Mycoplasmal pericarditis: evidence of invasive disease

Although the pathogenic mycoplasmas usually infect the respiratory and urogenital tracts, these organisms also can cause disease in remote sites. Such infections are difficult to diagnose because of both the fastidious nature of the mycoplasmas and the failure to consider their presence. Pericarditis is an uncommonly diagnosed and rarely confirmed example of invasive mycoplasmal infection. As part of a prospective study of large pericardial effusions, we discovered two cases with Mycoplasma pneumoniae infection. Subsequently, two cases of pericarditis due to Mycoplasma hominis and one due to Ureaplasma urealyticum were diagnosed. For all five patients, cultures of pericardial tissue and/or fluid were positive. In addition, four of the five patients either were immunocompromised or had undergone cardiac surgery previously. Appropriate antibiotic therapy was uniformly effective. We report here our experience with mycoplasmal pericarditis, provide evidence of an invasive pathogenesis for this syndrome, and suggest that pericardial disease caused by these organisms may not be an uncommon finding when sought in an aggressive manner.

Levo-praziquantel versus praziquantel in experimental and clinical treatment of schistosomiasis japonica

Levo-praziquantel is the left isomer of racemic praziquantel. Animal experiments showed that it is an active component of schistosomicidal activity, while dextro-praziquantel is almost ineffective. Clinical trials in three endemic areas of Schistosomiasis japonica indicated that the therapeutic efficacy of levo-praziquantel is superior to racemic praziquantel. Pharmacokinetic and pharmacodynamic activities of the stereoselectivity of praziquantel isomers (enantiomers) are discussed.

Prenatal ontogeny of substance P-like immunoreactivity in the nucleus tractus solitarii and dorsal motor nucleus of the vagus nerve of the human fetus: an immunocytochemical study

By using immunocytochemical method, the prenatal ontogeny of substance P-like immunoreactivity (SP-LI) was demonstrated in the dorsal motor nucleus of the vagus nerve (nX) and the nucleus tractus solitarii (nTS) of the human fetus at fetal age (menstruation age) of 11.5 weeks to 40 weeks. The time of initial appearance of SP-LI in the human brainstem nTS was between the fetal age 11.5 weeks and 16 weeks. At fetal age 16 weeks, the nTS showed moderate density of SP-LI fibers and terminals in subnucleus dorsalis of the nTS and nX. While the fetus grew, the density of SP-LI in the human fetus brainstem nTS and nX increased gradually from fetal age 16 weeks to 40 weeks. According to the Nissl staining, at fetal age 23 weeks, the nTS of human fetus can be subdivided into dorsal, medial, dorsolateral, ventrolateral, ventral and gelatinosus subnuclei. The cytoarchitectonic subdivisions of human fetus nTS is in good agreement with the results obtained by immunocytochemical staining. These findings indicated that substance P (SP) might play an important role in the development of human brainstem nX, nTS, their related cranial nerves, and in their functional establishment during the prenatal period.

A new bladder stimulator--hand-held controller and miniaturized implant: preliminary results in dogs

A new urinary-tract stimulator that is intended to restore normal bladder function to patients who have spinal-cord injuries is described. The system is composed of two principal parts. The first, which is external, consists of a hand-held device based on an inductive-coupling technique. This controller incorporates all the circuitry necessary to transmit data transdermally. The second, a fully programmable implantable device, includes a complementary metal oxide semiconductor gate-array integrated circuit controlling eight monopolar (or four bipolar) stimulation channels. To protect the tissues and the device, three different biocompatible polymers encapsulate the implant. In the experimental phase, the authors investigated the effect of early electrical stimulation of the bladder during the spinal-shock phase in paraplegic dogs. In addition, using the stimulator, they localized the parameters of stimulation that give the best results in terms of effective bladder pressure and voiding a high volume of urine.

Successful segmental small bowel allotransplantation in pigs

The two step small-bowel transplantation was performed experimentally in pigs. Both ends of heterotopic segmental allografts of 100 cm small bowel were enterostomized during the first operation. After 4-6 weeks, the allograft was interposed in the continuity of the intestine. Rejection was developed in Group I (n = 6) without immunosuppression. The mean survival time of the grafts was 17.7 +/- 7.6 days, and recipients were alive after resection of necrotic grafts. The animals of Group II (n = 6) were treated by cyclosporine concomitantly with azathioprine and methylprednisolone. Two pigs were killed for severe pneumonia on day 92, 97 and the grafts were alive, the other four recipients and their grafts survived for more than 300 days, 270 days, 260 days and 260 days respectively. No GVHD was observed and rejection was the major problem in segmental intestinal transplantation.

