[A patient with aneurysm of extracranial internal carotid artery presenting lower cranial polyneuropathy similar to Tapia's syndrome]

Tapia's syndrome, first described in 1904 by A.G. Tapia, is considered to be a syndrome consisting of ipsilateral hemiplegia of larynx and tongue with spared movement of soft palate. A 61-year-old Japanese woman had been in good health until August 1991, when she developed hoarseness and atrophy of the left side of her tongue. Although she also showed mild disturbance of elevation of bilateral soft palates and loss of taste in the posterior third of her tongue as well, the main symptoms were the paralyses of the ipsilateral larynx and tongue without involvement of the ipsilateral sternocleidomastoid and trapezius muscles. We concluded that she had cranial polyneuropathy similar to that of Tapia's syndrome. A carotid angiography revealed that she has a large aneurysm, which originated from the extracranial internal carotid artery in the region near the skull base. No other abnormal findings were detected by any computed tomography, magnetic resonance imaging or 67Ga-scintigraphy. The patient's lower cranial polyneuropathy was considered to be caused by the aneurysm. A survey of the literature indicates that extracranial carotid aneurysm is an extremely rare cause of Tapia's syndrome. In this case, the location of the aneurysm, which was present considerably distant from the skull base, seems to be the reason for the sparing of the accessory nerve.

Second-harmonic and sum-frequency generation from optically trapped KTiOPO(4) microscopic particles by use of Nd:YAG and Ti:Al(2)O(3) lasers

We describe the single-beam optical trapping of microscopic KTiQPO(4) crystals, using Nd:YAG and Ti:Al(2)O(3) lasers. The high power density of the laser beam at the crystals to be trapped induces the second-harmonic and sumfrequency generation. By changing the wavelength of the Ti:Al(2)O(3) laser, we detect the sum-frequency generation with the fixed wavelength of Nd:YAG laser between 430 and 486 nm for the particle during the trapping.

Age-related decrease in toe-thumb temperature difference with lumbar epidural anaesthesia

With lumbar epidural anaesthesia, big toe skin temperature increases and is associated with a compensatory decrease of thumb temperature. The purpose of the present study was to examine whether thumb-big toe temperature differences were affected by age. Following the attachment of temperature probes at the digital pad of the right big toe and the right thumb, lumbar epidural anaesthesia at L2/3 was performed in 54 patients with 10 ml lidocaine 1.5%. Big toe and thumb skin temperatures were measured continuously and recorded every minute. Fifteen minutes after epidural injection, the toe temperature increased 6.3 +/- 2.1 degrees C (delta F) from the control value, 29.4 +/- 2.2 degrees C, and the thumb temperature decreased -1.5 +/- 1.0 degrees C (delta H) from the control value, 31.6 +/- 2.8 degrees C. Regression coefficient between delta T15 (toe-thumb skin temperature 15 min after epidural injection) and age was: Y = -0.7X + 8.95 (r = 0.35, P < 0.01; Y = delta T15, X = age). The ratio of delta H to delta F and age was expressed as: Y = 0.51X - 46.57 (r = 0.41, P < 0.01: Y = delta H/delta F, X = age). It is concluded that, in lumbar epidural anaesthesia, the decrease of the thumb skin temperature is reduced with aging.

[Clinical analysis of MRSA pneumonia. Niigata Research Group of MRSA.ABK]

Aged or immuno-compromised patients were mostly affected, by pneumonia caused by infection of MRSA, and more than half of the cases were superinfected with glucose-nonfermentative Gram-negative rods including Pseudomonas aeruginosa. These patients were treated with a monotherapy of arbekacin (ABK) by intravenous drip administration or with a combination of ABK and imipenem/cilastatin, ceftazidime or antifungals. The clinical efficiencies were 55.6% in 11 monotherapy cases and 83.3% in combined therapy. MRSA was eradicated in 31.9% of the patients. These results are comparable with, or superior to the vancomycin therapy in the treatment of MRSA pneumonia. When MRSA is isolated from sputum of pneumonia patients, the discrimination between colonization and infection is important, but the diagnosis is very difficult in many clinical cases before the initiation of chemotherapy. The number of bacteria and the grade of inflammation should be carefully scored before starting a chemotherapy.

