Polymorphism of dopamine receptors and transporter genes in neuropsychiatric diseases

The advances made in studies on the molecular biology of the dopamine transporter (DAT) and receptors (D1, D2, D3, D4 and D5) are reviewed, and their pharmacological characteristics and the relationship between polymorphic variations of these human proteins and neuropsychiatric disorders are discussed. Data from four studies on the variants of the D2 receptor gene (Ser311-->Cys). BalI polymorphism in D3, 48-base repeat polymorphism in D4, and 40-base repeat polymorphism in the DAT gene in patients with schizophrenia, mood disorder, neurological disease and controls are reported.

Combined use of detachable coil against persistent mechanical hemolysis after transcatheter occlusion using Rashkind umbrella device in adult patient with patent ductus arteriosus

Mechanical hemolysis after transcatheter occlusion of the patent ductus arteriosus using the Rashkind umbrella device has been postulated as a rare, but serious complication, even necessitating surgical repair. A rare, case of an adult patient with massive hemolytic anemia, successfully controlled by the combined use of several detachable coil devices is reported. The use of coil devices might be considered as a therapeutic option in such cases.

[Malignant paraganglioma with intracranial metastasis: a case report]

We report a case of malignant paraganglioma with intracranial metastasis. A 26-year-old man presented with leg pain. On admission a metastatic bone tumor was found. General examination revealed metastatic lesions in the lung, liver, orbits, ethmoid sinus, anterior mediastinum, and brain. An MRI of the head showed multiple lesions in the skull bone and intracranial space. A biopsy was performed on the right temporal tumor, resulting in a diagnosis of malignant paraganglioma. The tumor origin could not be determined. The tumor resection was not indicated because of multiple metastasis. Both chemotherapy and radiotherapy were given to the patient, but a satisfactory outcome was not obtained.

A new and efficient method for gene transfer into mouse FM3A cells using metaphase chromosomes by electroporation

We introduced chromosome-mediated genes into mouse thymidine kinase-deficient FM3A (FM3Atk-) cells, by electroporation. The effects of some parameters on the electric shock-mediated transfection of FM3Atk- cells were investigated. Gene transfer of mouse L929 metaphase chromosome DNA into FM3Atk- resulted in a maximum frequency of (3.0 +/- 0.3) x 10(-5) at a cell density of 2.0 x 10(8)/ml and chromosome dosage of 5.0 x 10(7) cell equivalents/ml in a buffer containing 0.25 M mannitol, 0.5 mM MgCl2, 0.1mM CaCl2, and 1 mM Tris-HCl (pH 7.1). The highest yield of the transformants was obtained at an electric field strength of 1 kV/cm and a capacitance of 35 microF, with a single exponentially decaying pulse at 0 degrees C was optimal for post-shock incubation after electroporation. The tk gene was detected in the transformants by in situ hybridization analysis.

Plasma concentration and acute clinical effects of docarpamine, orally active dopamine prodrug, in infants

Currently, there are no data available on the optimal doses and efficacy of docarpamine in infants. In the present study, three doses of docarpamine, 15.0-20.4 (19.0 +/- 1.9; mean +/- SD) mg/kg per dose every 8 h to 10 infants suffering heart failure. Age and bodyweight were from 1 to 4 (1.4 +/- 1) months and 2960-5160 (3350 +/- 872) g, respectively. In all infants, plasma concentrations of free dopamine were measured 1, 2 and 3 h after the first administration. Heart rate and systolic blood pressure were examined before and at the same time as the first administration. In seven infants, the 24 h urinary output and urinary excretion of electrolytes and creatinine before and during docarpamine were measured. Peak plasma concentration of free dopamine (ng/mL) was achieved after 1 or 2 h of administration, 0-163.1 (37.9 +/- 47.2) and 0-105.0 (37.8 +/- 39.3), respectively. The concentration had decreased rapidly by 3 h to 0-34.2 (12.4 +/- 11.0). Both heart rate (b.p.m.) and blood pressure (mmHg) tended to increase from 120-154 (140 +/- 15) and 56-90 (76 +/- 11) to a peak of 124-162 (148 +/- 14) and 70-92 (79 +/- 8), respectively (P = 0.197, P = 0.289). There were no significant changes in urinary output or excreta. Oral docarpamine of 15-20 mg/kg per dose can achieve plasma free concentrations of dopamine that increase heart rate and systolic blood pressure.

