Cytotoxicity of commercial and novel binary titanium alloys with and without a surface-reaction layer

Titanium-based alloys form a surface reaction layer when cast. This study investigated the effect of the surface reaction layer on the cytotoxicity of novel Ti-based binary alloys. The cytotoxicities of the novel alloys were compared with commercially pure titanium, Ti-6Al-4V and Ti-6Al-7Nb. Cast discs with or without the reaction layer were first tested for cytotoxicity, then for elemental release into cell-culture medium. The elements released into the extracts were measured by means of an inductively coupled plasma atomic emission spectrometer. The commercial and novel binary Ti-based alloys showed no statistically significant cytotoxicity, although some trends were noted for several alloys. The presence of the reaction layer did not significantly alter the cytotoxicity. These favourable biocompatibility results show that these novel alloys have promise for use in dental restorations.

SEM/EDS evaluation of porcelain adherence to gold-coated cast titanium

The adhesion between titanium and dental porcelain is related to the diffusion of oxygen to the reaction layer formed on cast-titanium surfaces during porcelain firing. The diffusion of oxygen could be suppressed by coating the titanium surface with a thin gold layer. This study characterized the effects of gold coating on titanium-ceramic adhesion. ASTM grade II CP titanium was cast into a MgO-based investment (Selevest CB, Selec). The specimen surfaces were air abraded with 110-microm Al(2)O(3) particles. Gold coating was applied on titanium surfaces by three methods: gold-paste (Deck Gold NF, Degussa-Ney) coating and firing at 800 degrees C for three times, single gold-paste coating and firing followed by sputter coating (40 mA, 500 s), and sputter coating (40 mA, 1000 s). Surfaces only air abraded with Al(2)O(3) particles were used as controls. An ultra-low-fusing dental porcelain (Vita Titankeramik, Vident) was fused on titanium surfaces. Specimen surfaces were characterized by SEM/EDS and XRD. The titanium-ceramic adhesion was evaluated by a biaxial flexure test (N = 8), and area fraction of adherent porcelain (AFAP) was determined by EDS. Numerical results were statistically analyzed by one-way ANOVA and the Student-Newman-Keuls test at alpha = 0.05. SEM fractography showed a substantial amount of porcelains remaining on the gold-sputter-coated titanium surfaces. A new Au(2)Ti phase was found on gold-coated titanium surface after the firing. Significantly higher (p <.05) AFAP values were determined for the gold-sputter-coated specimens compared to the others. No significant differences were found among the other groups and the control. Results suggested that gold coatings used in this study are not effective barriers to completely protect titanium from oxidation during the porcelain firing, and porcelain adherence to cast titanium can be improved by gold-sputter coating used in the present study.

Leaching from solid waste incineration ashes used in cement-treated base layers for pavements

Waste incineration bottom ash and treated flue gas cleaning products mixed with 2.5% of cement (50 kg/m3) were tested in the laboratory in terms of compressive strength and tank leaching tests over a 64-day period. Although the material displayed lower mechanical strength than a reference concrete, the strength still was sufficient for use as a base layer for roads. The metal content in the incineration-residue-based specimens was up to 100 times higher than in the reference concrete, suggesting that the mixed waste incineration residue should be used only for dedicated purposes. The leaching of Cl and Na was increased by a factor of 20-100 from the incineration-residue-based specimens as compared to the reference, while the leaching of K, Ca and SO4 was increased by a factor of 2-10. The leaching of heavy metals was also higher from the incineration-residue-based specimens than from the reference with respect to Cu (50 times), Cd, Pb and Zn (5 times), but not with respect to Cr and Ni. The leaching curves did only allow for a closer evaluation of the leaching process in a few cases. The physical retention of the constituents seemed to be the same in the reference as in the incineration-residue-based specimens. Heavy metal leaching was limited by enhanced chemical retention in the incineration-residue-specimens as compared to the reference. Since no quality criteria in terms of leaching from a monolithic material are currently available, the leaching issue must be evaluated case by case.

