Case report: the "aurora sign"--a new sonographic sign of pneumatosis cystoides intestinalis

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas-filled cysts of varying size within the intestinal wall. Although the characteristic findings on plain abdominal radiograph, computed tomography (CT), and barium enema have been well described, the sonographic findings have not. We recently encountered a case of PCI in which abdominal sonography disclosed a unique finding. We were able to reproduce the finding experimentally and have coined it the "aurora sign".

Agarose-carrageenan hybrid polysaccharides from Lomentaria catenata

Two polysaccharide fractions, PS1 and PS2 from Lomentaria catenata consisted of D-Gal, L-Gal, D-Glc, D-Xyl, D-GlcA and sulphate. Partial hydrolysis led to the isolation and identification of oligosaccharides indicating the co-existence of an agarose and carrageenan backbone structure, in which D-Glc and D-GlcA residues occur as single units branching at O-3 of -->4)alpha-D-Gal(1--> and O-4 of -->3)beta-D-Gal(1-->, respectively.

[A case of Jordans' anomaly]

A 35-years old female with Jordans' anomaly was reported. She had been treated for diabetes mellitus and hypertension at another hospital. She was admitted to our hospital for operation for diabetic retinopathy on July 9, 1992. Wright-Giemsa stained peripheral blood smear revealed multiple vacuoles in the cytoplasm of the granulocytes and monocytes. Histochemical studies of these vacuoles showed positive for Sudan III but negative for peroxidase, alkaline phosphatase and PAS staining. Electron microscopic examination revealed that lipid containing vacuoles had no clear membrane and were not associated with cell organelles. Laboratory findings of the serum showed hyperglycemia (FBS 188mg/dl), high HbA1c level (9.4%) and mild type IIa hyperlipidemia. Abdominal sonogram and abdominal CT showed no remarkable abnormalities except for mild fatty liver. Her elder sister and daughter had similar morphological findings in granulocytes, monocytes and lymphocytes.

Renal protective effect of efonidipine hydrochloride (NZ-105), a new calcium antagonist, in spontaneously hypertensive rats

1. We investigated the renal protective effect of efonidipine hydrochloride (NZ-105) in spontaneously hypertensive rats (SHR). SHR were given a diet containing 0.075% NZ-105 from 8 weeks old for 20 weeks. 2. 24-hr urinary protein excretion in the control SHR (drug-free diet) increased with age (from 77.3 mg/kg/day at 8 weeks old to 385.4 mg/kg/day at 28 weeks old), while that in NZ-105-treated SHR was maintained at almost the same level as that in Wistar-Kyoto rats (WKY), matched control animals throughout the experimental period. 3. The histological changes of the kidney were examined by light microscopy at the end of the treatment period. In control SHR, swelling and hyalinization of glomeruli, dilatation of renal tubules containing hyaline casts and arteriolosclerosis were revealed. The long-term administration of NZ-105 markedly suppressed these changes. 4. The kidney weights and plasma creatinine concentration in control SHR were higher than those in WKY, while they were significantly reduced in NZ-105-treated SHR. The long-term administration of NZ-105 also suppressed the elevation of systolic blood pressure and the increases of plasma renin activity and aldosterone concentration. 5. These findings suggest that NZ-105 inhibits the development of proteinuria and progressive kidney damage in SHR and may become a useful antihypertensive drug with the renal protective effect.

Effect of pravastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, on hepatic cholesterol 7 alpha-hydroxylase, acyl-coenzyme A: cholesterol acyltransferase, and bile lipid secretion in the hamster with intact enterohepatic circulation