High dose of intravenous antithrombin III without heparin in the treatment of disseminated intravascular coagulation and organ failure in four children

In several animal experiments, high doses of antithrombin III concentrates have shown beneficial effects on mortality and reversal of coagulation abnormalities which had resulted from disseminated intravascular coagulation. Other experiments have suggested that antithrombin III infusion without heparin is effective in the treatment of organ failure. We clinically treated children suffering disseminated intravascular coagulation only with antithrombin concentrate. Four patients suffering disseminated intravascular coagulation with organ failure were selected. We started antithrombin III concentrate infusion as soon as the diagnosis was established. The dosage of antithrombin III was 120-250 units/kg/day for 2 or 3 days. Heparin was not used. All 4 patients recovered completely and quickly without any complications within 14 days. We suggest that the high-dose antithrombin III infusion without heparin is an effective and safe therapy for disseminated intravascular coagulation with organ failure.

Xanthogranuloma with massive hematoma in the third ventricle: case report

OBJECTIVE AND IMPORTANCE

Symptomatic xanthogranulomas of the ventricular system are rare entities. No case of a massive hematoma in the xanthogranuloma, which may cause sudden deterioration, has been reported. This is the first report of a massive hematoma arising from a xanthogranuloma in the third ventricle.

CLINICAL PRESENTATION

A 35-year-old woman was referred to our hospital with a 1-month history of progressively deteriorating consciousness. Neuroradiological findings revealed a mass in third ventricle and obstructive hydrocephalus.

INTERVENTION

Bilateral external ventricular drainage was performed as an emergency treatment. Two weeks later, the mass was removed totally via the transcallosal-transforaminal approach. The disturbance of consciousness completely disappeared 2 weeks after the second operation. The pathological diagnosis was xanthogranuloma causing massive hematoma.

CONCLUSION

The pathogenesis, clinical and radiological features, differential diagnosis, and treatment of this rare benign tumor are discussed. The hypothalamic dysfunction caused by a massive hematoma in the lesion of the third ventricle may cause sudden deterioration and death, whether the obstructive hydrocephalus exists. The risk of hemorrhage and hydrocephalus still remains after aspiration alone because of the presence of the cyst wall. Radical extirpation should be the choice of treatment for xanthogranulomas or colloid cysts of the third ventricle.

Ampullary carcinoma in familial adenomatous polyposis: report of a case

We report the case of a 48-year-old man with familial adenomatous polyposis (FAP) who was found to have ampullary carcinoma 6 years after undergoing total colectomy. The patient was examined periodically after colorectal surgery except for duodenoendoscopy because he had also previously undergone distal gastrectomy with gastrojejunal anastomosis for a duodenal ulcer at 27 years of age. An ampullary lesion was suspected on blood chemistry and detected by computed tomography scan and ultrasonography although the patient showed no clinical symptoms. A pancreatoduodenectomy was performed and the histological examination revealed well-differentiated adenocarcinoma with no metastasis to the regional lymphnodes. Long-term periodic surveillance of the upper gastrointestinal tract including the papilla of Vater is therefore important for FAP patients who have undergone prophylactic colectomy.