Corrosion behavior of cast titanium with reduced surface reaction layer made by a face-coating method

This study characterized the corrosion behavior of cast CP titanium made with a face-coating method. Wax patterns were coated with oxide slurry of Y(2)O(3) or ZrO(2) before investing with a MgO-based investment. Three surface preparations were tested: ground, sandblasted, and as-cast. Uncoated castings served as controls. Sixteen-hour open circuit potential (OCP) measurement, linear polarization and potentiodynamic cathodic polarization were performed in an aerated modified Tani-Zucchi synthetic saliva at 37 degrees C. Anodic polarization was conducted in the same deaerated medium. Polarization resistance (R(p)) and Tafel slopes were determined. Corrosion current density was calculated for each specimen. Results (n=4) were subjected to nonparametric statistical analysis (alpha=0.05). Cross sections of cast specimens were examined by optical microscopy. Energy dispersive spectroscopy (EDS) spot analysis was performed at various depths below the surface. The OCP stabilized within several hours for all the specimens. Apparent differences in anodic polarization behavior were observed among the different surfaces. A distinctive wide passive region followed by breakdown was seen on specimens with ground and sandblasted surfaces. There were no significant differences in the corrosion resistance among the control and the two face-coating groups for each group. The Mann-Whitney test showed significantly lower OCP and higher R(p) values for ground surfaces. The surface condition significantly affected the corrosion behavior more than the face coating methods. In most cases, specimens with as-cast surfaces exhibited the least corrosion resistance during the potentiodynamic anodic polarization.

Vascular endothelial growth factor (VEGF) expression and the effect of exogenous VEGF on survival of a random flap in the rat

The induction of endogenous vascular endothelial growth factor (VEGF) production in the skin flap with ischemic injury and the effect of exogenous VEGF on survival of the ischemic skin flap were studied in rats. A dorsal flap model (3x10 cm(2)) was used in this study. In Part I, biopsies were taken from the flap at 2.5, 5.5, and 8.5 cm distances from the distal edge at 0, 6, 12, and 24 h after the flaps were sutured. Malonyldialdehyde (MDA) and VEGF(165) protein level were measured. In Part II, exogenous VEGF (1 microg/ml) was injected subdermally into the flaps in 14 rats before the flaps were replaced. Flaps that received a saline injection were used as the controls. The skin paddle survival was measured on postoperative day five. The results showed that the MDA level in the distal part of the flap significantly increased at 24 h postoperatively when compared to MDA in other parts of the flap. However, VEGF levels in the distal part of the flap significantly decreased when compared to the middle part of the flap. Subdermal injection of exogenous VEGF to the distal area of the flap could significantly improve survival of the distal flap (89% of total skin paddle) when compared to the control, which had a 64% mean percent survival. We conclude that production of endogenous VEGF protein is significantly increased in the skin flap with mild ischemia, but decreased in the flap with severe ischemia. Administration of exogenous VEGF could significantly enhance survival of ischemic flaps.

Measurement of the spatial coherence function of undulator radiation using a phase mask

A measurement of the horizontal coherence function of 7.9 keV radiation from an undulator beam line at the Advanced Photon Source is reported. X-ray diffraction from a phase-shifting mask was used, and the coherence function was measured as a function of the width of beam-conditioning slits in the beam line. The coherence distribution is found to be best described by a Lorentzian function.

The complete nucleotide sequence of Beet black scorch virus (BBSV), a new member of the genus Necrovirus

The complete nucleotide sequence of Beet black scorch virus (BBSV) was determined. The BBSV genome is composed of 3641 nucleotides and has similar organization with Tobacco necrosis virus D of 61% nucleotide identity. The 5'-proximal open reading frame (ORF) encodes a putative 23 kDa protein and a 82 kDa protein by reading-through of an amber termination codon. Three small ORFs located in the center of the genome may encode for a 4.2 kDa protein and two 7 kDa proteins. The 3'-proximal ORF encodes a 24.5 kDa protein equivalent in mass to the viral coat protein. Considering biological and molecular similarities with TNV, it is concluded that BBSV is a new member of the genus Necrovirus.