A transcutaneous implantable bladder controller

We describe a computerized experimental system to investigate the effect of early electrical stimulation of the bladder during the spinal shock phase in paraplegic dogs. This system is composed of two main devices; an external part (or controller) based on a portable microcomputer, and a versatile implant (internal) based on a multichannel CMOS microstimulator. Using a new operative technique, this system enabled us to obtain many favorable results.

Effect of early bladder stimulation on spinal shock: experimental approach

The period of spinal shock which frequently follows spinal cord injury is associated with bladder areflexia and urinary retention. We studied the effect of early bladder electric stimulation on detrusor activity during the spinal shock phase in the dog. The animals had a spinal cord section at T10 vertebra, and their bladder management was assigned to one of the three following groups: intermittent catheterization, indwelling catheterization, and electric bladder stimulation. The parameters for evaluating each treatment included: blood chemistry, and radiographic and urodynamic tests. The most important finding was the early return of detrusor activity in the group of animals treated by early electric stimulation of the bladder.

Replication capacities of natural and artificial precore stop codon mutants of hepatitis B virus: relevance of pregenome encapsidation signal

The emergence of hepatitis B virus variants unable to express HBe protein during late stage of viral infection may represent an important mechanism of viral persistence. The molecular mechanisms responsible for the elimination of HBe expression are nonsense or frameshift mutations or initiation codon mutations in part of its coding sequence, the precore region. So far only 2 of the 29 precore amino acid codons have been found mutated to stop codons in nature, although a total of 10 codons are convertible to stop codons by single nucleotide changes. Since the HBe-coding sequence is largely overlapped by the pregenome encapsidation signal (epsilon signal), a recently found cis-acting element required for the packaging of pregenomic RNA, the absence of other potential nonsense mutants could result from their impairment of the epsilon signal. Seven such potential stop codon mutants were constructed and tested for replication capacities by transfection into a hepatoma cell line. Five mutants were replication competent, but at levels lower than that of a prevalent natural stop codon mutant. The remaining two mutants were completely defective in DNA replication, which clearly explained why these two mutants are not found in nature. Northern blot analysis revealed wild-type levels of RNA transcription by these two mutants but complete lack of packaged pregenomic RNA. Additional studies lent further support to the importance of the epsilon signal in pregenome encapsidation and suggested relaxed sequence requirements for the computer-predicted hexanucleotide bulge region as compared to the hexanucleotide loop of the signal.

[Hepatitis C virus infection in hemodialysis patients]

To study whether HCV infection is present in dialysis patients and the status of antibody responses to HCV viremia, 16 patients undergoing hemodialysis were assayed for anti-HCV by ELISA and RIBA. A high incidence of anti-HCV (13/16) was found. All the 16 patients were studied for HCV viremia by 'nested' PCR and 10 were HCV RNA positive. Altogether 14 were anti-HCV and/or HCV RNA positive, which indicates that the incidence of HCV infection is high in hemodialysis patients, at least in some units. Cloning, sequencing of the PCR products showed high homology among isolates, with 91% homology to that of Japanese strains. It is important to study anti-HCV/HCV RNA in dialysis patients.

[Complications caused by artificial hinge knee joint]

Artificial hinge knee joint was used in 25 patients with bone tumors around the knee joint. 23 patients were followed on the average for 3 years and 3 months. Complication was noted in 10 patients including infection in 7 (5 short-term, 2 long-term), broken joint in 1 patient and loosening in 2. The causes for complication and counter-measures were discussed.

Prenatal ontogeny of substance P-like immunoreactivity in the parabrachial nucleus of the human fetus--an immunocytochemical study

Using an immunocytochemical method, the prenatal ontogeny of substance P-like immunoreactivity (SP-LI) was demonstrated in the parabrachial nucleus (PB) of human fetus, fetal age (menstruation age) 11.5 to 40 weeks. The time of initial appearance of SP-LI in the human brainstem PB was between fetal age 11.5 weeks and 16 weeks. While the fetus grew, the density of SP-LI fibers and terminals in the human fetus brainstem PB increased constantly from fetal age 16 weeks to 40 weeks. These findings indicate that substance P (SP) might play an important role in the human parabrachial nucleus development and in its functional establishment during the prenatal period.

