Platelet Ca2+ is not increased in stroke-prone spontaneously hypertensive rats: comparative study with spontaneously hypertensive rats

We have reported that cytosolic Ca2+ concentration ([Ca2+]i) is increased in platelets from spontaneously hypertensive rats (SHR) in both basal and thrombin-stimulated conditions. To determine whether the correlation between blood pressure and cellular Ca2+ metabolism exists in stroke-prone SHR (SHRSP), we investigated Ca2+ handling using fura 2 and aggregation response in platelets of 12- to 13-week-old male SHRSP, SHR, and Wistar-Kyoto rats (WKY). Systolic pressure was highest in SHRSP and lowest in WKY (213 +/- 8, 172 +/- 7, and 135 +/- 5 mm Hg, respectively). Basal [Ca2+]i was significantly higher in SHR than WKY (45.9 +/- 4.5 versus 41.2 +/- 4.8 nmol/L, P<.05), and that in SHRSP (40.2 +/- 2.8 nmol/L) was similar to that in WKY. Thrombin (0.1 IU/mL)-stimulated [Ca2+]i rise was greater in SHR and smaller in SHRSP than in WKY in the presence of extracellular Ca2+ (530 +/- 50 and 408 +/- 52 versus 475 +/- 50 nmol/L, respectively; P<.05). The recovery rate from the peak [Ca2+]i response to thrombin was greatest in SHRSP and least in WKY. Ionomycin (5 micromol/L)-stimulated [Ca2+]i rise was similar in WKY, SHR, and SHRSP (731 +/- 97, 743 +/- 88, and 683 +/- 70 nmol/L, respectively). Thrombin-induced maximum platelet aggregation response was higher in SHR and lower in SHRSP than WKY (82 +/- 4 percent and 61 +/- 15 percent versus 73 +/- 6 percent, respectively; P<.05). In contrast to SHR, basal [Ca2+]i in SHRSP was similar to that in WKY, and thrombin-stimulated [Ca2+]i was attenuated. These result suggest that platelet Ca2+ handling differs between SHR substrains and that an increased [Ca2+]i is not obligatory in genetically hypertensive rats.

Liver haem metabolism in adjuvant-induced arthritic rats

1. Adjuvant-induced arthritic (AA) rats show a striking decrease in the level of cytochrome P450, a key microsomal haemoprotein involved in electron transport and drug metabolism in the liver. In the present study, we examined the relationship between the reduction of P450 content and haem metabolism in the liver of AA rats. 2. The activities of many enzymes catalyzing the biosynthesis of haem in the liver were significantly higher in AA rats than in normal rats, whereas only coproporphyrinogen oxidase activity in AA rats was markedly lower than that in normal rats. Furthermore, the activity of haem oxygenase, a key enzyme in the haem degradative pathway, increased significantly in AA rats. In addition, the degree of increase in the activity of this enzyme was clearly higher than that in the activity of 5-aminolevulinate synthase, a key enzyme in the haem synthetic pathway. 3. These results suggest that the reduction of live P450 content in AA rats is based on the lowering of liver haem content due to the combined action of the increased haem oxygenase activity and the decreased coproporphyrinogen oxidase activity. The changes in these enzyme activities were apparently suppressed by the continuous administration of indomethacin, which improved the arthritic states of the animals.

Purification and Properties of Flavin- and Molybdenum-Containing Aldehyde Oxidase from Coleoptiles of Maize