Realities of high-throughput liquid chromatography/mass spectrometry purification of large combinatorial libraries: a report on overall sample throughput using parallel purification

We report on the development of a validated, streamlined high-throughput process for the purification of parallel-synthesis-derived combinatorial libraries. The steps involved in this library purification process include dissolution of dry films of crude synthetic material, dual-column LC/MS purification, dual-column postpurification analysis, quantitation, reformatting, and submission of pure compounds for registration. Although the purification and postpurification analysis times decreased essentially linearly as a function of the number of HPLC columns employed, it was not possible to decrease the total purification process time linearly as a function of the number of columns employed in the system. This was due primarily to the fact that numerous steps in the total purification process are independent of sample analysis and purification (e.g., evaporation, reconstitution, and reformatting, etc.). Additionally, experiments were also performed to assess whether separate gradient pumps were necessary for each channel of this two-channel LC/MS or if acceptable results could be reliably obtained by splitting the flow from one set of gradient pumps between two HPLC columns. On the basis of the parallel, two-column LC/MS system employed in this work, throughput estimates were extrapolated to more massively parallel systems (e.g., four-channel LC/MS).

Observation of columnar microstructure in step-graded Si1-xGex/Si films using high-resolution X-ray microdiffraction

Columnar microstructure in step-graded Si(1-x)Ge(x)/Si(001) structures with low threading dislocation densities has been determined using high angular resolution (approximately 0.005 degrees ) x-ray microdiffraction. X-ray rocking curves of a 3-microm-thick strain-relaxed Si(0.83)Ge(0.17) film show many sharp peaks and can be simulated with a model having a set of Gaussians having narrow angular widths (0.013 degrees -0.02 degrees ) and local ranges of tilt angles varying from 0.05 degrees to 0.2 degrees. These peaks correspond to individual tilted rectangular columnar micrograins having similar (001) lattice spacings and average areas of 0.8 to 2.0 microm(2).

Accuracy of sampling methods in morphometric studies of human sural nerves

The aim of this study was to ascertain the minimum sample required to accurately measure the total number of myelinated fibres, mean myelinated fibre density (MFD), myelinated fibre diameter (Ds) and axonal diameter (Da) in morphometric studies of sural nerve biopsies. Measurements were obtained by sampling a single fascicle or systematic sampling of up to 50% of the total transverse fascicular area of two control and eighteen pathological sural nerves showing varying degrees of demyelination and axonal degeneration. MFD and fibre size were heterogeneous between fascicles in both control and pathological sural nerves, and morphometric results from one fascicle and systematic sampling of up to 50% of the total transverse fascicular area did not accurately represent the whole myelinated fibre population in the sural nerve. For accurate morphometric data it is necessary to quantitate all the myelinated fibres in the sural nerve.

X-ray microdiffraction images of antiferromagnetic domain evolution in chromium

Magnetic x-ray diffraction combined with x-ray focusing optics was used to image individual antiferromagnetic spin density wave domains in a chromium single crystal at the micron scale. The cross section for nonresonant magnetic x-ray scattering depends on the antiferromagnetic modulation vector and spin polarization direction and allows these quantities to be extracted independently. The technique was used to show that the broadening of the nominally first-order "spin-flip" transition at 123 kelvin, at which the spins rotate by 90 degrees C, originates at the walls between domains with orthogonal modulation vectors. During cooling, the transition begins at these walls and progresses inward. The modulation vector domains are themselves unchanged.

[A comparative morphometrical study on development of anterior septonasal accessory organs in the cleft palate mice]

OBJECTIVE

The aim of this study was to investigate whether cleft palate is associated with the mal-development of the vomer, Jacobson's organ and para-septal cartilage.

METHODS

Sixty craniomaxillary complexes, which came from 30 pairs of trisomy 18 with cleft palate (Ts + CP) and euploid mouse fetuses were precisely orientated in the coronal plane, and serially sectioned at 7 microns thickness. With the aid of computer imaging analysis system the vomer in coronal and sagittal direction, Jacobson's organ and para-septal cartilage in the boundary plane of the primary and secondary palate were measured and compared quantitatively.

RESULTS

The hard tissues (including the vomer and para-septal cartilage) of the anterior nasal septum in Ts + CP foetuses show serious developmental hypoplasia, however, the Jacobson's organ had no significant different between the cleft and non-cleft samples.

CONCLUSION

Development hypoplasia of these hard tissues may be more closely related with the autosomal trisomic condition more than the cleft palate.

[Applied study on computerized quantitative facial nerve functional estimating system]

OBJECTIVE

To prove the clinical applied value of quantitative facial nerve functional estimating system (QFES) by comparing the estimating results of the computerized QFES with manual QFES.

