A novel fluorescent derivative of glucose applicable to the assessment of glucose uptake activity of Escherichia coli

A novel fluorescent derivative of glucose was synthesized by reacting D-glucosamine and NBD-Cl. The TLC analysis of the reaction mixture showed the generation of a single spot with intense fluorescence (lambda Ex = 475 nm, lambda Em = 550 nm). The obtained novel fluorescent product, which was identified as 2-(N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)-2-deoxyglucose (2-NBDG) by 1H-NMR and FAB-MS spectrometries, was applied to the assessment of the glucose uptake activity of Escherichia coli B. 2-NBDG accumulated in living cells and not in dead cells. The uptake of 2-NBDG was competitively inhibited by D-glucose and not by L-glucose, which suggested the involvement of the glucose transporting system in the uptake of 2-NBDG. 2-NBDG taken into the cytoplasma of E. coli cells was supposedly converted into another derivative in the glucose metabolic pathway.

1,25-Dihydroxyvitamin D3 increased beta-adrenergic adenylate cyclase response of fetal rat keratinizing epidermal cells (FRSK cells)

Using fetal rat keratinizing epidermal cells (FRSK), the effects of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on adenylate cyclase system were investigated. The beta-adrenergic adenylate cyclase response was significantly increased by the stimulation of 1 x 10(-7) M 1,25(OH)2D3. The effect was observed by 6 h and continued for at least 48 h. The 1,25(OH)2D3-induced beta-adrenergic augmentation effect was dose-dependent and the maximal response was observed at a concentration of 1 x 10(-7) M 1,25(OH)2D3. Other adenylate cyclase systems (adenosine, prostaglandin E2 and histamine) were not affected by treatment with 1,25(OH)2D3. The thymidine incorporation in FRSK cells was not significantly affected by 1,25(OH)2D3 treatment. Forskolin-induced cyclic AMP accumulation was significantly increased by 1,25(OH)2D3 treatment. Cholera toxin-induced cyclic AMP accumulation was moderately increased, but this was statistically not significant. Northern blot hybridization showed that none of the mRNAs (the beta 2-adrenergic receptor, the alpha subunits of the stimulatory or inhibitory guanine nucleotide binding proteins, Gs alpha, Gi2 alpha, Gi3 alpha) were significantly altered by 1,25(OH)2D3 treatment. We have already reported that the beta-adrenergic response was increased by dexamethasone and inhibited by retinoids in FRSK cells. The addition of both 1,25(OH)2D3 and dexamethasone to the incubation medium resulted in an additive augmentation. On the other hand, the beta-adrenergic augmentation by the 1,25(OH)2D3 treatment was suppressed by the addition of all trans-retinoic acids. Our results indicate that 1,25(OH)2D3 induces beta-adrenergic augmentation without an alternation of thymidine incorporation of FRSK cells.

[Serial changes of SPECT and MRI findings in a patient with herpes simplex encephalitis]

We report a case of herpes simplex encephalitis in which the patient was repeatedly examined by magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). The patient was a 36 year-old woman who had been transferred to our institution 6 days after the onset of symptoms with mild consciousness disturbance, nuchal rigidity, and high fever. Cerebrospinal fluid examination revealed an elevated mononuclear cell count with normal sugar concentration. Intravenous aciclovir was started 7 days after the onset of symptoms. The initial plain computed tomography (CT) scans did not reveal any abnormal findings, but contrast enhanced CT the next day showed a slight enhancement effect around the affected middle cerebral artery. Serial MRI showed the initial high intensity lesion starting on the medial cortex of the temporal lobe, then spreading to throughout the entire temporal lobe. During this period SPECT showed a marked, broad hot spot in the temporal lobe. The medial temporal lobe was high density on the CT 15 days after the onset. As the encephalitic lesion spread more laterally, the hot spot on SPECT moved laterally and then decreased in activity. Eleven weeks after the onset, the MRI showed intracerebral vacuolization of the lesion and it appeared as a wide cold spot on SPECT. The cause of the hot spot seen in the acute period was thought to be vasoparalysis of the affected area rather than breakdown of the blood-brain barrier, or impaired washout of the isotope, because the SPECT images after acetazolamide administration showed the cold spot even in the subacute phase.