Electrical stimulation induced sphincter fatigue during voiding

The stimulation of the sacral nerves to induce voiding is often associated with simultaneous contraction of the striated sphincter rendering micturition difficult or impossible. Rhizotomy of some sacral nerves was found to be necessary to facilitate voiding with stimulation. An main objective in the present experiment was to evaluate the feasibility of achieving the same result using electrical stimulation to fatigue the sphincter. In order to compare the effect of rhizotomy and fatiguing striated sphincter, the bladder outlet resistance was measured. S2 nerves were stimulated with 3 V, 35 Hz and 100 microseconds duration for 5 to 10 sec. Following S2 nerves stimulation the pudendal nerve was stimulated till we obtained sphincteric fatigue. The optimal parameter to induce sphincter fatigue were 3 V, 100-500 Hz and 100 microseconds. for 15-20 sec. The combined pressure-flow studies showed that fatiguing the sphincter via the pudendal nerve using these parameters was as good as cutting it in achieving bladder emptying with stimulation.

[Importance of PCR in the diagnosis of hepatitis C]

The identification of hepatitis C virus, based on DNA amplification, gives a precise estimation of the prevalence of the most frequent agent of NANB hepatitis. The first ELISA allowing the detection of anti-HCV antibodies, had too many false positive results and required the development of more sensitive and specific assays to confirm its results. PCR, allowing the hepatitis C virus diagnosis by showing directly HCV RNA sequences, offers a complementary approach to immunoserological tests. In blood donors with anti-HCV antibodies and with indeterminate or negative confirmatory tests, the finding of HCV RNA sequences reveals serum infectivity. During acute hepatitis, the delay in the appearance of anti HCV hampers acute phase diagnosis. The early detection of HCV RNA in peripheral blood, confirms the diagnosis and opens up therapeutic possibilities. In chronic hepatitis, the diagnosis of seronegative forms may only be resolved by PCR. Moreover, the presence of HCV RNA in peripheral blood represents the only marker of on-going viral replication and coincides with the severity of liver damage. During treatment with interferon, the follow up of HCV RNA sequences makes it possible to monitor its efficacy. The search for HCV RNA sequences directly in liver tissue shows that HCV may replicate in the liver in the absence of viremia. The presence of HCV RNA in the liver and the serum of liver transplanted patients is essential for the etiological diagnosis and management of hepatitis and bone marrow failure occurring after transplantation. Epidemiological study using PCR is a major tool in documenting vertical transmission between mother and child. Finally, PCR is important for the analysis of the HCV genome. Thus, in France there are at least three main strains, one close to the US prototype, the other close to the Japanese strain, possibly responsible for a more severe illness and a third one distinct from the previous two. However, its limits and constraints imply that PCR must not be considered as a routine assay. This emphasizes the need for more simple and rapid diagnostic tests, allowing the detection of HCV antigens and, as in hepatitis B, the progressive unravelling of the life cycle of HCV.

Computerized transcutaneous control of a multichannel implantable urinary prosthesis

In the present paper we describe a personal computer interface of a multichannel implantable urinary prosthesis. This system is composed of two main parts: the first one is internal and consists of an implant using a 4-microns CMOS gate array chip controlling a wide variety of waveforms via eight monopolar channels. The second, an external controller featuring a versatile software, a PCB card plugged in a portable microcomputer, and a radiofrequency-coupled technique. This device is used to transmit the power, the data and the synchronization clock to the implant by a simple binary signal modulating a 20 MHz carrier. We also report the features of implant encapsulation and electrode design and fabrication. In the experimental phase, we studied the effect of early electric stimulation of the bladder during the spinal shock phase in the dog. We present the operative techniques that enabled us to perform chronic electrostimulation of the sacral roots and discuss the results.

Mesencephalic trigeminal nucleus neurons with collaterals to both the masseter and the inferior alveolar nerves. A fluorescent double-labeling study in the rat

After fluorescent tracers were applied to the inferior alveolar nerve and the masseter nerve on the same side of the rat, double-labeled neurons were observed in the caudal part of the mesencephalic trigeminal nucleus (Vme), reflecting simultaneous innervation of both the periodontal ligaments and masseter muscle spindles by collaterals of peripheral processes of single Vme neurons.

Prenatal ontogeny of substance P-like immunoreactivity in the trigeminal spinal caudal subnucleus of the human fetus--an immunocytochemical study

Using an immunocytochemical method, the prenatal ontogeny of substance P-like immunoreactivity (SP-LI) was demonstrated in the trigeminal spinal caudal subnucleus (TSCS) of human fetus, fetal age (menstruation age) 11.5-40 weeks. The time of initial appearance of SP-LI in the human brainstem TSCS was between the fetal age 11.5 weeks and 16 weeks. While the fetus grew, the density of SPLI fibers and terminals in the human fetus brainstem TSCS increased constantly from fetal age 16 weeks to 40 weeks. These findings indicated that substance P (SP) might play an important role in the human trigeminal nerve system development and in its functional establishment during the prenatal period.