The traA gene of the Enterococcus faecalis conjugative plasmid pPD1 encodes a negative regulator for the pheromone response

The Enterococcus faecalis conjugative plasmid pPD1 (59 kb) produces an aggregation substance in response to pheromone. The traA gene (962 bp) is a member of a gene cluster involved in the regulation of the pPD1 pheromone response. A chimeric E. faecalis suicide plasmid containing a 762-bp DNA fragment from the middle portion of the traA gene was constructed. The pPD1 traA was disrupted by integration of this chimeric plasmid via homologous recombination. The E. faecalis strain containing pPD1 with the disrupted traA exhibited dry colony morphology, constitutive clumping, and an ability to transfer at high frequencies in a short (10-min) mating period, indicating that the traA product of pPD1 is a negative regulator for the pheromone response.

Correlation between cerebral blood flow values obtained by Xenon/CT and Kety-Schmidt (N2O) methods

The means of the cerebral blood flow (CBF) values obtained by the stable xenon enhanced CT (Xe/CT) method using two different CT scanners were compared with global CBF value obtained by the Kety-Schmidt (N2O) method as a reference. Xe/CT CBF values were obtained using a GE CT9200 (31 patients, 2 flow maps, 120 kV, absorption constant of 0.040) as well as a GE ProSeed Accell (38 patients, 4 flow maps, 80 kV, absorption constant of 0.028). The protocol of inhalation in the Xe/XT method consisted of 4 min wash-in and 4-min wash-out of 35% stable xenon. In the Kety-Schmidt method, 15% N2O gas was inhaled for 10 min. The N2O content of blood samples was measured using a van Slyke-Neill blood gas analyzer. We corrected all obtained CBF values for a PaCO2 of 34 mmHG (CBF34). The global CBF34 values obtained by the Kety-Schmidt method were linearly correlated with the CBF34 values obtained using the CT9200 and with those obtained using the ProSeed Accell, and the regression line equations were, respectively, Y = 0.64X + 13.7 (X: CT9200, Y: Kety-Schmidt, r = 0.666, p < 0.01) and Y = 0.99X + 11.2 (X: ProSeed Accell, Y: Kety Schmidt, r = 0.756, p < 0.01). Since the CBF values obtained by the Xe/CT method using different CT scanners are not always the same as the global CBF values obtained by the Kety-Schmidt method, CBF values obtained by the Xe/CT method should be corrected referring to the regression line obtained by applying both methods for each patient.

Catecholamine-induced ductus arteriosus constriction in children

Our data suggest that the vascular smooth muscle of the PDA remains capable of constriction beyond a patient's infancy, at least at the pulmonary end. In some cases of PDA, catecholamines may induce late closure.

Cloning and genetic organization of the bacteriocin 31 determinant encoded on the Enterococcus faecalis pheromone-responsive conjugative plasmid pYI17

The conjugative plasmid pYI17 (57.5 kb) isolated from Enterococcus faecalis YI717 confers a pheromone response on the host and encodes the bacteriocin 31 gene. Bacteriocin 31 is active against E. hirae 9790, E. faecium, and Listeria monocytogenes. pYI17 was mapped physically by restriction enzyme analysis and the relational clone method. Deletion mutant and sequence analyses of the EcoRI fragment B cloned from pYl17 revealed that a 1.0-kb fragment contained the bacteriocin gene (bacA) and an immunity gene (bacB). This fragment induced bacteriocin activity in E. faecalis OG1X and E. hirae 9790. The bacA gene is located on the pYI17 physical map between 3.37 and 3.57 kb, and bacB is located between 3.59 kb and 3.87 kb, bacA encodes 67 amino acids, and bacB encodes 94 amino acids. The deduced amino acid sequence of the bacA protein contained a series of hydrophobic residues typical of a signal sequence at its amino terminus. The predicted mature bacA protein (43 amino acids) showed sequence homology with the membrane-active class II bacteriocins of lactic acid bacteria. Analysis of Tn5 insertion mutants and the resulting transcripts indicated that these genes are transcribed as an operon composed of bacA, bacB, and an open reading frame located downstream of bacB designated ORF3.