Virulence region of plasmid pNL2001 of Salmonella enteritidis

The virulence region of the Salmonella enteritidis 55 kb plasmid pNL2001 was identified by Tn1-insertion mutagenesis, DNA hybridization studies, and Western blot analysis of proteins encoded in the virulence region of the plasmid. DNA hybridization studies showed that the pNL2001 plasmid contained a 6.4 kb SalI-EcoRI fragment homologous to the 6.4 kb SalI-EcoRI Salmonella plasmid virulence (spv) region of the S. choleraesuis 50 kb plasmid (pKDSC50). One of the 247 Tn1-insertion mutants of S. enteritidis, designated strain TA19, showed a reduced mouse lethality, and the Tn1-insertion of strain TA19 was located within this homologous 6.4 kb region, suggesting that the 6.4 kb SalI-EcoRI fragment of pNL2001 contained the spv region. Two contiguous SalI-EcoRI fragment were cloned into the expression vectors. By the 6.4 kb SalI-EcoRI fragment were cloned into the expression vectors. By Western blot analysis using four Spv peptide antisera, each specific for individual proteins encoded in the spvR, spvA, spvB and spvC genes of pKDSC50, four proteins encoded in the 6.4 kb SalI-EcoRI fragment of pNL2001 were identified. Protein SpvR with an apparent molecular mass of 32 kDa was produced from the 2.3 kb SalI-EcoRI fragment, and protein SpvA, SpvB and SpvC with apparent molecular masses of 32, 70 and 29 kDa, respectively, were produced from the 4.1 kb EcoRI-EcoRI fragment. From the 4.1 kb EcoRI::Tn1 fragment of the TA19 plasmid, proteins SpvA and SpvB were expressed, but not SpvC. It was therefore suggested that the spvC gene may contribute to the expression of virulence of S. enteritidis. Furthermore, the nucleotide sequence of the 6.4 kb SalI-EcoRI fragment encoding these four proteins was determined. Four open reading frames which encoded the four proteins with deduced molecular masses of 33,906, 28,200, 65,349 and 27,646 Da were detected. Deduced amino acid sequences of each protein showed a high degree of identity to corresponding sequences in the virulence region of S. choleraesuis, S. dublin and S. typhimurium virulence plasmids. Therefore, we confirmed that the virulence plasmids of Salmonellae including S. enteritidis share the highly conserved region responsible for virulence.

Promoting and synergistic effects of chrysazin on 1,2-dimethylhydrazine-induced carcinogenesis in male ICR/CD-1 mice

The modifying effects of chrysazin on 1,2-dimethylhydrazine (DMH)-induced colon and liver carcinogenesis were examined in male ICR/CD-1 mice. Starting at 6 weeks of age, mice were divided into four groups, two of which were treated with s.c. injections of DMH (20 mg/kg body wt) once a week for 12 weeks. A week after the final injection of DMH, one group was kept on the basal diet throughout the study (group I), and the other group was fed the diet containing chrysazin (mixed in basal diet at 0.2% concentration) alone for 42 weeks (group II). The other two groups were injected with normal saline and given the diet containing 0.2% chrysazin for 42 weeks (group III), or the basal diet during the experiment (group IV). The incidence and multiplicity of colon tumors of group II were significantly greater than those of group I (P < 0.05, P < 0.01). The incidence and multiplicity of the hepatocellular neoplasms of group II were larger than those of group I (P < 0.002, P < 0.02 respectively). In group III, colon tumors were not found, though a few liver neoplasms and severe inflammatory lesions of the colon were observed. The activity of ornithine decarboxylase of the colonic mucosa in mice exposed to chrysazin was stronger than that of animals without chrysazin. The results suggest that the promoting effect of chrysazin is probably related to an increase of cell proliferation in the target organ. A synergistic effect of DMH with chrysazin was also observed in liver tumorigenesis.