Role of electric stimulation in bladder evacuation following spinal cord transection

Neural stimulation is potentially a valuable therapeutic tool in the treatment of neurogenic bladder with detrusor areflexia. We studied 20 dogs in different groups, up to eight months, and compared the effect of electric stimulation with intermittent catheterization, specially during spinal shock phase. We found that early stimulation hastened the return of detrusor activity. When stimulation was delayed, the bladder could still regain its activity, and when the pace-maker was turned off, the detrusor activity was gradually decreased. Neurostimulation can completely empty bladder up to eight months. The lowest A.Ch. content in detrusor muscle was found in intermittent catheterization group and in this group the detrusor strips showed marked supersensitivity to urecholine stimulation than the bladders managed by electric stimulation. Also, we found that electric stimulation reduced the complications caused by intermittent catheterization and protected kidney function.

Transmission of serologically silent hepatitis B virus along with hepatitis C virus in two cases of posttransfusion hepatitis

The polymerase chain reaction (PCR) was used to investigate the presence of hepatitis B virus (HBV)-related DNA sequences in blood from three blood donors and two transfusion recipients who developed posttransfusion non-A, non-B hepatitis (NANBH). In the first case, the sole donor was positive for antibody to hepatitis B surface (HBs) and core (HBc) antigens and had elevated alanine aminotransferase (ALT) levels, while the recipient had no HBV serologic markers. Both the donor and the recipient had serologic markers of hepatitis C virus (HCV) and were found positive for HBV DNA and HCV RNA sequences by PCR. The second case involved two donors and one recipient. Serologic tests for conventional HBV markers were negative in all three individuals, but one of the donors had elevated ALT. HBV DNA sequences were detected by PCR in the serum of the recipient and of the donor with high ALT, but not in the serum of the donor with normal ALT. Anti-HCV was detected in the serum of the recipient and of the suspect donor but not in that of the donor with normal ALT. The sequences amplified in the S region and determined after cloning of PCR products for both donor-recipient pairs were indistinguishable from each other and identical to the sequence of the major HBV subtype of adw in the first case and ayw in the second case. Furthermore, for the second case, an identical single-point mutation was found in both the donor and the recipient. These data confirm the transmission of conserved HBV sequences together with HCV in posttransfusion NANBH.(ABSTRACT TRUNCATED AT 250 WORDS)

Lack of pre-C region mutation in woodchuck hepatitis virus from seroconverted woodchucks

Woodchuck hepatitis virus, which shares a large degree of homology with human HBV, was examined for indications of mutational variants. No alteration in the pre-C region was found, but as in HBV, viral DNA could still be detected by PCR after seroconversion to anti-WHe.

Generation of a 1.5-kb cDNA fragment of the hepatitis C virus genome by overlap extension

Hepatitis C virus (HCV) is a recently identified RNA virus responsible for most of non-A, non-B hepatitis. Genetic analysis of HCV sequences and their encoded proteins has been hampered by the difficulty in obtaining cDNA fragments of sufficient lengths: construction of cDNA library requires technical expertise while amplification by the polymerase chain reaction (PCR) usually yields fragments of less than 400 base pairs. In this report we have generated a 1.5-kb HCV cDNA fragment by overlap extension of smaller PCR fragments and by ligation through restriction sites. Sequencing of the cloned fragment confirmed the absence of significant sequence alteration produced by this procedure. Overlap extension may represent an easy method for generating relatively large HCV cDNA clones for the expression of HCV-encoded proteins.

Histopathologic study of cholestasis induced by total parenteral nutrition or intraperitoneal sepsis in rats

Wistar rats were divided into two groups, intraperitoneal sepsis group (group IS) and total parenteral nutrition group (group TPN), to evaluate the characteristics of pathologic alterations in rats with cholestasis. Biochemical assay showed that cholestasis developed in both groups after 10 days. Light microscopic examination of liver specimens revealed that the degeneration in the intermediate and external zone of hepatolobules was the major alteration in group IS, and group TPN showed characteristic dilation of central veins and hepatic sinuses and the proliferation of Kupffer cells with marked phagocytosis. Electron microscopic pictures presented the enlargement of bile canaliculi with altered microvilli in group IS and many highly electron-dense bile particles within cytoplasm and secondary lysosomes near dilated bile canaliculi in group TPN. It is concluded that there were different histopathologic alterations of liver specimens in TPN-supported animals and septic animals when cholestasis developed. It is unsuitable to take intraperitoneal sepsis as a unique factor of cholestasis in TPN-supported rats. Bile stasis is only one sign of TPN-induced hepatic lesion, which needs further exploration to determine its causes and mechanisms.