Mucosa-associated lymphoid tissue in middle ear and Eustachian tube in children

The presence of mucosal lymphoid follicles with germinal centers, so called mucosa-associated lymphoid tissue (MALT), in the Eustachian tube (ET) and middle ear (ME) was investigated in 23 human temporal bones containing the entire ET obtained from 23 children, 3 months to 10 years old at death. Greater numbers of MALTs were found in specimens from children with otitis media (OM) than from those without OM. MALT showed a wedge-shaped distribution through the ME and ET: in all 3 specimens that had MALTs in the ME, these tissues were seen throughout the ET; in all 4 specimens with MALTs in the bony portion of the ET, these tissues were present both in the tympanic and pharyngeal portions of the cartilagines ET; all 7 specimens that had MALTs in the tympanic half of the cartilagines ET had MALTs in the pharyngeal portion of the cartilagines ET as well. Furthermore, MALTs were noted in the pharyngeal portion of the ET in more than half of the specimens without OM but in none of the MEs of specimens without OM. These results support the hypothesis that persistent and recurrent inflammation in the nasopharynx spreads through the ET to play a role in the pathogenesis of chronic OM in children.

Relationships between fiber composition and NMR measurements in human skeletal muscle

The purpose of this study was to examine the relationships between the relative contents of phosphocreatine (PCr), inorganic phosphate (Pi), beta-adenosine triphosphate (ATP), and transverse relaxation time (T2) with fiber composition, which determined histochemically in the human skeletal muscle. The vastus lateralis muscles of 28 volunteers were subjected to phosphorus nuclear magnetic resonance (31P NMR) spectroscopy, magnetic resonance imaging (MRI) and muscle biopsy. Muscle fibers were divided into type I and type II fibers using myosin ATPase stain. A wide range of fiber composition levels were observed in the subjects (27.3-74.6% type I fibers). The PCr/ATP, Pi/ATP and (PCr + Pi)/ATP ratios were positively related to the percentage of type II fibers (r = 0.695, p < 0.001, r = 0.429, p < 0.05 and r = 0.773, p < 0.001, respectively). There was no correlation between fiber composition and the PCr/Pi ratio (r 0.127, n.s.) or intracellular pH (r = 0.305, n.s.). Moreover, no correlation was found between T2 and fiber type (r = 0.144, n.s.). These results suggest that 31P NMR can detect the differences in relative content of phosphates between type I and type II fibers, thereby noninvasively evaluating fiber composition in human skeletal muscle.

Targeting chemotherapy for malignant brain tumor using thermosensitive liposome and localized hyperthermia

Thermosensitive liposomes are microscopic vesicles that can contain drugs and release them effectively in response to hyperthermia. To deliver an antitumor drug specifically to brain tumor, the authors used thermosensitive liposomes containing cis-diamminedichloroplatinum (CDDP) in conjunction with localized brain heating. The authors then investigated the antitumor effect on rat malignant glioma. Rous sarcoma virus-induced malignant glioma cells were transplanted into the brains of Fisher rats. Ten days after tumor inoculation, the rats were assigned to one of six treatment groups: control, free CDDP, hyperthermia, free CDDP + hyperthermia, liposomes containing CDDP (CDDP-liposome), and CDDP-liposome + hyperthermia. Liposomes containing CDDP or free CDDP were injected via the tail vein. Brain tumor heating was administered by means of a radiofrequency antenna designed at our institute. The rats treated with CDDP-liposome + hyperthermia had the longest survival time and the tumor CDDP level of this group was the highest when compared to the other groups. Histopathological examination showed that tumor cells were necrotized but surrounding normal brain tissue remained undamaged. On the basis of these findings we suggest that the combination of thermosensitive liposome and localized hyperthermia may better focus antitumor drugs to the tumor, providing a significantly greater antitumor effect.