[Immunological findings of bronchoalveolar lavage fluid (BALF) in sarcoidosis; analysis of soluble CD4 molecule and soluble CD8 molecule]

Since the introduction of bronchoalveolar lavage (BAL) by Reynolds and Newball in 1974, this procedure has been used to characterize the cellular and soluble components of alveolar lining fluid in many interstitial lung diseases. We reviewed BAL fluid findings of clinical and pathophysiologic researches in patients with pulmonary sarcoidosis. Moreover, our recent data about soluble CD4 molecule (sCD4) and soluble CD8 molecule (sCD8) were also described. The sarcoidosis patients had the significantly higher level of sCD4 in BAL fluid compared with normal subjects. The level of sCD8 in serum in active sarcoidosis was significantly higher than that in normal subjects. Furthermore, significant correlation between the levels of serum sCD8 and ACE was observed in sarcoidosis.

The anthocyanin responsible for purplish blue flower colour of Aconitum chinense

The anthocyanin in the purplish blue flowers of Aconitum chinense was identified as delphinidin 3-rutinoside-7-O-(6-O-(4-(6-O-(4-hydroxybenzoyl)-beta-D-glucosyl)oxyb enzoyl- beta-D-glucoside), violdelphin by means of chromatography, FAB-MS including MS-MS, 1H and 13C NMR. The anthocyanin is stable in neutral or slightly acidic aqueous solution and the absorption spectra in the pH range of 4.0-6.2 exhibited three characteristic bands at 534, 569 and 620 nm, which are practically identical with those of purplish blue petals of A. chinense. Thus the purplish blue flower colour is manifested by intramolecular co-pigmentation of the anthocyanin.

Balloon pulmonary valvuloplasty for double outlet right ventricle with valvular pulmonary stenosis

A male neonate presented with cyanosis. Echocardiograms showed a double outlet right ventricle, an absent outlet septum, a subaortic ventricular septal defect and valvular pulmonary stenosis. Balloon pulmonary valvuloplasty was performed at 19 days of age, resulting in an immediate increase of the systemic arterial oxygen saturation from 67 to 87%. As far as could be found, this is the first report of a patient with a double outlet right ventricle without the outlet septum who was clinically observed and underwent balloon pulmonary valvuloplasty.

High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men

BACKGROUND

The objective of this study was to examine the relation of high-density lipoprotein cholesterol (HDL-C) to coronary heart disease in Japanese men whose serum total cholesterol is low by Western standards.

METHODS AND RESULTS

A prospective, observational study based on 7.7 years of follow-up for incidence of coronary heart disease and stroke was conducted. The subjects were 6408 middle-aged male workers aged 40 to 59 years at baseline in urban companies in Osaka, Japan, whose mean serum total cholesterol was 5.10 mmol/L. Mean HDL-C adjusted for age, total cholesterol, systolic blood pressure, alcohol intake, cigarette smoking, and body mass index was 1.27 to 1.28 mmol/L for men who developed coronary heart disease (n = 46) or definite myocardial infarction (n = 21) compared with 1.46 mmol/L for those free of cardiovascular disease (n = 6256; difference, P < .01). There was no significant difference in mean HDL-C between stroke cases (n = 33) and those free of cardiovascular disease. The incidence rates of coronary heart disease and definite myocardial infarction, adjusted for the other risk factors, were three to four times higher in the lowest HDL-C quartile (< 1.24 mmol/L) than the highest quartile (> or = 1.66 mmol/L), and there was a significant dose response for definite myocardial infarction. Serum total cholesterol was positively and significantly associated with coronary heart disease incidence. Furthermore, the inverse association for HDL-C was apparent among men with total cholesterol < 5.69 mmol/L (mean total cholesterol, 4.76 mmol/L) and men with total cholesterol > or = 5.69 mmol/L (mean total cholesterol, 6.26 mmol/L).

CONCLUSIONS

Coronary heart disease incidence is inversely related to HDL-C in urban Japanese middle-aged men, whose mean total cholesterol (5.10 mmol/L) is relatively low.

Electron paramagnetic resonance study on nitric oxide production during brain focal ischemia and reperfusion in the rat

The production of nitric oxide (NO) during brain focal ischemia and reperfusion was measured using diethyldithiocarbamate (DETC)/Fe-citrate, NO trapping reagents, and electron paramagnetic resonance spectroscopy. The NO production is potentiated after 5 min of ischemia, and is continued during 60 min of ischemia. During the reperfusion period after 60 min of ischemia, NO was also produced. However, its production during reperfusion was not observed when the ischemia time was less than 15 min. The NO signal during reperfusion after 60 min of ischemia decreased after 15 min of reperfusion. These results suggest that NO production during ischemia is a physiological reaction for increasing cerebral blood flow, while NO production during reperfusion may be related to cellular damage.