Monosynaptic connections between neurons of trigeminal mesencephalic nucleus and jaw-closing motoneurons in the rat: an intracellular horseradish peroxidase labelling study

In order to confirm the monosynaptic connections of muscle spindle-mediated jaw stretch reflexes, 8 neurons of trigeminal mesencephalic nucleus innervating masseteric muscle spindles were identified electrophysiologically and stained intracellularly with horseradish peroxidase. These axon terminals projected to ipsilateral dorsal and dorsolateral divisions of trigeminal motor nucleus and extensive premotor areas. Under electron microscope, labeled terminals made monosynaptic contacts predominantly with dendrites in the jaw-closing motoneuron pools. One labeled and many non-labeled terminals were frequently observed to converge simultaneously on one dendrite in the area. However, it was of particular interest that 28% of the labeled terminals constituted the intermediate component of axo-axodendritic synaptic triads. The present study confirmed, for the first time, monosynaptic connections between jaw-closing muscle spindle afferents and jaw-closing motoneurons. These findings also provided ultrastructural evidence for the monosynaptic excitation of muscle spindle-mediated jaw stretch reflexes which received presynaptic and postsynaptic inhibitions of the premotor neurons from other sources.

Two French genotypes of hepatitis C virus: homology of the predominant genotype with the prototype American strain

A hepatitis C virus (HCV) cDNA covering part of the nonstructural region, NS3, was amplified from the serum of 50 out of 76 French non-A, non-B hepatitis patients by the nested polymerase chain reaction (PCR). Determination of a 407-bp sequence from four such cases revealed the presence of two different virus genotypes, F1 and F2, which exhibited 19-20% sequence divergence. F1 was represented by three of the four isolates and showed a sequence homology of about 97.5% to the prototype American HCV isolate, but of only 79% to a reported Japanese isolate. In contrast, F2 had 91.6% homology to the Japanese isolate, but only 81% homology to the prototype American HCV. PCR products from the 50 samples were hybridized with labeled F1 and F2 fragments under stringent conditions; results indicated the F1-related strain(s) as the major HCV genotype. Furthermore, a total of 1477 bp of sequence has been determined for one of the isolates belonging to the F1 category. These results will have implications for the PCR detection of HCV infection and production of HCV vaccines, especially for European countries.

SP-like immunoreactivity in the primary trigeminal neurons projecting to the nucleus tractus solitarii

Using the double-labeling method of retrograde transport of HRP combined with PAP immunocytochemistry, the neurons containing SP-like immunoreactivity (SPLI) of the trigeminal nerve projecting to the nucleus tractus solitarii (NTS) were examined. HRP-SP double-labeled neurons in the trigeminal ganglion, mainly small or middle-sized, were found after the NTS or the lingual nerve was injected with HRP followed by SP-immunoreaction. These findings demonstrate that the projection of the trigeminal nerve to the NTS contains SPLI.

Decreased replication capacity of a duck hepatitis B virus mutant with altered distal pre-S region

We have observed in a previous study that insertion, deletion and partial frameshift mutation in the distal pre-S region did not abolish replication capacity of the duck hepatitis B virus (DHBV) (Li et al., 1989, J. Virol. 63, 4965-4968). To compare further the relative replication capacity between the pre-S mutant and wild type virus, ducts were infected with either the wild type DHBV strain or a pre-S mutant (FS-17) characterized by a total change of nine consecutive amino acid codons in the distal pre-S region. Compared with the wild type virus, FS-17 exhibited decreased replication capacity whether in separate or mixed infection. The decreased viral replication was correlated with delayed appearance of supercoiled DNA and viral RNA in the hepatocytes. Besides, FS-17 induced persistent viremia when inoculated into 1-day-old ducklings; hence the transient viremia which had been observed in the previous study was probably due to the time delay needed to generate compensatory deletion mutation.

Rapid screening for bacterial colonies harbouring tandem hepatitis B virus sequences by an oligonucleotide probe

Transfection of the hepatitis B virus (HBV) genome requires the cloning of tandem HBV sequences into a plasmid vector, which is usually screened for by restriction enzyme digestion of plasmid minipreparations from at least a dozen bacterial colonies. We describe a simple alternative screening method based on in situ hybridization of bacterial colonies with a [32P]-labelled synthetic oligonucleotide which spans the head-to-tail junction site of two tandem HBV molecules. The accurate detection by the oligoprobe is confirmed by enzymatic digestion.