The effects of administration of pravastatin, a 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, on hepatic cholesterol 7 alpha-hydroxylase and acyl-coenzyme A: cholesterol acyltransferase (ACAT) activities and bile lipid secretion were investigated in Syrian golden hamsters. Continuous administration of pravastatin induced no significant changes in hepatic cholesterol content, ACAT and cholesterol 7 alpha-hydroxylase activities, or bile lipid and acid composition. Abrupt withdrawal of pravastatin induced increases in hepatic cholesterol content and ACAT activity and no change in hepatic cholesterol 7 alpha-hydroxylase activity, and increased cholesterol saturation in bile. Hepatic cholesterol 7 alpha-hydroxylase activity paralleled hepatic mRNA levels of this enzyme. These results suggest that a change in hepatic cholesterol metabolism induced by continuous administration of pravastatin maintains a constant net balance of hepatic cholesterol content. In addition, the drug has no deleterious influence on metabolism of bile lipids and acids and related enzymes, except for a transient increase in cholesterol saturation in bile induced by an inappropriate increase in hepatic cholesterol content and a lack of response of cholesterol 7 alpha-hydroxylase activity to changes in hepatic cholesterol content upon abrupt withdrawal of pravastatin.

Multiple intrahepatic aneurysms following transcatheter arterial embolization. Work in progress

PURPOSE

To discuss the mechanism of multiple intrahepatic aneurysm formation after transcatheter arterial embolization (TAE) performed in five patients with hepatocellular carcinoma.

MATERIALS AND METHODS

TAE was performed with gelatin sponge particles and iodized oil as embolic materials. Mitomycin C was also used in four cases.

RESULTS

Three to 14 aneurysms 1-6 mm in diameter were found in third-to sixth-order branches of the hepatic arteries at repeat angiography performed 25-45 days after TAE. Follow-up angiograms in three cases revealed that most aneurysms were no longer apparent except in one patient in whom two aneurysms remained and were larger than before. In none of the five cases were any signs of aneurysm rupture noted.

CONCLUSION

Radiologists should be aware of this complication of TAE. It is speculated that the main cause of aneurysm formation in these patients was the embolic agents used.

Interaction of marine toxin dolastatin 10 with porcine brain tubulin: competitive inhibition of rhizoxin and phomopsin A binding

Dolastatin 10, a cytostatic peptide containing several unique amino acid subunits, was isolated from the marine shell-less mollusk Dolabella auricularia. It inhibits microtubule assembly at concentrations below 5.0 microM (IC50, 3.0 microM) and causes formation of tubulin aggregates at higher (> 10 microM) concentrations in a somewhat different manner from that caused by vinblastine. Electron microscopical analysis showed irregular aggregates of microtubule proteins in the presence of 10 microM dolastatin 10. Dolastatin 10 inhibited the binding of both radiolabeled rhizoxin and phomopsin A to tubulin with inhibition constants (Ki) of 7 x 10(-8) M and 1 x 10(-7) M, respectively. The results suggest that at least one of the binding sites of dolastatin 10 on tubulin is the rhizoxin binding site.

Identification of disulfide bridges in a cardiotoxic peptide by electrospray ionization

A new method was developed for subjecting a peptide to a specified number of Edman degradation cycles on an automated polypeptide sequencer and desorbing the residual peptide for further investigations. The procedure was applied in combination with electrospray ionization mass spectrometry to identify the four disulfide bridges present in a small tightly bound peptide. The task was accomplished using only a few nanomoles of the intact peptide.

Dual energy X-ray absorptiometry of the calcaneus: comparison with other techniques to assess bone density and value in predicting risk of spine fracture

OBJECTIVE

The calcaneus has been proposed as an alternative site for assessment of bone mineral density (BMD) in women with osteoporosis. The objectives of this study were to evaluate the clinical usefulness of dual-energy X-ray absorptiometry (DXA) of the calcaneus for predicting spinal fracture and to compare the predictive value of assessment of BMD by DXA of the calcaneus, quantitative CT or DXA of the lumbar spine, and DXA of the most distal part of the radius.

SUBJECTS AND METHODS

The study group consisted of 399 healthy volunteer women (aged 19-81 years) and 27 women (aged 44-85 years) who had osteoporosis. They had DXA of the calcaneus, quantitative CT and DXA of the lumbar spine, and DXA of the most distal part of the radius. T-score analyses were used to compare decreases in BMD in postmenopausal women with decreases in premenopausal women, and to compare decreases in women with and without osteoporosis.