METHODS

50 volunteers with normal facial nerve function were used. Every volunteer was taken 7 photos with digital camera, which including static, and forehead wrinkle, eyebrows knit tight, eyes closed tight, nose wrinkle, smile, pout and mouth open to maximal seven expressions. The facial nerve function was estimated by computerized QFES, and the estimating results were compared with manual estimations by QFES in our study during 1991-1994.

RESULTS

All estimating indices in this study were in the range of 0.70-0.90 as well as the manual estimating results. However, the stand deviation in this study showed significantly smaller than the previous study.

CONCLUSIONS

QFES is an ideal quantitative facial nerve functional estimating system, after computerization the efficiency is increased and the systemic error is decreased. It will benefit to apply computerized QFES in the facial nerve function estimating fields.

Overexpression of Ogt reduces MNU and ENU induced transition, but not transversion, mutations in E. coli

Studies of alkylation-induced mutations in Escherichia coli FX-11 revealed that both N-ethyl-N-nitrosourea (ENU) and N-methyl-N-nitrosourea (MNU) produced tRNA suppressor mutations (G:C to A:T) but only ENU produced a significant number of backmutations (A:T to G:C, A:T to T:A and A:T to C:G). Further, the ENU-induced transversions were absent in a UmuC-defective strain. This suggested that transition mutations could result from alkylation of guanine or thymine at the O(6)- and O(4)-positions, respectively, but that transversions might result from alkylation of thymine at the O(2)-position. To test this idea, the gene encoding O(6)-alkylguanine-DNA methyltransferase (ogt) was recombined into a plasmid to overexpress the cellular levels of this enzyme. Ogt protein can de-alkylate O(6)-alkylguanine and O(4)-alkylthymine, but not O(2)-alkylthymine. Cells harboring the plasmid (or a control plasmid lacking the ogt gene) were exposed to different concentrations of MNU or ENU and the resulting mutations were analyzed. With either MNU or ENU, the frequency of GlnV(o) suppressors was reduced about 70-fold in the Ogt-overexpressing cells, suggesting that Ogt eliminated O(6)-alkylguanine. Similarly, GlnU(o) suppressor frequencies were substantially reduced. In contrast, the reduction in frequency for the backmutations was slight, only about 2.5-fold with MNU and less than two-fold for ENU. However, DNA sequence analysis of the backmutations showed that only A:T to G:C transitions were affected by overexpression of Ogt, suggesting repair of O(4)-alkylthymine. The frequency of transversions, in comparison, was essentially unaltered. These results implicate O(2)-alkylthymine as a likely candidate for transversion mutagenesis induced by ENU.

Phase sensitive x-ray diffraction imaging of defects in biological macromolecular crystals

Conventional x-ray diffraction topography is currently used to map defects in the bulk of protein crystals, but the lack of sufficient contrast is frequently a limiting factor. We experimentally demonstrate that this barrier can be circumvented using a method that combines phase sensitive and diffraction imaging principles. Details of defects revealed in tetragonal lysozyme and cubic ferritin crystals are presented and discussed. The approach enabling the detection of the phase changes of diffracted x rays should prove to be useful in the study of defect structures in a broad range of biological macromolecular crystals.

Analysis of genes differentially expressed in astrocytes stimulated with lipopolysaccharide using cDNA arrays

We used cDNA arrays to investigate differentially expressed genes in astrocytes challenged with lipopolysaccharide (LPS). Astrocyte cultures were prepared from 1-day-old rat brains. Purified astrocytes were treated with LPS (1 microg/ml) for 2, 8 and 48 h. Differentially expressed genes in these astrocytes were examined with Atlas rat cDNA arrays. At all the three time points studied, three genes were found consistently up-regulated: I-kappaB alpha chain, NF-kappaB, and interferon induced protein. In addition to these three, six other genes were also up-regulated at 2 and 8 h. They were genes encoding vascular cell adhesion protein 1 (VCAM-1), interferon regulatory factor 1 (IRF-1), mitochondrial hydroxymethylglutaryl-CoA synthase (HMG-CoA synthase), aldehyde dehydrogenase 2, macrophage inflammatory protein 1 (MIP-1) and neurotensin receptor 2. At these two time points, three genes were down-regulated: copper-zinc-containing superoxide dismutase 1 (SOD-1), insulin-like growth factor binding protein 1 (IGFBP-1), and insulin-like growth factor binding protein 3 (IGFBP-3). Expression of several differentially expressed genes in cDNA array (I-kappaB, VCAM-1 and MIP-3) were further confirmed by reverse transcription polymerase chain reaction study. The prominently modulated genes could be classified into three categories: nuclear transcription factors, pro-inflammatory cytokines/chemokines and metabolic enzymes. Application of pyrrolidine dithiocarbamate, an inhibitor of nuclear factor-kB (NF-kappaB), prior to LPS stimulation not only prevented up-regulation of NF-kappaB gene expression, but also completely blocked up-regulation of pro-inflammatory cytokine genes (TNF-alpha and interleukin-1beta) and two chemokine genes: CXC chemokine LIX and CC chemokine MIP-3 alpha. These results indicate that both up-regulation of inflammatory cytokine expression and down-regulation of growth factor expression are probably involved in the response of astrocytes upon exposure to LPS.