Disseminated penicilliosis marneffei in China. Report of three cases

Three cases with disseminated Penicilliosis marneffei (PSM) are reported. They are all natives of Guangxi Zhuang Autonomous Region. Among them, 2 died and 1 remains alive. Their clinical features were characterized by multiple organ involvement, multiple subcutaneous abscesses, inflammatory papules, nodules and pustulae, and enlargement of superficial lymph nodes with chills, fever, anemia and leukocytosis. The mycology and histopathology of PSM are also discussed. The authors propose that the medical profession in Guangxi should be vigilant against the disease and reduce the mortality by early diagnosis and treatment.

Parietal cell vagotomy and selective vagotomy plus antrectomy in the treatment of duodenal ulcer. A follow-up of 10 years

Two hundred and thirty-eight patients with duodenal ulcer were subjected to vagotomy. According to the clinical manifestations and the results of gastric acid secretion test, parietal cell vagotomy was done in 100 patients and selective vagotomy plus antrectomy in 138 patients. Follow-up after operation for 10 years showed that 96% and 97% of patients belonged to Visick Grade I and II respectively. The recurrence rate for parietal cell vagotomy was 1.96%, but no recurrence was seen in the group of selective vagotomy plus antrectomy. Long-term side-effects were rarely found in the patients. They had good nutritional states. The follow-up data showed that the recurrence rate could be greatly reduced if the modality of vagotomy was selected according to the type of gastric acid secretion test. The importance of surgeons experience and careful manipulation was emphasized.

Morphological characteristics and terminating patterns of masseteric neurons of the mesencephalic trigeminal nucleus in the rat: an intracellular horseradish peroxidase labeling study

In order to study the morphological characteristics and terminating patterns of the neurons of the trigeminal mesencephalic nucleus (Vme), 55 masseteric neurons in Vme in the rat were stained by intracellular injection of horseradish peroxidase (HRP). Labeled cells were distributed throughout the nucleus. These neurons were divided into three types: uni- or pseudounipolar (type A, n = 43), bipolar (type B, n = 5), and multipolar cells (type C, n = 7). Each type was further divided into two subtypes according to the largest diameter of the perikarya (type a greater than or equal to 30 microns, type b less than 30 microns). The central processes of type Aa neurons projected to the following three groups of target nuclei: 1) nuclei functioning as interneurons, including supratrigeminal nucleus (Vsup), intertrigeminal nucleus (Vint), juxta-trigeminal region (Vjux), and parvicellular nucleus of the pontomedullary reticular formation (PcRF); 2) motor nuclei, including the trigeminal motor nucleus (Vmo), accessory facial nucleus (NVIIacs), accessory abducens nucleus (NVIacs), and a small number of labeled axons in the oculomotor nucleus and trochlear nucleus; 3) sensory nuclei, including the dorsomedial part of the principal trigeminal sensory nucleus (Vpdm) and the dorsomedial part of subnucleus oralis of the trigeminal spinal nucleus (Vodm). Labeled processes were dense in the Vsup, Vmo, and Vpdm. The proprioceptive pathway of the fifth nerve is discussed. Direct projections from type Aa neurons of Vme to the Vpdm and dorsolateral part of the Vsup contribute to conduction of the proprioceptive information from spindles of masticatory muscle to the contralateral thalamus in the rat. Different axon morphology, distribution, terminal branch density, and terminating patterns of type Aa neurons were noted in different functional groups of the projecting nuclei, especially in the Vsup, Vmo, and Vpdm. The highest terminal branching density, the most extensive distribution, and two different types of branching patterns (claw-like and comb-like) were observed in Vsup. Selective distribution and single-beaded or "Y"-shaped terminal branches were observed in Vmo. In the Vppdm the axonal branches were sparser than in the Vsup or Vmo, and had an arrangement like the branches of a weeping willow tree. These characteristics of anatomical organization might be related to the function of each projecting nucleus.

Evidence of two major genotypes of hepatitis C virus in France and close relatedness of the predominant one with the prototype virus

Hepatitis C virus (HCV) cDNA sequence in the nonstructural region NS3 was amplified from the serum of 66% French non-A, non-B hepatitis patients by the nested polymerase chain reaction. A 407 base-pair sequence was determined from four such cases, which revealed the presence of two different virus genotypes F1 (three cases) and F2 (one case) with 19-20% sequence divergence. F1 showed close homology (97.5%) to the prototype US isolate, but only limited (79%) homology to the reported Japanese isolates. In contrast, F2 had 91.6% homology to the Japanese isolate, but only 81% homology to the prototype US virus. Hybridization of the amplified products from 50 French samples with labeled F1 and F2 fragments suggested the F1-related strain(s) as the major hepatitis C virus genotype. Further studies involving a greater variety of samples will confirm whether the F1-related strain is the predominant hepatitis C virus strain circulating in France. Such data will have important implications for the PCR detection of HCV infection and production of HCV vaccines.

