for alpha 1,2-linked D-mannose oligosaccharides. An N-linked high-mannose type oligosaccharide, Man9GlcNAc2, was a good substrate, yielding Man5GlcNAc2, and the alpha 1,2-linked side chains of Saccharomyces cerevisiae mannan were also specifically hydrolyzed by the enzyme. p-Nitrophenyl alpha-D-mannopyranoside and 1,2-alpha-D-mannobiitol were not hydrolyzed at all. Calcium ion, 1-deoxyman-nojirimycin, and swainsonine had no effect on the enzyme, but the activity was completely inhibited by EDTA. The mode of action on alpha 1,2-linked mannotetraose indicated that the enzyme is an exo-1,2-alpha-D-mannanase.

Effect of 13-hydroperoxyoctadecadienoic acid on prostaglandin synthesis in rabbit kidney medulla microsomes

The effect of 13-hydroperoxyoctadecadienoic acid (13-HPODE) on the synthesis of prostaglandins (PGs) was examined in rabbit kidney medulla microsomes. Medulla microsomes were incubated with arachidonic acid in 0.1 M-Tris/HCl buffer (pH 8.0) containing reduced glutathione and hydroquinone and the PGE2, PGF2a and PGD2 formed were measured by high-pressure liquid chromatography using 9-anthryldiazomethane for derivatization. Under our incubation conditions rabbit kidney medulla was found to produce mainly PGE2. The addition of 13-HPODE inhibited the production of all three PGs to a similar extent. 13-Hydroxyoctadecadienoic acid did not suppress the formation of PGs, indicating the requirement of the hydroperoxy moiety for the inhibitory effect of 13-HPODE on PG formation. Experiments utilizing the native fatty acid linoleic acid and tert-butyl hydroperoxide suggested the importance of the fatty acid-derived hydroperoxide in PG synthesis by kidney medulla. We conclude that 13-HPODE is an inhibitor of renomedullary cyclooxygenase and may have functional effects within the kidney.

Doppler echocardiographic assessment of left ventricular diastolic function in patients with systemic lupus erythematosus

Thirty patients with clinically inactive systemic lupus erythematosus (SLE) were examined by Doppler echocardiography to investigate the diastolic properties of the left ventricle. Twelve age-matched healthy women were also examined as controls. The pulsed wave transmitral Doppler flow velocity curves were digitized and curves of their first derivatives were obtained. Isovolumic relaxation time (IRT), acceleration and deceleration half-time of the rapid filling wave (E) and atrial contraction wave (A) (AHTe, DHTe, AHTa, DHTa), A/E, peak dE/dt, -peak dE/dt, peak dA/dt, -peak dA/dt were measured. In the SLE group, IRT and DHTe were prolonged, A, A/E, peak dA/dt and -peak dA/dt were increased compared with the control group. We conclude that patients with SLE have abnormal left ventricular diastolic function, even though their disease is clinically inactive.

Estimation of absorbed dose to evacuees at pripyat-city using ESR measurements of sugar and exposure rate calculations

The external absorbed doses in Pripyat-city resulting from the Chernobyl nuclear power plant accident have been evaluated from eight ordinary granulated sugar samples using the electron spin resonance method. The indoor and outdoor external doses to the people evacuated from Pripyat-city at about 36 h after the Chernobyl accident have been estimated using both data from the eight household sugar samples present in Pripyat-city prior to and during the accident and information on the type of buildings and survey-meter measurements of the exposure rates there. The absorbed dose to the evacuated people, as estimated from the exposure rates calculated in combination with the sugar dosimetry data, agree approximately with the reported average effective dose equivalent to such people, which was derived from both calculations and exposure-rate surveys. If each person in Pripyat-city could remember exactly the proportion of time spent indoors before being evacuated after the accident, the absorbed dose could roughly be estimated from the relationship between the documented external dose outdoors during the period between the accident and evacuation and the length of the period spent indoors by each individual prior to evacuation. It is suggested that as little as 1 g of sugar would be one of the most useful emergency dosimeters for people inside their dwellings, at least for absorbed doses greater than about 0.02 Gy.

Erythropoietin production in patients with chronic renal failure

Studies were performed to reexamine the response of erythropoietin (Epo) production to acute hypoxic stimuli in patients with end-stage renal disease (ESRD). In the absence of acute bleeding or hypoxia, the serum Epo level in ESRD was similar to that of normal subjects despite severe anemia. In 11 dialysis patients with acute bleeding, the decrease in the Hb level from 8.9 to 5.8 g/dL provoked a significant increase in serum Epo up to 52.2 times the normal value. The increase in serum Epo was associated with a significant increase in corrected reticulocyte. Systemic hypoxemia (PaO2 < 65 mm Hg) in 8 dialysis patients provoked a significant elevation in the serum Epo level up to 24.6 times the normal level. There was an inverse relationship between serum Epo and arterial PaO2 (r = -0.715). The serum Epo level in these patients declined to or near the normal value after recovery from acute hypoxic stress. These data suggest that the ability of the Epo production is well preserved in ESRD, indicating that acute hypoxic stimuli provoke a significant increase in serum Epo.