Aldehyde oxidase (AO; EC 1.2.3.1) that could oxidize indole-3-acetaldehyde into indole-3-acetic acid was purified approximately 2000-fold from coleoptiles of 3-d-old maize (Zea mays L.) seedlings. The apparent molecular mass of the native enzyme was about 300 kD as estimated by gel-filtration column chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the enzyme was composed of 150-kD subunits. It contained flavin adenine dinucleotide, iron, and molybdenum as prosthetic groups and had absorption peaks in the visible region (300-600 nm). To our knowledge, this is the first demonstration of the presence of flavin adenine dinucleotide and metals in plant AO. Other aromatic aldehydes such as indole-3-aldehyde and benzaldehyde also served as good substrates, but N-methylnicotinamide, a good substrate for animal AO, was not oxidized. 2-Mercaptoethanol, p-chloromercu-ribenzoate, and iodoacetate partially inhibited the activity, but well-known inhibitors of animal AO, such as menadione and estradiol, caused no reduction in activity. These results indicate that, although maize AO is similar to animal enzymes in molecular mass and cofactor components, it differs in substrate specificity and susceptibility to inhibitors. Immunoblotting analysis with mouse polyclonal antibodies raised against the purified maize AO showed that the enzyme was relatively rich in the apical region of maize coleoptiles. The possible role of this enzyme is discussed in relation to phytohormone biosynthesis in plants.

[Treatment of refractory hypoxemia due to right-to-left interatrial shunt complicating right ventricular infarction: successful short-term percutaneous catheter closure of the patent foramen ovale]

Refractory hypoxemia as a complication of right ventricular infarction is rare. A 74-year-old man developed persistent hypoxemia due to right-to-left interatrial shunting through a patent foramen ovale during the acute phase of right ventricular infarction. Short-term percutaneous transvenous closure of the patent foramen ovale with a large balloon occlusion catheter was life-saving.

MRI in thorotrastosis

Magnetic resonance imaging (MRI) and computed tomography (CT) were performed in four patients with thorotrastosis. On CT scan, Thorotrast (thorium oxide) deposition was shown as high-density areas in the liver and spleen and the abdominal lymph nodes. These deposits were not found on MRIs. Splenic volume was significantly small due to atrophy. The contrast-noise ratio in the spleen on T1-weighted images was significantly lower. Thorotrast deposition does not affect MRI appearance; therefore it may be useful for the early detection of malignant tumors as a complication of thorotrastosis.

[A semi-quantitative measurement of glycocalyx and an ATP bioluminescent assay for the analysis of Pseudomonas aeruginosa biofilm]

BACKGROUND

In order to analyze each element of a bacterial biofilm, a semi-quantitative measurement of glycocalyx using toluidine blue and an improved ATP bioluminescence assay were developed.

RESULTS

In the toluidine blue assay, a linear correlation was obtained between optical density and the amount of gellan gum, which is an exopolysaccharide derived from Pseudomonas elodea. By using the improved ATP assay, ATP at concentration of 1 x 10(-4) mol/l or floating bacterial cells of 10(3) cfu could be detected. The applicability of these two methods was examined in evaluating a total amount of glycocalyx and ATP content of Pseudomonas aeruginosa biofilms, which were developed or treated with antimicrobial agents in a modified Robbins device.

CONCLUSION

The changes in optical density and ATP luminescence were reasonable, and well correlated with those obtained by scanning electron microscopy. These results indicate that the toluidine blue assay and ATP assay are useful in analyzing bacterial biofilms.

Effect of the transmembrane gradient of magnesium and sodium on the regulation of cytosolic free magnesium concentration in human platelets

1. To clarify the mechanism by which cytosolic free Mg2+ concentrations ([Mg2+]i) are regulated in human platelets, we investigated platelet membrane permeability to Mg2+ by altering extracellular Mg2+ concentrations, and tested the existence of a Na(+)-Mg2+ exchanger by manipulating the transmembrane Na+ gradient. 2. Platelet [Mg2+]i was 421 +/- 52 mumol/l in healthy men. [Mg2+]i remained constant during a 120 min exposure to nominally zero (low) or 5 mmol/l (high) external Mg2+ concentrations. 3. Preincubation of platelets with 10(-4) mol/l ouabain effectively decreased the transmembrane Na+ gradient. The ouabain-induced increase in [Mg2+]i was statistically significant after 30 min of exposure (14.6 +/- 2.0%) and reached 24.6 +/- 4.5% after 60 min. Similarly, the replacement of extracellular Na+ with N-methyl-D-glucamine significantly increased [Mg2+]i by 48.5 +/- 3.9% and 78.8 +/- 12.5%, respectively. 4. These results suggest that [Mg2+]i is well controlled in the presence of large transmembrane Mg2+ concentration gradients, and a Na(+)-Mg2+ exchanger may be involved in the regulation of [Mg2+]i in human platelets.