RESULTS

T-score analysis of age-related changes in BMD in the control subjects showed that densities in the calcaneus, the lumbar spine, and the most distal part of the radius decrease significantly with age in postmenopausal women. In women with osteoporosis (n = 27), BMDs in the calcaneus (DXA, p < .0002), L1-L3 (quantitative CT, p < .0001), L1-L4 (DXA, p < .0005), and the most distal part of the radius (DXA, p < .005) were significantly lower than those in healthy control subjects (n = 77). T-score analysis indicated that in women with osteoporosis, DXA of the calcaneus showed BMD losses greater than those shown by DXA of L1-L4 and the most distal part of the radius and similar to those shown by quantitative CT of L1-L3. Receiver-operating characteristic (ROC) analysis showed that findings on DXA of the calcaneus were as good a predictor of the risk of spinal fracture as findings on DXA of the lumbar spine and not as good as findings on quantitative CT of the lumbar spine.

CONCLUSION

The results suggest that DXA assessment of BMD in the calcaneus is not a useful adjunct to other measurements. However, it can be used to predict the risk of fracture when better measures, such as quantitative CT, are unavailable.

Drebrin, a development-associated brain protein from rat embryo, causes the dissociation of tropomyosin from actin filaments

Drebrin is a development-associated neuroprotein whose cDNA into fibroblasts causes the formation of dendrite-like structures (Shirao, T., Kojima, N., and Obata, K. (1992) Neuroreport 3, 109-112). To explore molecular functions of drebrin during brain development, we purified drebrin from brains of rat embryos. Drebrin bound to actin filaments at a stoichiometry of 1:5 with a dissociation constant (Kd) of 1.2 x 10(-7) M. It strongly inhibited the actin binding activity of tropomyosin. Excess amounts of tropomyosin also inhibited the drebrin binding to actin filaments, suggesting that drebrin and tropomyosin competitively bind to actin filaments. Further, drebrin inhibited not only the actin binding activity of alpha-actinin but also the actin cross-linking activity of alpha-actinin. Gene transfection experiments revealed that tropomyosin was dissociated from actin filaments in drebrin-overexpressing fibroblasts. Thus we hypothesize that drebrin may destabilize actin filaments by dissociating tropomyosin and alpha-actinin from actin filaments, resulting in the formation of axon and dendrites during neuronal development.

The two subunits of a phospholipase A2 inhibitor from the plasma of Thailand cobra having structural similarity to urokinase-type plasminogen activator receptor and LY-6 related proteins

Amino acid sequences of the two subunits (31-kDa and 25-kDa subunits) of a phospholipase A2 (PLA2) inhibitory protein, purified from the blood plasma of Thailand cobra Naja naja kaouthia, were determined by alignment of peptides obtained by lysyl endopeptidase, staphylococcal V8 protease and endoproteinase Asp-N digestions. The respective subunits were composed of 188 and 185 amino acid residues, and the former contained one asparagine-linked sugar chain at the position 157. There was 29% identity between 31-kDa and 25-kDa subunits. The analysis of internal homology in each sequence of the two subunits revealed the existence of two repeats of approximately 90 amino acid residues. These sequence units were found to be significantly homologous to those of urokinase-type plasminogen activator receptor and of Ly-6 related proteins, such as Ly-6A/E, Ly-6C, ThB, and CD59 antigens.

Epidemiologic study of Chlamydia trachomatis infection in pregnant women

GOAL OF THE STUDY

The presence of Chlamydia trachomatis in the cervical canal was investigated in 10,980 married pregnant women and 1,792 unmarried pregnant women who underwent artificial abortions in Hokkaido.

STUDY DESIGN

Cervical canal smears were screened for C. trachomatis in pregnant patients.

RESULTS

In the married women, the detection rate of C. trachomatis was 5.6% (615 of 10,980 cases). In the unmarried women, the detection rate of C. trachomatis was 15.2% (272 of 1,792 cases). Stratification of the data on the detection of C. trachomatis as a function of the subjects' age showed that, for both the married and the unmarried women, the detection rate increased as the age of the subjects decreased. Analysis of the detection rate of C. trachomatis as a function of the year revealed that it had not changed since 1986.