In vitro and in vivo replication capacity of the precore region defective hepatitis B virus variants

Although the precore region defective hepatitis B virus variants have been implicated in chronic liver disease and fulminant hepatitis, our knowledge on the molecular biology of these variants is still limited. Using an in vitro transfection assay, we confirmed the replication competent but HBeAg-negative nature of the major variants containing a TAG stop codon in the distal precore region associated with one or two point mutations. Transfection of the two-point-mutated variant into a chimpanzee induced serological responses including anti-HBc and anti-HBs. Interestingly, anti-HBe response was found in the absence of HBeAg antigenemia, suggesting that anti-HBe can be stimulated by degraded HBc. Using the rabbit reticulocyte system the possible effect of the different precore region mutations on the expression of HBcAg from precore- and core-mRNAs was also studied.

Intraoperative coronary venography in observing changes of portal blood flow after portal-azygos disconnection

Intraoperative coronary venography was performed in 24 patients before and after portal-azygos disconnection for portal hypertension. Before the procedure the portal vein was found to be communicated with cardial and esophageal veins by two pathways, i,e., from the esophageal and gastric branches of the coronary vein to the esophageal varices, with the latter branches by way of the gastric intramural venula. The portal blood flow was postulated to be hepatofugal because the portal trunk could not be seen venographically. Coronary venography done after the disconnection revealed no pericardial and esophageal varices and the portal vein with hepatopetal blood flow. We conclude that the operation had the advantage of complete disconnection between the portal vein and the cardio-esophageal varices, thus preventing the bleeding from the varix and increasing hepatopetal blood flow.

Active hepatitis B virus replication in the presence of anti-HBe is associated with viral variants containing an inactive pre-C region

Although rise of anti-HBe immunity in the course of hepatitis B virus (HBV) infection is generally followed by clearance of the infectious virions, ongoing chronic liver disease with circulating virions has been repeatedly observed in a significant number of anti-HBe patients, especially in Mediterranean countries. To investigate the possible role of HBV variants, we cloned HBV DNA from the serum of three such anti-HBe cases. Comparative restriction mapping of HBV clones suggested circulation of different HBV genomes in the three cases. DNA sequencing revealed an inactive pre-C region in all 11 HBV clones derived from the three cases, either as one or two point mutations in the 3' terminus generating an in-frame TAG stop codon, or a 1 nucleotide insertion in the 5' terminus resulting in frameshift mutation. Furthermore, for one clone the complete 3182 nucleotide sequence was determined and no significant mutation was found in the remainder of the genome. We conclude that chronic hepatitis cases positive for anti-HBe are associated with HBV variants containing an inactive pre-C region and hence cannot synthesize pre-C region-derived HBeAg. This finding may provide a molecular explanation for the continued viral replication despite presence of anti-HBe immunity.

A morphological analysis of neurons in the lateral parabrachial nucleus: an intracellular horseradish peroxidase study in the rat

Neurons in the lateral parabrachial nucleus (LPB) of the rat were analyzed by the intracellular horseradish peroxidase method. Sixteen LPB neurons were successfully labeled with HRP injected intracellularly. HRP-labeled LPB neurons were divided into type I (7 neurons) and type II (9 neurons) LPB neurons. Type I LPB neurons, which were activated antidromically by stimulation of the ipsilateral posteromedial ventral nucleus of the thalamus, had long dendrites and a long axon. Type II LPB neurons, which were not activated antidromically by the stimulation of the thalamus, had short dendrites and a short axon. It was concluded that type I LPB neurons were projection neurons, while type II LPB neurons were local circuit neurons.

Changes of plasma amino acids in total parenteral nutrition-supported patients with intraabdominal infection

Plasma aminogram changes were prospectively studied in 95 patients with external enteric fistula and intraabdominal infection who were under total parenteral nutrition (TPN) therapy with anfuming 14s. Plasma amino acids and albumin were determined before the administration of TPN, weekly and at the end of the therapy or 2 to 5 days before death of patients. In patients with sepsis and starvation, the aminogram showed remarkably low total free amino acids before TPN therapy. In survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in the dead increased rapidly to a significantly high peak at the terminal stage. In both survivors and deceased, phenylalanine level remained high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acid preparation for the starved, septic patients should be high in BCAA and arginine but low in phenylalanine; the administration of inappropriate exogenous amino acids in metabolically decompensated septic patients may bring about more harm than benefit; and in septic patients the persistently elevated level of plasma phenylalanine and proline along with decrease of arginine is a useful prognostic sign.