Intravenous administration of L-arginine inhibits angiotensin-converting enzyme in humans

The iv administration of L-arginine, a precursor of endothelium-derived relaxing factor/nitric oxide, is known to decrease blood pressure in humans by its direct vasodilatory effects. The purpose of the present study was to determine whether L-arginine infusion modifies the renin-angiotensin (Ang)-aldosterone system as well as blood pressure and renal hemodynamics. L-Arginine and saline vehicle were iv administered to 10 healthy male subjects in random order on different days. L-Arginine infusion (500 mg/kg over 30 min) decreased mean blood pressure (from 81.2 +/- 2.7 to 74.0 +/- 2.5 mm Hg; P < 0.001) and renal vascular resistance (from 0.085 +/- 0.007 to 0.074 +/- 0.006 mm Hg/mL.min; P < 0.01) and increased heart rate (from 60.3 +/- 2.7 to 69.7 +/- 2.1 beats/min; P < 0.001) and renal plasma flow (from 616.6 +/- 37.8 to 701.0 +/- 49.2 mL/min; P < 0.05). L-Arginine reduced serum Ang-converting enzyme activity (from 10.4 +/- 0.6 to 8.9 +/- 0.5 nmol/mL.min; P < 0.05) and plasma Ang-II (from 19.3 +/- 3.3 to 12.7 +/- 2.8 pg/mL; P < 0.001), but had no effect on PRA or the glomerular filtration rate. The saline vehicle did not alter any of these parameters. The iv administration of L-arginine (endothelium-derived relaxing factor/nitric oxide) may reduce the plasma Ang-II concentration by inhibiting Ang-converting enzyme. The mechanism by which L-arginine infusion decreases blood pressure can be at least in part explained by inhibition of the renin-Ang system.

Expression of adult T-cell leukemia-derived factor in bronchoalveolar lavage cells after canine lung transplantation

Lung transplantation is now an accepted therapeutic option for patients with end-stage lung disease, and an early diagnosis of rejection is essential in the management of these patients. Adult T-cell leukemia-derived factor (ADF), known as a human homolog of thioredoxin, has been shown to be induced by a variety of stresses. In this study we examined ADF expression in lung tissues and bronchoalveolar lavage cells after canine lung transplantation to determine whether it could be induced by allogenic stimulations and could be used to diagnose early rejection. Allotransplantations were performed in adult mongrel dogs, and immunosuppression was performed from the day of operation to the fifth postoperative day. No immunosuppressant was given from the sixth to the tenth postoperative days. Animals were put to death on the tenth postoperative day. Bronchoalveolar lavage was performed on the fifth and tenth postoperative days, and the lavage cells and lung tissues were examined immunohistochemically with anti-ADF antibody. The grades of rejection were as follows: grade 1 in two animals, grade 2 in three animals, and grade 3 in two animals. The percentages of ADF high-producer cells in bronchoalveolar lavage cells on the fifth and tenth postoperative days were 4.29% +/- 2.65% and 26.6% +/- 3.99%, respectively (p < 0.01). The percentages of ADF high-producer cells in normal healthy dogs and in those with grade 1, grade 2, and grade 3 rejection were 3.00% +/- 1.64%, 20.5% +/- 9.00%, 25.5% +/- 6.06%, and 34.5% +/- 6.50%, respectively. The percentage in each rejection group was significantly higher than that in normal healthy dogs (p < 0.05). These results suggest that examination of bronchoalveolar lavage cells with ADF staining may be useful in the early diagnosis of rejection.