An iridoid glucoside from dipsacus asperoides

A new iridoid glucoside, loganic acid-6'-O-beta-D-glucoside, has been isolated from the defatted root of Dipsacus asperoides. Its structure has been elucidated by spectroscopic means as 1S-(1 alpha,4a alpha,6 alpha,7 alpha,7a alpha)-1-[(6-O-beta-D- glucopyranosyl-beta-D-glucopyranosyl)oxyl]1,4a,5,6,7,7a-hexahydro-6-hydr oxy-7- methyl-cyclopenta[c]pyran-4-carboxylic acid.

[Serum levels of solubule tumor necrosis factor (TNF) receptors in patients with pulmonary tuberculosis]

Tumor necrosis factor alpha (TNF-alpha) is released from cells of monocyte/macrophage lincage and mediates the development of a variety of clinical and pathomorphological features in various infectious diseases, autoimmune diseases and cancer. In the case of tuberculosis, it is suggested that the release of TNF-alpha in the affected regions and into the circulation could account for the pathological and clinical features such as the development of necrotic lesions and fever and weight loss in TB patients. In the present study, the levels of soluble TNF receptor type I (sTNFR type I) and type II (sTNFR type II) and TNF-alpha in the sera of patients with pulmonary TB were assayed, and we tried to know whether these levels have clinical significance in determining the disease activity in TB patients. The serum levels of both sTNFR types I and II were significantly higher in TB patients (n = 22) who were previously untreated than in the healthy control (n = 14): for sTNFR type I, 2.82 +/- 1.37 ng/ml vs. 1.40 +/- 0.33 ng/ml (p < 0.0001), and for sTNFR type II, 3.83 +/- 1.76 ng/ml vs. 1.62 +/- ng/ml (p < 0.0001). The serum levels of sTNFR types I and II in TB patients showed significant correlations with their serum levels of CRP. The serum levels of TNF-alpha in these TB patients was 2.21 +/- 1.72 pg/ml, whereas TNF-alpha was not detectable in the sera of 9 healthy control. The serum levels of sTNFR type I and II were significantly higher in cavitary TB (n = 17) than in non-cavitary TB (n = 5). When TB patients were treated with antituberculosis drugs and clinical improvements were achieved, the elevated levels of sTNFR type I and TNF-alpha in the sera of same 5 patients measured before starting treatment showed significant decline and the serum levels of sTNFR type II showed also declined, however, the decline was statistically not significant. From all the results obtained in this study, we conclude that the assay of the serum levels of sTNFR in TB patients is useful in the evaluation of the disease activity of TB.

Relationship between solvent inhalation and antisocial behavior: special emphasis on two types of violence seen in solvent abusers

Organic solvent inhalation is a serious problem among youths in Japan. It induces physical and mental disorders, and is related closely to crime and delinquency. The relationship between solvent inhalation and antisocial behavior was investigated in 75 youths. The subjects were divided into three groups according to the level of violent behavior and the time of appearance: a non-violent group, a late-onset group (violence occurred after the start of inhalation) and an early-onset group (violence had occurred before the start of inhalation). Various parameters were compared among the groups. The late-onset group showed the following characteristics; (i) the frequency of inhalation was high, and many subjects experienced hallucinations and mood changes caused by inhalation; (ii) the family environment was characterized by conflict; and (iii) the subjects had strong psychological conflicts and showed dissociative coping with frustration. The violence, psychological conflict and dissociation in this group were found to be related to the inhalation, with familial conflict as a background. The violence in the early-onset group was considered to be the manifestation of a violent personality as the frequency of inhalation and the incidence of mental symptoms were both low. The subjects in this group showed weak psychological conflict and tended to be demanding of others when attempting to cope with frustration. Two types of violent behaviors in the teenagers who inhaled solvents were identified. The violence of solvent inhalers should be managed according to the type.

[Zinc-deficient disorders of sense organs--dark adaptation, taste and smell disorders]

This review collected the literature on the disorders of visual, taste and smell senses caused by zinc deficiency. Human and experimental studies on the zinc-deficient taste and smell disorders were almost own experiences.