The relationship between the intrauterine environment and blood pressure in 3-year-old Japanese children

In 195 Japanese children the systolic pressure at 3 years of age was inversely correlated to the body weight at birth and positively correlated to the mothers' systolic pressure during pregnancy: the average systolic pressure in children whose body weight at birth exceeded 3510 g was 3.0 mmHg, which was lower than that of children whose body weight at birth was 2990 g or less. There was an increase of 0.12 mmHg in the children's systolic pressure with each increment of 1 mmHg in the systolic pressure of their mothers. The systolic pressure at 3 years in children of mothers who had had pretibial oedema during pregnancy (101.0 +/- 8.8 mmHg) was significantly higher compared with children whose mothers did not have oedema (96.6 +/- 9.6 mmHg).

[Angiotensin II receptors in a rat model of hypobaric hypoxic pulmonary hypertension]

Hypoxic pulmonary hypertension is characterized by profound remodeling of the walls of small pulmonary arteries: endothelial swelling and proliferation of media and adventitia to a degree that may narrow the lumen. The molecular mechanism responsible for these changes is unknown. Recent studies have demonstrated the existence of a vascular and cardiac renin-angiotensin system. This system can induce hypertrophy and proliferation of aortic smooth muscle cells and cardiac muscle cells in animal models of systemic hypertension. In the present experiments, Northern blot analysis and a receptor binding assay specific to angiotensin II (Ang II) receptors was used to study the pulmonary renin angiotensin system in a rat model of hypobaric hypoxic pulmonary hypertension. mRNA transcripts for the Ang II receptor AT(1A) were constitutively expressed, and specific binding of Ang II to the receptors occurred in lung tissue of control rats that breathed ambient air. After 3 days of hypobaric hypoxia (380 Torr), the AT(1A) mRNA level and the index of Ang II receptors had increased, but right ventricular hypertrophy was not still evident. Ang II receptors were significantly increased after 14 days of hypoxia, when histological evidence of pulmonary hypertension was observed. In addition, the Ang II level in pulmonary tissue was higher after 14 days of hypoxia than in normal controls. These findings suggest that the renin-angiotensin system in pulmonary tissue was activated in these rats, and that it contributes to the morphological changes observed in hypoxic pulmonary hypertension.

Molecular genetic analysis of clear cell adenocarcinomas of the vagina and cervix associated and unassociated with diethylstilbestrol exposure in utero

BACKGROUND

Prenatal exposure to the synthetic estrogen diethylstilbestrol (DES) is associated with the subsequent development of clear cell adenocarcinoma of the lower reproductive tract in young women, and data concerning the molecular genetic alterations involved in the etiology of this tumor type have not previously been reported. Such knowledge would be of potential value by providing insight into the molecular mechanisms of hormonal carcinogenesis in general, as well as by suggesting molecular markers for risk assessment in the estrogen-exposed population.

METHODS

A total of 24 samples of clear cell adenocarcinoma of the vagina or cervix, 16 associated with exposure in utero to DES and 8 with no history of DES exposure, were obtained as archival fixed and embedded tissue specimens. DNA was purified from these tissues and used to examine a number of biologically plausible molecular genetic endpoints for tumor specific alterations.

RESULTS

No evidence was found for mutations in the K-ras or H-ras protooncogenes, the Wilms' tumor (WT1) tumor suppressor gene, or the estrogen receptor gene. Sporadic overexpression of the p53 tumor suppressor gene was detected in some tumor cell nuclei by immunohistochemistry, but in the absence of detectable p53 gene mutation. Genetic instability as manifested by somatic mutation of microsatellite repeats was widespread in these tumors, with evidence of microsatellite instability in all DES-associated tumors examined, and in 50% of those tumors not associated with DES exposure.

CONCLUSIONS

These data are consistent with the hypothesis that the induction of genomic instability may be an important mechanism of DES-induced carcinogenesis.