Characterization of chitin synthase 2 of Saccharomyces cerevisiae. Implication of two highly conserved domains as possible catalytic sites

Chitin synthase 2 of Saccharomyces cerevisiae was characterized by means of site-directed mutagenesis and subsequent expression of the mutant enzymes in yeast cells. Chitin synthase 2 shares a region whose sequence is highly conserved in all chitin synthases. Substitutions of conserved amino acids in this region with alanine (alanine scanning) identified two domains in which any conserved amino acid could not be replaced by alanine to retain enzyme activity. These two domains contained unique sequences, Glu561-Asp562-Arg563 and Gln601-Arg602-Arg603-Arg604-Trp605, that were conserved in all types of chitin synthases. Glu561 or arginine at 563, 602, and 603 could be substituted by glutamic acid and lysine, respectively, without significant loss of enzyme activity. However, even conservative substitutions of Asp562 with glutamic acid, Gln601 with asparagine, Arg604 with lysine, or Trp605 with tyrosine drastically decreased the activity, but did not affect apparent Km values for the substrate significantly. In addition to these amino acids, Asp441 was also found in all chitin synthase. The mutant harboring a glutamic acid substitution for Asp441 severely lost activity, but it showed a similar apparent Km value for the substrate. Amounts of the mutant enzymes in total membranes were more or less the same as found in the wild type. Furthermore, Asp441, Asp562, Gln601, Arg604, and Trp605 are completely conserved in other proteins possessing N-acetylglucosaminyltransferase activity such as NodC proteins of Rhizobium bacterias. These results suggest that Asp441, Asp562, Gln601, Arg604, and Trp605 are located in the active pocket and that they function as the catalytic residues of the enzyme.

Influences of beta-blocking agents on cardiovascular actions induced by endothelin-3 administered intracerebroventricularly in anesthetized rats

Possible involvement that the pressor and positive chronotropic effects of endothelin-3 (ET-3) administered intracerebroventricularly (i.c.v.) participate in the central beta-adrenoceptor has been studied in urethane anesthetized rats. ET-3 administered i.c.v. at dose of 50 pmol elicited the increase in blood pressure and heart rate over a long duration, but a dose of 30 pmol had a minimal effect. These cardiovascular responses to ET-3 were significantly reduced by intravenous pretreatment with pentolinium, ganglionic blocking agent, and phentolamine, alpha-blocker. Also pressor responses to ET-3 were abolished dose-dependently by i.c.v. pretreatment with propranolol at a dose of 1 mumol, nonselective beta-blocker and ICI 118551, beta 2-selective adrenoceptor blocker, but not by i.c.v. pretreatment with metoprolol, atenolol, beta 1-selective blocker, procaine and phentolamine. These results suggest that ET-3 may play a role in cardiovascular regulation through the activation of the sympathetic nervous system involved in the central beta 2-adrenoceptor system.

Assessment of platelet cytosolic concentration of free magnesium in healthy subjects

We measured basal cytosolic concentration of free Mg2+ ([Mg2+]i) in platelets from 30 healthy volunteers by using mag-fura-2, a new fluorescent Mg2+ indicator. The mean [Mg2+]i was 381 +/- 22 mumol/L, with values ranging from 226 to 771 mumol/L. The day-to-day intrasubject coefficient of variation was relatively small (3.6%). [Mg2+]i was significantly higher in men than in women (430 +/- 38 vs 332 +/- 17 mumol/L, p < 0.03), and was not correlated with age. There was no significant relation between platelet [Mg2+]i and serum total Mg concentration. The results indicate that the gender but not age may decide intracellular Mg2+ status. In addition, the mechanisms that regulate [Mg2+]i may be independent of those that influence the extracellular concentration of Mg.