Quantitative analysis of repeat adenovirus-mediated gene transfer into injured canine femoral arteries

We quantitatively evaluated the effectiveness of a repeat administration of a recombinant adenoviral vector expressing bacterial Escherichia coli lacZ into the same arterial site of a relatively large animal, the dog. The replication-defective adenoviral vector was introduced percutaneously into balloon-injured femoral arteries through a double-balloon catheter. After a single dose of adenoviral vector, up to 90% of surface (73 +/- 16%, n = 7) and smooth muscle cells in multiple layers of the media showed transgene expression as evaluated by 5-bromo-4-chloro-3-indoyl beta-D-galactopyranoside histostaining without extralocal expression, as assessed by polymerase chain reaction. High-level expression (measured as beta-galactosidase activity) peaked 7 days after transfer and was transient, although it was retained for a month. Second does of the same adenovirus to the same arterial site were given 1, 2, 5, or 8 weeks after the first administration. At 1 week the second dose significantly enhanced lacZ expression. At 2, 5, or 8 weeks the second dose reinduced lacZ expression at 25% to 30% of the full expression. lacZ expression was also detected in preimmuned dogs, although the expression levels correlated inversely to the titer of neutralizing antibodies in their serum. These results demonstrate that arterial gene expression can be enhanced by a second administration of the same adenovirus after a short interval and that a repeat dose after a long interval partially but significantly reinduces gene expression despite the presence of an immune response. These data may provide an additional scientific foundation for the use of adenovirus-mediated arterial gene transfer in future clinical practice.

Physical mapping of the conjugative bacteriocin plasmid pPD1 of Enterococcus faecalis and identification of the determinant related to the pheromone response

The pheromone-responding conjugative bacteriocin plasmid pPD1 (59 kb) of Enterococcus faecalis was mapped physically by using a relational clone approach, and transposon analysis with Tn917 (Emr) or Tn916 (Tcr) facilitated the location of the bacteriocin-related genes in a segment of about 6.7 kb. Tn917 insertions within a 3-kb region resulted in constitutive clumping. The nucleotide sequence of the region that included the insertions giving rise to constitutive clumping was determined. The region of pPD1 spanned about 8 kb and was found to contain a number of open reading frames, some of which were named on the basis of homologies with two other pheromone-responding plasmids, pAD1 and pCF10. The genes were arranged in the sequence repB-repA-traC-traB-traA-ipd-traE-traF- orfY-sea-1 with all but repB and traA oriented in the same (left-to-right) direction. traC and traB corresponded, respectively, to traC and traB of pAD1 and to prgY and prgZ of pCF10.

Mild to moderate pulmonary valvular stenosis in infant sometimes improves to the condition unnecessary to do PTPV: Doppler echocardiographic observation

The purpose of this study is to clarify the natural history of the valvular pulmonary stenosis (PS) from the standpoint of the indication for percutaneous transvenous pulmonary valvuloplasty (PTPV). We retrospectively analyzed age-dependent changes of the peak velocity in the pulmonary artery (peak V) using Doppler echocardiography (Doppler), and some other echocardiographic and clinical findings in 55 children with mild to moderate PS. Groups A, B, and C consisted of those who had peak V above 3.54 m/sec, between 3.54 and 2.74 m/sec, and less than 2.74 m/sec, respectively. Peak V of 42 patients who had the first Doppler study before 1 year of age decreased from 2.61 +/- 0.66 to 2.27 +/- 0. 80 m/sec (p < 0.01). One infant in group A, that initially included 3 children, has improved to group B. Among the 15 patients in group B, one patient deteriorated to group A, and peak V of 10 infants reduced to less than 2.74 m/sec. In group C, peak V of 2 infants increased above 2.74 m/sec. Other than age at the first examination, we could not find specific indications that could predict the reduction of peak V. Mild to moderate PS younger than 1 year of age sometimes markedly improves; the invasive procedure of PTPV may not be necessary in non-critical infant patients with mild to moderate PS.