[Introduction of molecular biology in respiratory medicine and its perspective]

I reviewed the change of respiratory medicine in the past several decades, overlapping with my own history of medical training and clinical and research works. In the 1950's when I graduated from the medical school and internship, the tuberculosis had been conquered effectively by the development of new antituberculous agents and improvement of nutritional state in Japan. Fibroptic bronchoscopy was introduced in the respiratory medicine in 1968, and computed tomography, in the 1970's, which gave us a good insight into pathological and biological aspects of various lung diseases in vivo. Molecular biology was brought in the respiratory medicine and our laboratory in the last decade, and my colleagues used it for genetic study of hereditary diseases such as alpha-1 antitrypsin deficiency and protein C deficiency, biochemical analysis of lung cancer and other pulmonary diseases, rapid detection of microorganisms, and so on. In the next step, gene therapy will come true in the near future, and I hope many intractable diseases such as lung cancer and interstitial pneumonia will be cured by the new technology and scientific knowledge.

Effects of immersion in tepid bath water on recovery from fatigue after submaximal exercise in man

This study was conducted to determine whether bathing in tepid water is effective in facilitating recovery from fatigue after submaximal exercise. Subjects were six young healthy male university students. Following cycle exercise at 80% aerobic power (VO2 max) for 10 min, recovery was observed during and after 10-min bathing. Three conditions were set; (1) water temperature of 38 degrees C, (2) water temperature of 30 degrees C, and (3) no water in the bath tub (control). Measurements were heart rate, blood pressure, skin temperature, rectal temperature, blood lactase and subjective feelings. There were no significant differences in heart rate and blood pressure between the three conditions at any time. Mean skin temperature and rectal temperature decreased more rapidly after the 30 degrees C bathing than the other two conditions (p < 0.05). Lactate removal was largest for the 30 degrees C bathing, with significant difference between the 30 degrees C bathing condition and the no bathing condition (p < 0.05). Recovery from fatigue was best for the 30 degrees C bathing and worst for the control in terms of subjective feeling. In summary, it was shown that immersion in 30 degrees C water after submaximal exercise resulted in a larger removal of lactate than recovery in air.

[Changes of regional perfusion in metastatic brain tumor and peritumoral area after radiosurgery: a study by 123I-IMP dynamic SPECT]

Changes of regional perfusion in the tumor, peritumoral edematous area and juxtatumor brain after radiosurgical treatment for metastatic brain tumor were investigated by dynamic SPECT using 123I-IMP. The SPECT was performed in 12 patients before and 1, 7 and 30 days after stereotactic irradiation. A region of interest (ROI) was selected each in the tumor, peritumoral edematous area, juxtatumor brain and ipsilateral cerebellum. Radioactivity in each ROIs was counted on early SPECT based on dynamic SPECT from 0 to 5 minutes. Mean count/pixel in each ROIs was divited by mean count/pixel in the ROI of the ipsilateral cerebellum and its value was designated as a count ratio (CR). Assuming the pre-treatment CRs are 1.0, relative changes of post-treatment CRs investigated. rCR in the tumor did not show any significant change after radiosurgical treatment. rCR in the edematous area and the juxtatumor brain increased at 7 days after irradiation [Mean +/- SD 1.43 +/- 0.409 (p < 0.05), 1.248 +/- 0.228 (p < 0.05) by Mann-Whitney test] and at 30 days [1.359 +/- 0.245 (p < 0.01), 1.301 +/- 0.287 (p < 0.01)] respectively. Computed tomography revealed no change in the maximum diameter of the tumor at 1 month after irradiation but a significant reduction in the diameter [0.744 +/- 0.227 (p < 0.02)] at 2 months. Early improvement of regional cerebral blood flow in the juxtatumor areas after radiosurgery suggested that radiosurgery could be effective treatment for metastatic brain tumor.