Combination effect of fosfomycin and ofloxacin against Pseudomonas aeruginosa growing in a biofilm

We examined the combined effect of fosfomycin and ofloxacin against Pseudomonas aeruginosa in biofilms by using an in vitro experimental system with a modified Robbins device. Sessile cells in a mature or immature biofilm, developed on a silicon disk, were used, and an ATP bioluminescence assay was employed to assess antibacterial effects. A synergistic effect of fosfomycin and ofloxacin was clearly detected when concentrations at which each drug independently produced no detectable decrease in the bioactivity of sessile cells were used. Exposure of the cells in a mature biofilm to fosfomycin at concentrations of one-eighth of the MIC to 10 times the MIC (6.25 to 500 micrograms/ml) and ofloxacin at three or 10 times the MIC (18.75 or 62.5 micrograms/ml) resulted in reduction of the bioactivity to 1.5 to 4.5% after 72 h. Young sessile cells in an immature biofilm were more susceptible to this combination therapy. With a combination of fosfomycin at three times the MIC and ofloxacin at three times the MIC, complete eradication was confirmed by both ATP assay and scanning electron microscopy.

Hypothalamic hamartoma: anatomic, immunohistochemical and ultrastructural features

Four patients with hypothalamic hamartoma were examined by CT and/or MR imaging, immunohistochemistry and electron microscopy. The hamartomas arose from the hypothalamus and extended inferiorly. LH-RH neurons were detected in three cases by immunohistochemistry. Electron microscopy revealed large myelinated axons, axon terminals containing dense-core vesicles and axon terminals with clear vesicles forming asymmetrical synapses. The development of hypothalamic hamartoma and its functional manifestations (precocious puberty and laugh attacks) are discussed in reference to the migration of LH-RH neurons from the olfactory placode.

Systemic magnesium deficiency disclosed by magnesium loading test in patients with essential hypertension

The present study was designed to determine whether magnesium (Mg) deficiency is present in patients with essential hypertension. We measured the retention of an intravenously administered Mg load (0.2 mmol/kg MgSO4 over 4 h), and serum and erythrocyte Mg concentrations in 17 inpatients with essential hypertension and in 15 normotensive controls. There was no significant difference between the two groups in erythrocyte Mg concentration (normotensives vs., hypertensives: 2.0 +/- 0.5 vs. 2.1 +/- 0.4 mmol/l cells), serum Mg concentration (normotensives vs. hypertensive: 2.1 +/- 0.2 vs. 2.1 +/- 0.2 mg/dl), or in urinary Mg excretion (normotensives vs. hypertensives: 65.8 +/- 25.5 vs. 73.7 +/- 26.7 mg/day). However, Mg retention was significantly higher in hypertensives than in normotensives (normotensives vs. hypertensives: 31.8 +/- 12.1 vs. 41.9 +/- 13.3%). These results suggest that a systemic Mg deficiency, which is undectectable by serum or erythrocyte Mg determination, may exist in patients with essential hypertension.

Diagnosis and treatment of brainstem abscess using magnetic resonance imaging and microsurgical aspiration--case report

A 6-year-old boy presented with a pontine abscess initially misdiagnosed as brainstem glioma, but he deteriorated rapidly and developed new symptoms of respiratory distress. Magnetic resonance (MR) imaging revealed a rapidly growing mass lesion in the pons. Microsurgical evacuation of the abscess via a suboccipital retromastoid approach resulted in neurological improvement and resolution of the lesion on MR images. Brainstem abscess can be successfully treated with early, accurate diagnosis based on MR imaging and appropriate microsurgical and antibiotic management.

Calcified astrocytoma of the amygdalo-hippocampal region in children

Three pediatric cases of temporal lobe seizure due to calcified glioma of amygdalo-hippocampal region are described. Computed tomography and magnetic resonance imaging showed dense calcification with no postcontrast enhancement in the amygdalo-hippocampal region. Positron emission tomography showed low oxygen metabolism, low glucose metabolism, hypermetabolism of amino acids, and low regional cerebral blood flow in the tumors. Single photon emission computed tomography showed a high accumulation of 201Tl chloride and 123I-isopropyl iodoamphetamine in one tumor, but otherwise low radioisotope uptake. These studies indicated low-grade malignancies. The patients were treated by partial tumor removal and radiotherapy. Histological examination of the tumor specimens showed astrocytoma with interstitial calcification. One patient died due to tumor recurrence, while the others are doing well with minimal seizure. We recommended temporal lobectomy in similar cases to achieve complete remission.