Efficient room-temperature CO laser with high specific output

Efficient room-temperature operation of a fast-axial-flow rf-discharge-excited CO laser is described. A steady-state laser output of 268 W has been obtained with a CO/N(2)/He/Xe/O(2) mixture from a 19-mm-diameter, 300-mm-long discharge. The corresponding electrical conversion efficiency and the specific laser output are as high as 13.5% and 3.15 W/cm(3), respectively. The role of Xe in the mixtures is discussed. The specific laser output achieved is comparable with those of the high-power industrial CO(2) lasers in which a similar excitation scheme is applied.

Generation of optical Haar wavelets by zone plates

Optical Haar wavelets are generated by zone plates that are designed to realize the bipolar nature of Haar wavelets. We present a circular Haar wavelet in two-dimensional space, which can extract the edge and corner features simultaneously, and characterize its properties with computer simulations. A comparison with rectangular Haar wavelets is also given.

Possible involvement of peripheral 5-HT4 receptors in copper sulfate-induced vomiting in dogs

The involvement of visceral afferent fibers and 5-HT3 or 5-HT4 receptors in the vomiting induced by oral administration of copper sulfate was investigated in beagle dogs. Vomiting induced by copper sulfate (100 mg/kg) was inhibited markedly by bilateral abdominal vagotomy and bilateral greater splanchnic nerve section. The vomiting induced by copper sulfate was inhibited by blocking 5-HT4 receptors with high doses (1 and 3 mg/kg, i.v.) of ICS 205-930. On the other hand, blocking 5-HT3 receptors with MDL 72222 (0.5 and 5 mg/kg, i.v.) or low doses (0.01 mg/kg i.v.) of ICS 205-930 had no apparent effect on the vomiting induced by copper sulfate. Oral administration of a 5-HT4 receptor agonist, 5-methoxytryptamine (5-MT), caused vomiting at a dose of 100 mg/kg, and the vomiting was inhibited markedly by abdominal visceral nerve section or a high dose (1 mg/kg, i.v.), but not a low dose (0.01 mg/kg, i.v.), of ICS 205-930. Intravenous administration of 5-MT (10 mg/kg) failed to induce vomiting. These results suggest that the abdominal visceral afferent fibers and possibly peripheral 5-HT4 receptors play an important role in the vomiting induced by oral administration of copper sulfate in dogs.

[Clinical significance of DNA ploidy heterogeneity in early gastric cancers]

To evaluate the clinical significance of DNA ploidy heterogeneity (DH), four or more fresh tissue specimens were obtained from a tumor in 68 resected early gastric cancers. DNA content was measured by flow cytometry and the presence of DH was prospectively investigated. The incidence of DH correlated to invasion depth (m < sm), lymph vessel invasion (negative < positive) and tumor size (10 mm or less in diameter < more than 10). When the criteria of indication for minimum surgery were determined as the intramucosal cancer without n, ly and v factor, 85% of contraindication cases demonstrated DH. These results indicate that DH is a useful marker of tumor progression in early gastric cancer and will be an aid for determining indications for minimum resection.

[Flow cytometric analysis of DNA ploidy in intramucosal gastric carcinoma]

In order to investigate whether or not DNA ploidy was altered in intramucosal gastric carcinomas, nuclear DNA content of biopsy specimen was measured using flow cytometry in 38 intramucosal carcinomas. DNA aneuploidy was detected in 27 of 38 lesions (71.1%), and noted more frequently in differentiated carcinomas than in undifferentiated ones (83.0% vs. 20.0%, p < 0.01). There was no significant relationship between the frequency of DNA aneuploidy and macroscopical type or tumor size. DNA aneuploidy was even found in two of three minute carcinomas (5 mm or less in diameter). DNA indices showed 1.2 or lower values in 40% of the lesions with DNA aneuploidy. The average value of DNA index was significantly larger in depressed type than in elevated type (p < 0.01). In conclusion, DNA ploidy is altered in most differentiated intramucosal carcinomas. A high resolution method is essential for accurate determination of DNA ploidy in intramucosal carcinomas, especially elevated ones.