[Efficacy of adjuvant chemotherapy in nasopharyngeal cancer]

A total of 36 patients with nasopharyngeal cancer underwent radiotherapy followed by CDDP-based adjuvant chemotherapy during the period from 1983 to 1991. The survival rate in the cases treated with radiotherapy followed by adjuvant chemotherapy was better than in 53 cases treated with radiotherapy alone. Distant metastasis was noted in only 8 (22%) of the former cases as opposed to 21 (40%) of the latter. In particular, multiple metastasis to both sides of the neck was found in 12 (63%) of 19 cases treated with radiotherapy alone, but in only 1 of the 10 cases treated with adjuvant chemotherapy. The interval until the detection of metastasis was also longer in the latter group. The above results suggest that adjuvant chemotherapy suppresses distant metastasis and contributes to the improvement of the clinical outcome in nasopharyngeal cancer.

DCC protein expression in hematopoietic cell populations and its relation to leukemogenesis

Using flow cytometry and immunoprecipitation (IP), we have investigated the deleted in colon cancer (DCC) protein expression on the bone marrow (BM) and peripheral blood (PB) cells of 16 normal subjects, 17 myelodysplastic syndrome (MDS) patients, and 10 acute myelogenous leukemia (AML) patients. With regard to the BM mononuclear cells (BM-MNCs) of normal subjects, the DCC protein expression ranged from 6.6 to 57.0%. Two-color flow cytometry revealed that among the IBM-MNCs the DCC protein was clearly expressed on the CD14+, CD13+, and factor 8+ cells, whereas it was low on the CD19+ and CD7+ cells and did not express on the CD34+, CD8+, and the glycophorin A+ cells. Further, the DCC protein expression was not seen on the PB CD11b+ and CD13+ cells. The IP results revealed that the 180-kD DCC protein was detected on the MNCs of both the BM and PB cells by the antibodies AF5, specific for the DCC extracellular domain, and G97-449, specific for the cytoplasmic domain. In contrast, flow cytometry did not detect the DCC protein on any BM-MNC MDS lineages (0.1-1.5%) or on AML leukemic cells (0.1-0.9%). The IP results indicated that the AF5 antibody did not detect the DCC protein on BM-MNCs of three of five MDS patients and four of five AML patients; however, the G97-449 antibody detected the 180-kD DCC protein in two MDS patients in whom AF5 had detected greatly reduced DCC band. These findings suggest that the DCC protein presence appears to be associated with normal hematopoiesis, and that its absence on the surfaces of the BM-MNCs and AML cells may contribute to the MDS and AML pathogenesis.

Inflammatory cytokines in the herniated disc of the lumbar spine

STUDY DESIGN

Tissues in the area of herniated lumbar discs were examined for inflammatory cytokines to elucidate the causes of sciatic pain in lumbar disc herniation.

OBJECTIVES

To determine the role of inflammatory cytokines in the stimulation of sciatic pain in lumbar disc herniation.

SUMMARY OF BACKGROUND DATA

It is postulated that in addition to mechanical compression of lumbar nerve roots and sensory root ganglia by herniated discs, there is a chemical stimulus to the production of sciatic leg pain. The exact mechanisms of chemical stimulation are not clearly defined.

METHODS

During surgery, cases of lumbar disc herniation in 77 patients were classified macroscopically into protrusion, extrusion, and sequestration types. Tissues adjacent to nerve roots at the herniation were excised and analyzed biochemically and immunohistochemically for the presence of inflammatory cytokines and for the production of these cytokines and prostaglandin E2 in vitro.

RESULTS

The homogenates of samples were analyzed for interleukin-1 alpha, interleukin-1 beta, interleukin-6, tumor necrosis factor-alpha, and granulocyte-macrophage colony stimulating factor, which were detectable. Most of the cytokine-producing cells were histiocytes, fibroblasts, or endothelial cells in extrusion and sequestration types, and chondrocytes in protrusion type. The secretion of these cytokines and prostaglandin E2 was decreased by the addition of betamethasone. The prostaglandin E2 production was dramatically enhanced by additional interleukin-1 alpha, but decreased by the addition of tumor necrosis factor-alpha.

CONCLUSION

The results demonstrate that at the site of lumbar disc herniation, inflammatory cytokines such as interleukin-1 alpha are produced, which increases prostaglandin E2 production. Further studies are required to elucidate the role of inflammatory cytokines in causing sciatic pain.