Recurrence of primary intracranial germinomas after complete response with radiotherapy: recurrence patterns and therapy

Nine germinoma patients are described who developed a recurrence after a complete response to radiation without adjuvant chemotherapy. Extraembryonic tumors producing alpha-fetoprotein and human chorionic gonadotropin were excluded from this study. Four patterns of recurrence are described with respect to mechanism and appropriate treatment. Type I germinoma recurrence, characterized by intracranial recurrence caused by an inadequate initial irradiation field was treated by total craniospinal irradiation. Type II recurrence, characterized by a benign teratoma caused by late growth of the teratoma component was treated by surgery alone. All patients with these patterns of recurrence are still alive. Type III local recurrence is characterized by human chorionic gonadotropin- or alpha-fetoprotein-producing tumors of extraembryonic origin. This pattern of recurrence should be treated by chemotherapy or radiosurgery, because all these patients died. Type IV germinoma recurrence consists of extraneural metastasis without evidence of intracranial recurrence. Two of these patients were treated with chemotherapy. In summary, four patients died after recurrence, whereas the remaining five patients survived. The classification of germinoma recurrence patterns should facilitate the selection of the most appropriate treatment. However, it has been difficult to identify the precise histopathology by biopsy or partial resection alone. Furthermore, chemotherapy is indicated in treating germinomas that have a ventriculoperitoneal shunt because of the risk of extraneural metastases.

[A study of the drug distribution on intra-hepatic arterial infusion chemotherapy; how much difference between continuous infusion and rapid infusion?]

The subjects were 41 cases with implantable reservoir systems for unresectable hepatic tumors. We evaluated the difference in drug distribution between intra-hepatic arterial continuous infusion and rapid infusion using hepatic perfusion scintigraphy by 99mTc-macroaggregated albumin via reservoirs. The 41 cases were divided into 2 groups (A and B) according to the imaging of the perfusion scintigraphy. There were 17 cases in group A with equal distribution and 24 cases in group B with a different distribution between the continuous infusion and the rapid infusion. The 24 cases in group B were subdivided into groups according to the distribution of 99mTc-MAA in and around liver. In some cases the distribution pattern after rapid infusion improved more than with continuous infusion. These results suggested that the infusion method must be selected for every case.

Right atrial to left atrial shunt through foramen ovale during pneumoperitoneum for laparoscopic cholecystectomy

A 62-year old female patient in whom paradoxical right atrial to left atrial shunt flow through the foramen ovale was detected by transesophageal echocardiography during pneumoperitoneum for laparoscopic cholecystectomy was reported. This patient had a history of mitral valve replacement with residual tricuspid valve regurgitation. It was considered that the onset of paradoxical interatrial shunting through the foramen ovale might be caused not only by mechanical ventilation with positive end-expiratory pressure but also by pneumoperitoneum, especially in patients with heart disease, even if the intra-abdominal pressure was maintained at 12 mmHg.

Laparoscopic deroofing for symptomatic liver cysts: report of a case

We present herein the case of a 73-year-old woman with symptomatic liver cysts and cholelithiasis for whom successful deroofing of the liver cysts and cholecystectomy were performed via laparoscopy. Histopathological diagnosis of the resected cyst wall and direct observation of the inner surface of the remaining cyst wall confirmed that they were benign biliary cysts. The laparoscopic deroofing of liver cysts is therefore not only an effective means of treatment, but it also facilitates the establishment of an exact differential diagnosis.