Percutaneous transluminal gene transfer into canine myocardium in vivo by replication-defective adenovirus

OBJECTIVE

The aim was to examine the feasibility, efficiency and safety of adenovirus-mediated in vivo gene transfer into the canine myocardium by a percutaneous transluminal method using a needle-catheter.

METHODS

Either a replication-defective adenovirus (Adex1SRLacZL) or a plasmid (pSRLacZ), both expressing E. coli lacZ coding beta-galactosidase (beta-gal), was directly injected into the left ventricle of dogs through a needle-catheter inserted via a femoral artery. Expression of lacZ was examined by histochemical staining and quantified by measuring beta-gal activity.

RESULTS

Injections with Adex1SRLacZL induced lacZ expression as a result of 40 out of 41 injections; the expression level was 10 times higher than that obtained with pSRLacZ. Induced beta-gal activity was detected within 24 h, peaked at 7 days and retained for 2 weeks after gene transfer. A repetitive administration of the same adenovirus at 14 days after the first injection also evoked a reduced but significant level of expression despite neutralizing antibodies to adenovirus in serum. Although injection induced an inflammatory response that peaked at 3 days after injection and gradually subsided without a second peak, the temporal change and the extent of inflammation induced by adenovirus injection was not significantly different from those induced by injection with either saline or plasmid. Neither leakage of enzymes such as CPK or LDH nor alteration in the ECG was detected in the 30 days following gene transfer.

CONCLUSIONS

Our findings demonstrate that a catheter-mediated direct injection with an adenovirus can induce gene expression in the ventricle more efficiently without additional myocardial damage and inflammation compared with injection with a plasmid. A repeat dose of the same adenovirus elicited gene expression at an attenuated but significant level. This method may potentially have clinical applications: in modifying myocardial phenotype and/or improving general circulation under certain circumstances.

[Influence of aging on electrogustometric threshold]

Electrogustometric testing was carried out, with one researcher examining the electrogustometric threshold at three sites, in 461 normal cases, by TR-06 (Rion Co.), over a wide range. A multiple comparison procedure (Tukey-Kramer) was applied to age groups, revealing a significant increase in the threshold with advancing age; high threshold values were observed in the "60s and older" group for the chorda tympani nerve area (tongue tip) and the glossopharyngeal nerve area (tongue base), and in the "70s and older" group for the superficial greater petrosal nerve area (soft palate). As to the gender difference in women, a significant drop was observed in the late teens whereas a low tendency in all sites tested was not statistically, significant in other age groups. Differences between the right and the left sides were seen in most cases but were within 6dB. As to site differences, the soft palate threshold was higher than those of the tongue tip and the tongue base in all age groups. A significant decrease in the threshold of the tongue tip, as compared to the tongue base, was observed for those in their late teens, whereas minimal differences were noted in the other age groups and at other sites. The soft palate threshold was significantly reduced in smokers in their 30s and 40s as compared with non-smokers.

Adenovirus-mediated arterial gene transfer does not require prior injury for submaximal gene expression

We investigated whether gene expression in arterial wall following adenovirus-mediated gene transfer would be enhanced by prior injury. We introduced Escherichia coli lacZ into the balloon-injured canine femoral arteries through a double-balloon catheter by either a replication-defective adenovirus or liposome-mediated transfection (lipofection) using an expression plasmid, and quantified beta-galactosidase activity in arterial homogenates harvested 5 days after gene transfer. Gene expression by lipofection was enhanced six-fold when gene transfer was performed at 3 days, instead of 0 days after injury. However, gene expression achieved by adenovirus infection was not significantly changed irrespective of when gene transfer was performed between 0 and 12 days after injury, and beta-galactosidase activity was 25-fold higher than the enhanced value obtained by lipofection performed 3 days after injury. Our study indicates that submaximal gene expression in arterial wall can be achieved when adenovirus-mediated gene transfer is performed at the same time as angioplasty.