CONCLUSIONS

The findings in this study show that there has been an epidemic of asymptomatic C. trachomatis infections in Hokkaido, especially in young women.

Inhibition of serine proteases of the blood coagulation system by squash family protease inhibitors

Squash family inhibitors are the smallest protein serine protease inhibitors, being composed of approximately 30 amino acid residues. We isolated 8 squash family inhibitors from the seeds of bitter gourd, squash, gourd and luffa and examined their effect on serine proteases of the blood coagulation system. Five of them prolonged the activated partial thromboplastin time of human plasma to various extents, but three did not. Only Momordica charantia (bitter gourd) trypsin inhibitor-II prolonged the prothrombin time of human plasma. All inhibitors inhibited the amidolytic activities of factor XIIa, plasma kallikrein, factor Xa, but did not inhibit significantly those of factor XIa, factor IXa, factor VIIa, and thrombin. Ki values for factor XIIa, plasma kallikrein, and factor Xa were in the order of 10(-6)-10(-9), 10(-4)-10(-5), and 10(-4)-10(-6)M, respectively. The prolongation of the activated partial thromboplastin time by inhibitors appeared to correspond to their inhibitory potencies for factor XIIa. Momordica charantia trypsin inhibitor-II, which has the strongest inhibitory potency toward the amidolytic activity of factor Xa, with a Ki value 10-100 times smaller than those of other inhibitors, inhibited the activation of factor X by factor VIIa-tissue factor complex or factor IXa, while others did not.

A case of neural cell adhesion molecule-positive peripheral T-cell lymphoma associated with human T-cell lymphotrophic virus type 1 showing an unusual involvement of the gastrointestinal tract during the course of the disease

We report a case of neural cell adhesion molecule (NCAM)-positive peripheral T-cell lymphoma (PTCL), pleomorphic, medium and large cell type according to the updated Kiel classification, which was associated with human T-cell lymphotrophic virus type 1 (HTLV-1). The patient showed an unusual involvement of the gastrointestinal tract forming a bulky mass during the course of his disease, and a relatively indolent clinical course for 53 months until death. Phenotypic analysis showed CD2+, CD3-, CD4+, CD5+, CD7+, CD8-, CD16-, CD56+, and CD57- phenotype. Human T-cell lymphotrophic virus type 1 antibody was detected by the enzyme-linked immunosorbent assay. The proviral integration of HTLV-1 and the monoclonal rearrangements of T-cell receptor beta and gamma genes also were confirmed in DNA extract from fresh material. This fact calls attention to NCAM as one of the potential factors playing a role in the localization and behavior of lymphomas even within the category of PTCL associated with HTLV-1, ie, adult T-cell leukemia/lymphoma (ATLL).

Effect of basic fibroblast growth factor on synthesis/secretion of pS2 protein by human breast cancer cells (MCF-7)

pS2 is an estrogen-induced mRNA species that was originally identified in the breast cancer cell line MCF-7. Exposure of the cells to basic fibroblast growth factor (bFGF) at the concentration of 10-100 ng/ml for 48-72 h resulted in a marked increase in the concentration of pS2 protein in the medium. The polymerase chain reaction with reverse transcriptase revealed that bFGF increased the amount of intracellular pS2 mRNA: immunocytochemical studies showed that exposure to the factor increased the amount of intracellular pS2 protein. Simultaneous addition of cycloheximide with bFGF completely abolished induction of pS2 protein, although it did not affect the induction of pS2 mRNA. Actinomycin D did not affect the stimulatory effect of bFGF on synthesis/secretion of pS2 protein. bFGF effectively abolished decay of the pS2 mRNA level caused by actinomycin D. These results suggest that the induction of the synthesis/secretion of pS2 protein by bFGF occurs at the post-transcriptional level, most probably due to the stabilization of pS2 mRNA. Another finding, that bFGF and estradiol have a synergistic effect on induction of pS2 protein, suggests the possibility that these two inducers act by a different but partly overlapping mechanism.