[Flow cytometric DNA analysis of colorectal carcinoma in adenoma]

We evaluated the DNA ploidy in 23 lesions of colorectal carcinoma in adenoma (CIA) and 90 adenomas without carcinomas by flow cytometry using fresh samples. DNA ploidy of carcinoma and adenoma components were assessed, respectively, with 17 paraffin-embedded samples of CIAs. The incidence of DNA aneuploidy (AP) was significantly higher in CIAs than in adenomas (47.8% vs. 12.2%, p < 0.01). Even in adenoma components of CIAs, AP tended to be found more frequent than in adenomas (41.2% vs. 12.2%). The incidence of AP in adenoma components was similar to that in carcinoma components (35.3%) in CIAs. In conclusion, DNA aneuploidy in adenomas may be a marker of malignant potential.

[MultiCycle software for cell cycle analyses]

MultiCycle software (M-cycle), a computer cell cycle analysis program that has a background debris and aggregation compensating function, was utilized in this study to prove the usefulness of the M-cycle. The S phase fraction (SPF) calculated by the M-cycle was compared to that of bromodeoxyuridine labelling index (BLI) using colorectal carcinoma cell lines. The SPF value was slightly lower using the M-cycle than that of the BLI in Colo 201 and Colo 320 and lower significantly in Widr. This may indicate that the M-cycle effectively compensated for the background existing in the DNA histogram. The SPF value was computed both by the M-cycle and the sum of broadened rectangles model (SOBR). The SPF value of these cell lines showed a lower figure in the M-cycle than in the SOBR. The SPF value of paraffin-embedded material through the M-cycle and the SOBR was compared according to DNA ploidy patterns. The SPF value computed by the M-cycle was significantly lower in both ploidy patterns than that of the SOBR. In conclusion, the M-cycle is a useful tool for cell cycle analyses of simple DNA flow cytometric histograms obtained by paraffin-embedded material.

Arteriovenous differences in PCO2 and cardiac output during CPR in the dog

Using 14 mongrel dogs, we investigated the correlation between arteriovenous differences of PCO2 (AVD-CO2) and cardiac output (CO) during CPR. Ventricular fibrillation was induced by an electrical current and the respirator was stopped for 5 min. Cardiopulmonary resuscitation (CPR) was performed during the next 10 min and CO was measured with simultaneous arterial and venous blood gas analysis. CO was measured 26 times during CPR. The animals were divided into two groups according to the values of CO during CPR: low-CO group (CO < 0.3 l/min) and high-CO group (CO > or = 0.3 l/min). AVD-CO2 in the low CO group was 39.8 +/- 5.7 mmHg and that of the high group was 27.4 +/- 14.8 mmHg (mean +/- S.D., P < 0.05). In conclusion, AVD-CO2 showed an inverse result with the degree of CO during CPR.

Clinical usefulness of an assay for hepatitis C virus core in the diagnosis of non-A, non-B hepatitis and monitoring of the response to interferon therapy

The clinical utility of a new JCC-2 enzyme-linked immunosorbent assay kit that detects and quantitates anti-hepatitis C virus (anti-HCV) core antibodies (anti-HCc) was investigated. Serum samples were obtained from 102 patients with various non-A, non-B liver diseases, including 19 cases of chronic hepatitis type C who had been treated with interferon (IFN). The results of the anti-JCC-2 assay were significantly correlated with serum HCV-RNA positivity. Patients who were HCV-RNA positive exhibited a high rate of positivity for anti-JCC-2 (72.2% in acute hepatitis, > 90% in chronic liver diseases). The geometric mean of the anti-JCC-2 titre was not significantly different among different stages of chronic liver disease (among CPH, CAH and LC). The anti-JCC-2 titre decreased gradually in cases that became HCV-RNA negative after IFN therapy. If HCV-RNA positivity recurred, the anti-JCC-2 titre increased, indicating that serial measurements of the anti-JCC-2 titre are useful for monitoring the antiviral effect of IFN treatment. These results suggest that quantification of anti-HCc by the anti-JCC-2 assay is superior to the semi-quantification of circulating HCV-RNA provided by monitoring of IFN therapy. Monitoring of HCV-RNA status using reverse transcription-nested polymerase chain reaction (RT-nested PCR) is possible, but it is technically demanding and too expensive for routine clinical use.