Demonstration of Borna disease virus RNA in peripheral blood mononuclear cells derived from Japanese patients with chronic fatigue syndrome

CFS, a recently named heterogeneous disorder, is an illness of unknown etiology. The association of CFS with viral infections has been suggested. A common association between CFS and several viruses examined has not been confirmed. Here, we centered on the possible link between CFS and BDV infection. By nested RT-PCR followed by hybridization, BDV RNA was demonstrated as a clear signal in PBMCs in 3 out of 25 CFS patients. The amplified cDNA fragments were cloned and sequenced. A total of 16 clones were studied. Intra-patients divergencies of the p24 were 2-9%, 3-20%, and 3-11% in the deduced amino acids. Inter-patient divergencies among the 16 clones were 3-24%. Antibodies to recombinant BDV p24 protein were detected in 6 CFS patients including one carrying BDV RNA. Overall, these gave the prevalence of 32% (8/25) in Japanese CFS patients, suggesting that Japanese CFS is highly associated with active infection of BDV, or a related agent.

Detection and comparison of viral antigens in measles and rubella rashes

Measles and rubella skin lesions were immunocytochemically compared by the avidin-biotin-peroxidase complex method for detecting viral antigens. Cryostat sections of biopsied specimens of the skin were stained with mouse monoclonal antibodies to P protein of measles virus and to E1 protein of rubella virus. The measles virus antigen was concentrated in the corneal layer and the keratinocytes of the epidermis and in the surface part of the dermis in the biopsy secimens taken within 6 days after the onset of rash. On the other hand, the rubella virus antigen was dispersed in all parts of the dermis and the subcutaneous layer but not in the epidermis in the biopsy specimens taken within 2 days after the onset of rash. The differences in the distribution and density of the viral antigen and in the times of its detection suggest distinct patterns of spread of infection with each virus in the skin.

[Complete remission of steroid-resistant minimal-change nephrotic syndrome by cyclosporin after additional low-density lipoprotein apheresis treatment]

Steroid-resistant nephrotic syndrome (SRNS) is still difficult to treat in spite of the introduction of various immunosuppressive drugs. In recent years, low-density lipoprotein apheresis (LDL-A) has been used to treat SRNS, mainly on focal glomerular sclerosis (FGS), and some cases have shown amelioration of the nephrotic syndrome. We describe here a case of steroid-resistant minimal-change nephrotic syndrome (MCNS), which was also unresponsive to cyclosporin A (CsA), but attained remission after the additional LDL-A treatment. A 20-year-old man with MCNS was treated with prednisolone at the dose of 40 mg/day for 6 weeks, but his nephrosis continued. The administration of CsA (2.5 mg/kg/day) induced remission temporarily for 2 months. However his nephrosis soon recurred, and persisted without improvement in spite of an increase in the CsA dose (4.5 mg/kg/day). After 6 LDL-A treatments given concomitantly with the administration of CsA (5 mg/kg/day), the urinary protein excretion remarkably reduced, and the patient remained free of the disease. Although the precise mechanism of hyperlipidemia on CsA is still unknown, it can be speculated that the rapid improvement of hyperlipidemia by LDL-A might strengthen the effect of CsA, presumably through the increased cellular uptake of CsA. LDL-A might be useful for ameliorating steroid-resistant MCNS, which also is unresponsive to immunosuppressive drugs, such as CsA.