Assessment of quantitative exercise thallium-201 emission computed tomography in patients with vasospastic angina--value of washout rate analysis

This study was performed to assess the value of washout rate analysis of quantitative exercise thallium-201 emission computed tomography in vasospastic angina patients without significant coronary stenosis. Quantitative analysis of both thallium-201 perfusion and washout rate before and after drug treatment was performed in 48 patients with vasospastic angina and no significant coronary artery stenosis. All of the patients attained more than 90% of their age-predicted heart rate during each exercise test. Before drug treatment, 26 patients exhibited exercise-induced ischemia (perfusion defects on stress polar map), 17 did not exhibit exercise-induced ischemia (normal stress and washout rate polar maps), and the remaining 5 patients showed no perfusion defects, but did show extensive abnormal washout rates. On coronary angiography, multivessel coronary spasm was documented in 12 of the 26 patients with exercise-induced ischemia, in 7 of the 17 patients without exercise-induced ischemia and in 4 patients with an extensive abnormal washout rate and a normal stress polar map. In the 17 patients without exercise-induced ischemia, the mean washout rate was significantly decreased (p < 0.05) in association with a significant decrease in the double product (p < 0.05) after drug treatment. Of the 26 patients with exercise-induced ischemia, 18 (group 1) showed an increase in the mean washout rate with improved perfusion defect after drug treatment. The remaining 8 patients (group 2) showed a decrease in the mean washout rate with improved perfusion defect after drug treatment, which increased significantly on repeat exercise test performed after additional increased doses of antianginal drugs were administered (p < 0.01). The number of patients with multivessel coronary spasm was significantly high in group 2 (p < 0.01). Thirteen patients showed an extensive abnormal washout rate before drug treatment, including 8 patients with exercise-induced ischemia and 5 patients with no perfusion defects, who showed an increased mean washout rate after drug treatment (p < 0.05). These findings indicate that washout rate analysis aids in the diagnosis in vasospastic angina patients with exercise-induced ischemia. Some patients with exercise-induced ischemia can not be detected by thallium-201 perfusion analysis alone, especially those with multivessel coronary spasm and when this procedure is performed after drug treatment. In addition, a high frequency of abnormal washout rate in vasospastic angina may result not only from exercise-induced ischemia due to main epicardial coronary artery spasm, but also from microspasm, or impairment of microcirculation or myocyte.

An immunohistochemical study of Warthin-Finkeldey cells in measles

An autopsy case of an 18 month old male infant with measles infection is reported. An autopsy revealed generalized lymphadenopathy, splenomegaly and hyperplastic thymus. Histologically, there were many Warthin-Finkeldey cells (WFC) in hyperplastic lymphoid tissues. Although viral particles and inclusions were not detected electronmicroscopically, the infection of measles virus was detected in WFC by immunofluorescent technique using anti-measles antibody. Warthin-Finkeldey cells were morphologically and immunohistochemically divided into two groups. The first type was WFC appearing in the germinal centers of lymphoid tissue, revealing many large nuclei and B cell markers. The second type was WFC appearing in the interfollicular areas and thymus, showing many small hyperchromatic nuclei and T cell markers. The data indicate that there might be a morphologic and immunophenotypic heterogeneity in WFC.

Evaluation of treatments for liver abscess: significance of intra-arterial antibiotic injection therapy

Various treatments were performed in 14 patients with liver abscess, and their clinical effects were compared. The treatments were intra-arterial antibiotic infusion therapy (Group A, 4 patients), intra-arterial infusion therapy plus percutaneous drainage of the abscess (Group B, 4 patients), and intravenous antibiotics alone (Group C, 6 patients). The period from the beginning of treatment to negative conversion of CRP* (period until cure) was compared among the groups. Groups A and B had received intravenous antibiotics for a mean of 10 days and 16 days, respectively, but the treatment was ineffective. The mean period until cure from the beginning of intra-arterial infusion therapy was 36 days for Group A and 18 days for Group B. In Group C, the mean period until cure was 28 days. All patients recovered, and recurrence was observed in only one patient. Although liver abscess can be treated successfully in many patients by intravenous antibiotics alone, intra-arterial therapy is effective in those in whom intravenous therapy is not effective.