A new thymopoietin precursor gene from human thymus

Thymopoietin-related peptide (TPRP) gene was identified and cloned from a human thymus cDNA library. The cloned cDNA encoded a mature TPRP including the active site of thymopoietin (TP) (residues 32-36). TPRP and bovine TP were very similar in amino acid sequence, each being a 49 amino acid linear polypeptide. TPRP differed in only one residue from bovine putative TP and in only five residues from bovine TP I; whereas TPRP differed much more, at 12 amino acid residues, from human TP from thymus. This suggests that TPRP is a novel peptide and a genuine counterpart of the bovine TP.

Coronary fistulous communications with left ventricular chamber and giant mural thrombus after myocardial infarction

Selective coronary arteriography, performed in a 67-year-old man with post-infarction angina, demonstrated severe three vessel disease and coronary fistulous communications with the left ventricular chamber adjacent to a giant mural thrombus formed in the apical aneurysm. Most of the contrast media seemed to empty directly into the chamber without presenting hypervascular blushes of the thrombus itself. This was somewhat different from the observation previously reported in a case with coronary fistulae associated with a post infarction mural thrombus. It was stressed that one should not misinterpret this condition as a rare coronary artery-cardiac chamber shunt associating myocardial infarction.

Deterioration of mechanical properties of the autograft in controlled stress-shielded augmentation procedures. An experimental study with rabbit patellar tendon

Effects of partial and complete stress shielding on mechanical properties and histology of in situ frozen patellar tendons were studied in 120 mature female Japanese White rabbits that were divided into three groups: completely stress-shielded, partially stress-shielded, and sham-operated groups. In the former two groups, tendon tension was reduced to 0% and about 30% of normal force, respectively, with a polyester artificial ligament. Tensile tests were conducted on patella-patellar tendon-tibia complexes harvested 1, 2, 3, 6, or 12 weeks after surgery. Tensile strength significantly decreased compared with the sham group to 17% and 28% at 3 and 6 weeks, respectively, in the completely stress-shielded group, and to 54% and 63% at 3 and 12 weeks, respectively, in the partially stress-shielded group. Patellar tendon cross-sectional area significantly increased to 156% and 157% at 2 and 3 weeks, respectively, in the completely stress-shielded group and to 133% at 2 weeks in the partially stress-shielded group, compared with the sham group. Stress shielding significantly changed tensile strength, tangent modulus, and cross-sectional area of in situ frozen patellar tendon; these changes depended on degree of stress shielding. Histologic observations indicated that remodeling occurred in the patellar tendon while there were no cells in the fascicle.

Formation of thick, curving bundles of actin by drebrin A expressed in fibroblasts

Drebrin A is a neuron-specific protein, the expression of which is regulated during development. Upon transfection of fibroblasts with drebrin A cDNA, the protein is expressed at high levels in fibroblasts and the outgrowth of highly branched, neurite-like cell processes is induced. In this report, we describe a biochemical examination of the binding of drebrin A to actin filaments. We also demonstrate by an immunocytochemical method that, when drebrin A is expressed in transfected cells, it binds to actin filaments and is concentrated in cell processes. Furthermore, we provide evidence that thick, curving bundles of actin together with drebrin are formed in some of the transfected cells. Our results suggest that the actin filaments that bind drebrin might be a novel class of actin filaments and might play a role in neuronal morphogenesis.