[A case of subacute sclerosing panencephalitis treated with intraventricular interferon--the side effects of interferon-alpha to the central nervous system]

A patient with subacute sclerosing panencephalitis (SSPE) was treated with an intraventricular alpha interferon (IFN-alpha) through an Ommaya reservoir. A 17-year-old boy, who had a history of measles exposure at age 1, showed forgetfulness, difficulties in calculation, reading and writing. Two months later he developed generalized convulsions and myoclonic spasms. He was admitted to the National Saigata Hospital in May 20, 1992. On admission, anti-measles antibody titer in the CSF was 1:16 by complement-fixation method. His EEG revealed a periodic synchronous discharge. Therefore, the diagnosis of SSPE was confirmed. An Ommaya reservoir was implanted on July 7, 1992, and an intraventricular administration of INF-alpha was begun after two weeks. The dose of INF-alpha was gradually increased from 1.0 x 10(6) IU/m2 to 2.0 x 10(6) IU/m2 twice a week. Fever, vomiting and anorexia were developed when the INF-alpha injection was first started. When he received a total dose of 8.0 x 10(6) IU, he became bed ridden for remarkable lethargy. The lethargy was continued for about 10 days despite the therapy was interrupted, and then he gradually became alert. The frequency of myoclonus became more frequent and mentality got worse, so the treatment with INF-alpha was tried again in decreasing the dose to 1.0 x 10(6) IU/m2 twice a week. However, be became drowsy again after he received a total of 7.5 x 10(6) IU. With intramuscular or intravenous administrations of the high doses of INF-alpha (> or = 1.0 x 10(7) IU), significant neurological abnormalities were reported to occur.(ABSTRACT TRUNCATED AT 250 WORDS)

Roles of hemodynamic and tubular factors in gentamicin-mediated nephropathy

Gentamicin (GM) often causes polyuric acute renal failure (ARF) in humans and animals. GM-mediated ARF in rats was accompanied with activated renin-angiotensin system, increased renal endothelin content, and enhanced lipid peroxidation. Suppression of the renin-angiotensin activity by desoxycorticosterone acetate and saline drinking, and treatment with superoxide dismutase attenuated the GM-induced decline in whole-kidney GFR with well-maintained RBF but did not reduce the severity of tubular necrosis. On the other hand, treatment with dimethylthiourea, a hydroxyl radical scavenger, attenuated the GM-mediated decline in GFR and lessened tubular necrosis but did not ameliorate the reduction in RBF. These data suggest contributions of both vascular and tubular factors to the GM-induced decline in GFR in rats. However, relative importance of these factors probably differs with different doses of the agent.

Multivariate statistical analysis of bile cytology

Cytologic features predictive of carcinoma in bile fluid were characterized by a review of 35 cases (22 malignant and 13 benign). Thirty-two cytologic variables were subjected to a stepwise multiple regression model to separate the criteria best suited to the benign versus malignant groups. Six key criteria were selected as useful indicators of malignancy: loss of honeycomb arrangement, enlarged nuclei, loss of polarity, bloody background, flat nuclei and cell-in-cell arrangement. Three or more of these criteria were observed in carcinoma cases more often than they were in noncancer cases (P < .01). By using these criteria, the overall sensitivity of diagnosing carcinoma by bile cytology was 86.4%, and the specificity was 76.9%.

An autopsy case of pulmonary adenocarcinoma of fetal type treated with radiation therapy

A 68-year-old female patient with well-differentiated adenocarcinoma simulating fetal lung tubulus in pseudoglandular stage (pulmonary adenocarcinoma of fetal type) is reported. This type of tumor was first described by Kradin et al. in 1982, and reported by Kodama et al. in 1984. This tumor has characteristics consistent with those of pulmonary endodermal tumor but not with typical pulmonary blastoma. This patient with clinical stage IIIA disease was treated with definitive radiation therapy alone and had shown a good course for two years, but died from malignant pleural effusion and extensive distant metastases. At autopsy, the tumor showed pathological features consistent with those of previously reported cases.

Two cases of recurrent hepatic injury associated with early pregnancy: hCG on hepatocytes is a suspected target antigen for lymphocyte attack

Two cases of recurrent hepatic injury which appeared in the first trimester of pregnancy were studied. Case 1 was a 35 year old woman, gravida 4, para 0, who suffered repeatedly from hepatic injury requiring induced abortions. The patient was healthy before the pregnancies and the plasma aminotransferases increased after 8 weeks gestation and promptly returned to normal after the abortions. No fluctuation of aminotransferases was observed in the menstrual cycle. A liver biopsy immediately after abortion showed spotty necrosis of hepatocytes with mononuclear cell infiltration. Most of the infiltrating cells were cytotoxic T cells that were directly in contact with hepatocytes. Numerous lymphocytic infiltrations were also found in the decidua of the uterine curettage material. The patient's lymphocytes showed conspicuous blast transformation in culture with human chorionic gonadotropin (hCG). The hCG was detected in close vicinity to the injured hepatocytes by immunostaining. Case 2 was a 23 year old woman, gravida 2, para 0, who underwent an induced abortion due to hepatic dysfunction in the first pregnancy. Although hepatic dysfunction reappeared from 10 weeks gestation during the second pregnancy, her health gradually improved with conservative therapy and resulted in a full-term delivery. She lacked allergies to drugs or foods and was healthy when she was not pregnant. These two cases suggest that some hepatotoxic materials appeared transiently in the first trimester. The results of Case 1 suggest strongly that hCG on the hepatocytes was recognized as an antigen and evoked lymphocytic attack.