Duck hepatitis B virus can tolerate insertion, deletion, and partial frameshift mutation in the distal pre-S region

In-frame and frameshift mutations were introduced into the pre-S region (1,212 base pairs) of duck hepatitis B virus. The in-frame mutants retained the inserted 12 nucleotides, while the frameshift mutants either reverted to wild type or exhibited a 10-nucleotide compensatory deletion downstream of the original mutation site. Thus, although duck hepatitis B virus has a compact and highly economical genome organization, it can replicate despite alterations of up to 9 amino acid codons in the pre-S and P open reading frames.

[Changes in serum amino acids in total parenteral nutrition supported patients with intra abdominal infection]

Serum aminogram changes were prospectively studied in 95 patients with enteric fistula and intraabdominal infection who was under total parenteral nutrition (TPN) therapy with Anfuming 14s. In patients with sepsis and starvation, the aminogram showed remarkably low total free amino acids before TPN therapy. In 81 survivors, free amino acids increased gradually to normal in 2 weeks after use of TPN and in 14 dead cases increased rapidly to a significantly higher peak at terminal stage. Both in survivors and nonsurvivors, phenylalanine level remained high during the study. In response to infection, proline was also elevated but to a lesser degree; the ratio of branched chain amino acid (BCAA) to aromatic amino acid (AAA) was lower than normal and the decrease of arginine was parallel to the severity of infection. We conclude that the ideal amino acids preparation for the starvated and septic patients should be high in BCAA and arginine but low in phenylalanine, administration of inappropriate exogenous amino acids in decompensated metabolic septic patients may bring about more harm than benefit, and in septic patients that the levels of serum phenylalanine and proline are elevated persistently along with the decrease of arginine level is a useful prognostic indication.

[Acute rupture of lumbar intervertebral disc caused by violent manipulation]

Five cases of acute rupture of lumbar intervertebral disc caused by violent manipulation are reported. After protrusion of the lumbar intervertebral disc were treated by violent manipulation, the lumbo-leg pain were severe suddenly. The operations found that the annulus fibrosus had ruptured and the nerve root or cauda equina was constricted by the nucleus pulposus which had entered into the spinal canal. It must be emphasized that their is in danger of more damaging intervertebral disc degenerated by violent manipulation, then the adhesion of the nerve root will occur gradually. We don't suggest to make violent manipulation for the patient with the nerve root injured. We have acquired good results in treating protrusion of lumbar intervertebral disc by combined therapy and they are introduced in this article.

[Studies on the alkaloids of radix Sophorae Tonkinensis]

Six alkaloids were isolated from Radix Sophorae Tonkinensis. On the basis of spectrometric analysis and physico-chemical constants they were identified as (I) (+)-matrine, (II) (-)-cytisine, (III) (+)-matrine N-oxide, (IV)(+)-sophocarpine N-oxide, (V)(+)-sophoramine and (VI) (+)-sophoranol respectively. (II), (IV), (V) and (VI) were isolated for the first time from Radix Sophorae Tonkinensis.

[Studies on the quality of Gastrodia elata Bl. cultivated with various kinds of fungus-growing materials]

In this article, the chemical compositions of 14 kinds of fungus-growing materials, and their corresponding rhizomorph and G. elata are analysed with thin layer chromatography. The properties of each G. elata and the contents of gastrodin in each G. elata are also analysed. The result shows that their properties and chemical compositions are similar, thus providing a basis for a larger choice of fungus-growing materials in cultivating G. elata.

Interaction of Epstein-Barr virus DNA polymerase with aphidicolin, phosphonoformate and 5'-GMP

Epstein-Barr virus (EBV)-specified DNA polymerase was purified from P3HR-1 cells, a Burkitt lymphoma EBV producer cell line, treated with phorbol-12,13-dibutyrate (PDB) and n-butyrate. Its inhibition by aphidicolin, phosphonoformate (PFA) and 5'-GMP was examined. Aphidicolin could inhibit EBV DNA polymerase competitively with respect to dATP and dCTP and noncompetitively with respect to dGTP and dTTP; whereas 5'-GMP was a noncompetitive inhibitor with respect to all four dNTPs. Combinations of aphidicolin and PFA, or PFA and 5'-GMP, produced a mutually exclusive inhibition pattern of EBV DNA polymerase that suggested that the binding sites of these compounds on the enzyme molecule are kinetically overlapping.