A quantitative histochemistry technique for measuring regional distribution of acetylcholinesterase in the brain using digital scanning densitometry

Studies of brain acetylcholinesterase (AChE) are traditionally based on biochemical assays, immunoreactivity, and histochemistry. Conventional histochemistry yields rich morphological data from tissue sections but yields quantitative results only with great difficulty. Several histochemical methods developed in recent years, including microdensitometry, microphotometry, and video-based histochemistry, are effective in quantitative and detailed study of AChE in tissue sections. However, they are usually time-consuming. As we report here, we adapted digital scanning densitometry to quantitate AChE histochemical staining in brain sections. The AChE and butyrylcholinesterase (BuChE), as measured by the method, were heterogeneously distributed throughout the brain, results that are consistent with those obtained by biochemical methods. The staining intensity is dependent on section thickness, substrate concentration, and reaction time. The cholinesterase inhibitor methyl paraoxon significantly decreased AChE staining intensity. Furthermore, data acquired from densitometry are similar to those obtained by video-based microscopy or by spectrophotometry. The advantage of the densitometric measurements compared to other quantitative histochemical methods is that it is very rapid while collecting data that are equivalent in quality. Because the digital scanning densitometers provide high quality and sensitive imaging, wide dynamic ranges, and convenient image analysis software, they are very useful tools in quantitative histochemistry.

Effect of heat treatment on mechanical properties of age-hardenable gold alloy at intraoral temperature

OBJECTIVE

The aim of this study was to investigate the effect of various heat treatments on the mechanical properties of gold alloys capable of age-hardening at intraoral temperature.

METHODS

Dumbbell-shaped patterns (ISO 6871) were cast with three gold alloys (Sofard; NC Type-IV; Aurum Cast, NihombashiTokuriki Co.). The Sofard alloy is age-hardenable at intraoral temperature. The castings underwent various heat treatments [as-cast (AC); solution treatment (ST); high-temperature aging (HA); intraoral aging (IA)]. After these heat treatments, ultimate tensile strength (UTS), 0.2% offset yield strength (YS), and elongation (EL) were measured at a strain rate of 1.7x10(-4)/s. Fracture surfaces of the specimens after tensile testing were observed using SEM. Vickers hardness was also measured after heat treating.

RESULTS

After IA, the hardness values of the Sofard alloy increased and reached values similar to the hardness of the Sofard specimens aged at high temperature (HA). The hardness values of the NC Type-IV and Aurum Cast specimens slightly increased after IA, but did not reach the values of the specimens after HA. All the Sofard, NC Type-IV and Aurum Cast specimens showed significantly (P<0.05) greater hardness values after HA, compared with the values after any other heat treatments (AC, ST and IA). The UTS and YS of the specimens indicated a tendency similar to the results obtained for hardness. The Sofard specimens with ST showed the greatest elongation compared to the corresponding NC Type-IV and Aurum Cast specimens. However, the elongation of the Sofard specimens was abruptly reduced after intraoral aging.

CONCLUSION

Intraoral aging significantly improved the mechanical properties and hardness of the Sofard alloy.

National survey on prevalence of cancer pain

OBJECTIVE

To collect nationwide basic data about cancer related pain.

METHODS

Sixty cancer patients in each province were randomly selected to participate in this survey. The subjects represented all stages of cancer, tumor sites, and different demographic characteristics. Two self-designed structured questionnaires including reasons, types of pain and pain management were used by patients and physicians respectively. Subjects were asked to report whether he/she had experienced any type of cancer related pain and filled out the equivalent questionnaire. The severity of pain was assessed by using "visual analogue scale". Original data input and analysis were using EPI-INFO software package.