Autonomic dysfunction in hemodialysis patients with persistent hypotension

To investigate autonomic mechanisms underlying persistent hypotension in long-term hemodialysis patients, high-frequency (HF, > 0.15 Hz) and low-frequency (LF, 0.04-0.15 Hz) components of heart rate variability and plasma noradrenaline were analyzed in 10 persistently hypotensive hemodialysis patients (group H), 11 normotensive patients (group N) and 10 healthy controls (group C). The HF amplitude, an index of cardiac parasympathetic activity, and LF-to-HF ratio, an index of sympathetic predominance, were in the order of groups C > N > H (p < 0.01). While the HF amplitude decreased with standing in all three groups (p < 0.05 for all), the LF-to-HF ratio increased only in groups N and C (p < 0.05 for both) but not in group H. Conversely, plasma noradrenaline level was in the order of groups C < N < H (p < 0.001). Furthermore, while the LF-to-HF ratio correlated positively with the plasma noradrenaline level in group C (r = 0.73, p < 0.01), it correlated negatively in group H (r = 0.69, p < 0.05). These results indicate that an impairment in both parasympathetic and sympathetic functions exists in hemodialysis patients with persistent hypotension, and that the apparent sympathetic dysfunction could result from a reduction in cardiovascular responsiveness to sympathetic stimulation.

Combined therapy for hypopharyngeal cancer

We studied 69 hypopharyngeal cancer patients who were treated between 1979 and 1992. The 5-year cumulative survival rate was 53%. There were five stage I, seven stage II, 20 stage III and 37 stage IV patients; survival rates for stages I, II, III, and IV were 80%, 54%, 61% and 47%, respectively. The 5-year survival rate for the 25 patients who received preoperative radiotherapy (fewer than 40 Gy) followed by total pharyngo-laryngo-esophagectomy was 59%. Forty-four patients received radical radiotherapy as a main treatment. From the standpoint of preserving vocal function, we recommend using the radical radiation as a first-choice treatment. The 5-year survival rate was 48%. There were 16 radiation failure patients after radical radiotherapy and two of them refused to have surgery. Fourteen patients (36%) received a salvage operation and the survival rate was 36%. The survival rate for the 30 patients who did not receive surgery was 61%; the patients who received surgery as a palliative purpose and the patients who refused to undergo surgery were included in this group. Both treatment regimens of the present study showed higher survival rates compared to the results of previous studies. We concluded that the improved results were due to the proper selection of the treatment, especially the attention given to the patient's immune response and the minimum death as a result of neck node metastasis.

Influence of hypotension on cochlear blood flow in polycythemic condition

We examined the influence of hypotension by infusion of acebutolol hydrochloride (AH), a cardioselective beta-receptor antagonist, on cochlear blood flow in guinea pigs with various hematocrit values. AH infusion lowered the mean blood pressure to almost the same degree in all animals, regardless of the hematocrit level. The degree of the concomitant decrease of CBF varied with the hematocrit, being greater in animals with a higher hematocrit. In those with the highest hematocrit CBF did not return to the initial level. From these values we calculated the O2 transport capacity after AH infusion and found it to be lower than in animals without AH infusion. The difference was greater at higher hematocrits. These findings suggest that the microcirculation of the inner ear is responsive to transient decreases of perfusion pressure at high hematocrits.

Polymerase chain reaction of Borrelia burgdorferi flagellin gene in Shulman syndrome

A 49-year-old man presented a progressive swelling and induration of the skin resulting in flexion contracture. He had a history of two tick bites at the age of 17 and 47 years. Serum anti-Borrelia-burgdorferi antibody was positive; isolation of B. burgdorferi from the skin lesion was unsuccessful. He had eosinophilia (white blood cells 8,300/microlitre, 33% eosinophils) and hypergammaglobulinemia. The diagnosis of Shulman syndrome (eosinophilic fasciitis) from clinical and histological findings was established. A part of the flagellin gene of B. burgdorferi was detected in a skin biopsy sample by using the polymerase chain reaction method. To the best of our knowledge, this is the first report of detection of B.-burgdorferi-specific DNA from a skin sample of Shulman syndrome.

Human T lymphotropic virus type II (HTLV-II): epidemiology, molecular properties, and clinical features of infection

Human T lymphotropic virus, type II (HTLV-II), infection has been shown to be endemic in a number of American Indian populations, and high rates of infection have also been documented in intravenous drug abusers in urban areas throughout the world. Although the role of HTLV-II in human disease has yet to be clearly defined, there is accumulating evidence that like HTLV-I, infection may also be associated with rare lymphoproliferative and neurological disorders. In this article we review and summarize the epidemiology, molecular properties and clinical features of HTLV-II infection.