A novel mutation in Cu/Zn superoxide dismutase gene in Japanese familial amyotrophic lateral sclerosis

Recently, several missense mutations in the Cu/Zn superoxide dismutase gene (SOD1) have been reported as a putative cause of chromosome-21q-linked familial amyotrophic lateral sclerosis (FALS). We have discovered a novel missense mutation (substitution of Thr for Ala4) in exon 1 (GCC to ACC) in two FALS patients from one Japanese FALS family. No mutations were found in 17 cases of sporadic ALS. The enzyme activity of recombinant fusion protein containing the Cu/Zn superoxide dismutase (SOD) with the Ala4-to-Thr mutation was significantly reduced in E. coli. On the other hand, in the expression system in insect cells using Baculovirus, the mutant SOD expressed an enzyme activity as high as wild-type SOD. These results suggest that the stability of SOD with the Ala4-to-Thr mutation is disrupted especially in the fusion protein. Autopsy was carried out on one of the two patients, and the pathological findings were typical of FALS with posterior column involvement. These results raise the possibility that mutation of the SOD1 is responsible for FALS with broader pathological involvement.

Horizontal condylar path in patients with disk displacement with reduction

In 32 patients with disk displacement with reduction, the condylar path in the horizontal plane during opening and closing movements of the mandible were analyzed with a computerized axiograph. The horizontal condylar tracings during opening were divided into 15 types. There was no clear relationship between the types and clinical symptoms. The specific correspondence of the types were revealed between the right and left joint. In 21 of 32 patients, the condyle on one side deviated medially, while the contralateral condyle deviated laterally at maximum opening. In most of the patients showing medio-lateral condylar deviation at maximum opening, a straight condylar path was observed from the maximum opening to the position just before the closing click. In some of the patients, the type of horizontal condylar tracing during opening was related to the displacement pattern of the disk assessed by magnetic resonance imaging (MRI).

Expression of cytokines, TNF-alpha and IL-1 alpha, in MAM acetate and 1-hydroxyanthraquinone-induced colon carcinogenesis of rats

The expression of cytokines, TNF-alpha and IL-1 alpha, was examined by means of a reverse transcription followed by PCR (RT-PCR) in rat colon carcinogenesis. Forty male F344 rats were used and divided into four groups. At the start of the experiment, 20 rats were treated with methylazoxymethanol (MAM) acetate (25 mg/kg body wt, one time, i.p.) and divided into two groups; group 1 was exposed to 1% 1-hydroxyanthraquinone (1-HAQ) and group 2 was fed a basal diet during the experiment (40 weeks). Other rats were also divided into two groups; group 3 was exposed to 1% 1-HAQ as group 1, and group 4 was used as control. Tumor incidence (100%) and multiplicity (5.00 +/- 2.05) in group 1 were significantly greater than those in group 2 (20% and 0.2 +/- 0.42) and group 3 (10% and 0.10 +/- 0.32) (P < 0.01 and P < 0.01 respectively). RT-PCR technique with RNA was applied to the tissues from colon neoplasms and mucosa in each group. Expression of TNF-alpha and IL-1 alpha in the colon neoplasms was much stronger than that in the colon mucosa of each group (P < 0.001 and P < 0.01 respectively). The expression of TNF-alpha was more remarkable in the colon mucosa of group 1 than that in corresponding tissue of groups 2 and 3 (P < 0.01). The expressions of TNF-alpha and IL-1 alpha were more increased in the colon mucosa of groups 1, 2 and 3 than that in group 4 as control (P < 0.01 and P < 0.05 respectively). The results indicate that TNF-alpha and IL-1 alpha may act as growth factors in rat colon carcinogenesis by MAM acetate and 1-HAQ. In addition, the synergistic effect of 1-HAQ with MAM acetate in colon carcinogenesis might be related to biological effects of the cytokines expressed in the inflammatory condition generated by 1-HAQ.