RESULTS

The result showed that 61.6% (958/1555) of patients had different types of cancer related pain. Majority of pain (85.1%) were caused by advanced cancer. The major reasons (64.4%) for poor management or impedimental factors of pain care are due to patient including over-concern on opioid analgesic addiction, reluctance to report pain or refused to use opioid analgesic until at times when pain is intolerable; 26.8% belonged to physician's reasons including fear to cause addiction on opioid and lack of knowledge about cancer pain management; 16.2% are due to lack of different kinds of opioid analgesic for use and 16.1% belonged to drug regulation.

CONCLUSIONS

The results showed that majority of patients (61.6%) had different types of cancer related pain. In most of patients, cancer pain was relieved when they were treated. The major reason for under-treatment or impeded factors for effective relief of cancer pain was fear of opioid addiction by both medical professionals and patients.

[Schizophrenia and dopamine D4 gene polymorphism in Chinese population: association analysis]

OBJECTIVE

To investigate the association of the 48 bp variable number tandem repeat (VNTR) polymorphism in the dopamine D4 receptor (DRD4) gene exon III with schizophrenia in Chinese Han population.

METHODS

Case-control association study was adopted to analyze the association between the 48 bp VNTR polymorphism of DRD4 gene exon III in 510 DSM-IV schizophrenics and 171 psychiatrically normal controls.

RESULTS

(1) The DRD4 gene 48 bp VNTR polymorphism was manifested as 2-7 repeats, with the 4 repeats the most common (78.6% in schizophrenics and 76.9% in controls respectively). The frequency of 2 repeats was 16.2% and 19.3% in the schizophrenics and controls respectively. (2) The genotypic frequency was statistically significantly different between the schizophrenics and the controls. The genotypic frequency of short tandem repeats (2/2 and 2/3 genotype) was lower in patients (3.3%) than in controls (10.5%) (chi 2 = 14.88, df = 2, P = 0.00). (3) the frequency of the genotype with 4-repeat allele in patients was higher (95.9%) than in controls (88.3%) (chi 2 = 13.00, df = 1, P = 0.000).

CONCLUSION

The most common allele in Chinese schizophrenics was 4 repeats in the 48 bp VNTR polymorphism of DRD4 gene exon III. The repeat number of 48 bp is probably associated with schizophrenia. Lack of 2-3 repeats or excess of genotype with 4-repeat allele may be associated with increased vulnerability to schizophrenia.

[Aminopeptidase inhibitor Bestatin induces HL-60 cell apoptosis through activating caspase 3]

OBJECTIVE

To study the variation and significance of caspase 3 activity in the process of amino-peptidase inhibitor--bestatin (BS) inducing human leukemic cell apoptosis.

METHODS

Cell apoptosis was evaluated by light microscopy, TUNEL labeling and flow cytometry (FCM). Caspase 3 activity was detected by colorimetry. The mitochondrial transmembrane potentials (DeltaPsi(m)) were detected by Rhodamine123 staining.

RESULTS

The apoptotic morphology, apoptotic peak on FCM and positive Annexin V(FITC) on cell membrane showed that BS could induce HL-60 cell apoptosis in a dose- and time-dependent manner. Caspase 3 activity was significantly higher in the apoptotic cells than in control cells. The apoptosis induced by BS was inhibited by AC-DEVD-CHO. The DeltaPsi(m) of cells treated with BS declined.

CONCLUSION

BS induces apoptosis of human acute leukemic cells through activation of caspase 3.

Focal myelin swellings and tomacula in anti-MAG IgM paraproteinaemic neuropathy: novel teased nerve fiber studies

Focal myelin swellings and tomacula in teased nerve fibers from a case of IgM anti-myelin-associated glycoprotein (MAG) paraproteinaemic neuropathy were examined using a novel technique. Five different morphologic abnormalities were identified--myelin sheath outfolding, myelin sheath infolding, enlargement of the adaxonal space, myelin degeneration, multiple increased concentric loops--and a combination of these structural abnormalities often occur in association with myelin degeneration. Similar structural changes were found in externally normal segments of teased fibers without evidence of myelin swelling or tomacula from the same case. These structural abnormalities are consistent with a disturbance of the normal adhesion functions of MAG in the maintenance of axon-myelin relationships.