Epstein-Barr virus-associated post-transplant non-Hodgkin's lymphoma: establishment and characterization of a new cell line

A new human lymphoma cell line derived from pulmonary non-Hodgkin's lymphoma that developed in a renal transplant recipient was established from the patient's pleural effusion and designated PTLC-1. PTLC-1 grew aggressively in suspension, forming very loose clumps with a doubling time of about 18.9 h. The morphological, chromosomal, and immunophenotypic characteristics of the patient's tumor cells and PTLC-1 cells were very similar. PTLC-1 showed a monoclonal rearrangement of IgH gene and was highly tumorigenic in athymic nude mice. In situ hybridization, Southern blot hybridization and polymerase chain reaction demonstrated the presence of Epstein-Barr virus (EBV) genome in the patient's tumor and PTLC-1. PTLC-1 has been maintained in culture for over 60 months. Since EBV has been implicated in the pathogenesis of post-transplant lymphoma, this new cell line should serve as a useful experimental model for studying the etiology and biology of lymphoma developing in organ transplant recipients.

Influence of efonidipine hydrochloride, calcium antagonist on the epithelium of prostates in spontaneously hypertensive rats

The hypertensive effect on the development of the prostatic abnormality in spontaneously hypertensive rats (SHRs) was examined using Efonidipine hydrochloride, a calcium antagonist. The control SHRs were given a high sodium and potassium diet (SP-diet) alone, and the treated SHRs were given a SP-diet with 0.15% Efonidipine hydrochloride from 8 to 28 weeks of age. The systolic blood pressure (SBP) in the control SHRs increased with age, while the elevation of SBP was significantly prevented in the treated SHRs. Light-microscopically, the prostatic lesion was observed both in the control and treated SHRs. The glandular lumen was narrowed with papillary protrusions, and the epithelium was composed of tall columnar epithelial cells. However, hypertension-induced complications in kidneys and hearts were not observed in the treated SHRs. These results suggested that the prostatic abnormality of SHRs might not be the consequent lesions upon hypertension.

Effect of surface roughness of hydroxyapatite-coated titanium on the bone-implant interface shear strength

We have investigated the bone-implant interface shear strength of hydroxyapatite (HA)-coated Ti-6Al-4V (HA-coating A) (roughness average, Ra = 3.4 +/- 0.5 microns) and HA-coated Ti-6Al-4V with a rougher surface (HA-coating B) (Ra = 8.4 +/- 1.8 microns). There was no significant difference between HA-coating A and HA-coating B implants with respect to the bone-implant interface shear strength as determined in push-out tests using the transcortical model in adult dogs. The bone-implant interface shear strength of bead-coated porous Ti-6Al-4V was significantly greater than that of both HA-coating A and HA-coating B implants. The failure site, as determined by scanning electron microscopy, was the coating-substrate interface, not the coating-bone interface. This indicates a need to protect the HA coating from the direct shear forces. HA coating enhances early bone growth into the porous surface of the implant. Long-term fixation should depend on bone anchoring to this porous surface. Hydroxyapatite coatings must be developed which do not obstruct the pores of the surface of the implant.

Treatment of severe myoclonic epilepsy in infants with bromide and its borderline variant

We studied the efficacy of bromides (BR) as add-on therapy in 11 patients with severe myoclonic epilepsy in infants (SME) and in another 11 with the borderline variant of SME (BVSME). Study subjects were aged 8.5-183 months (mean 64.4 months). Longest duration of BR treatment was 37 months (range 4-37 months; mean 19.7 months). Eight of 22 (36%) of patients with generalized tonic-clonic seizures (GTCS) had an excellent effect (> 75% reduction in total seizure frequency or duration) and 9 (41%) had a moderate effect (50-75% reduction) 3 months after introduction of BR. Twelve months after initiation of BR. 5 of the patients with significant improvement were no longer responsive; ultimately, therefore, 6 had an excellent effect and 2 had a moderate effect. Of those with partial seizures (n = 5) and myoclonic/absence seizures (n = 5), only 1 patient in each group showed a moderate effect at the 12-month time-point. Dosages and serum concentrations of BR ranged from 30 to 100 mg/kg (mean 58 mg/kg) and from 64 to 159 mg/dl (mean 101 mg/dl), respectively. Of the 12 patients experiencing side effects, including drowsiness, appetite loss, and skin rash, 1 required a reduction in BR dosage because of an extensive acneiform rash on the face. The results show that BR treatment holds promise for patients with SME and BVSME and should therefore be investigated further.