Evaluation of apocynin in vitro on high glucose-induced oxidative stress on tenocytes

Aims

The purpose of this study was to evaluate the in vitro effects of apocynin, an inhibitor of nicotinamide adenine dinucleotide phosphate oxidase (NOX) and a downregulator of intracellular reactive oxygen species (ROS), on high glucose-induced oxidative stress on tenocytes.

Methods

Tenocytes from normal Sprague-Dawley rats were cultured in both control and high-glucose conditions. Apocynin was added at cell seeding, dividing the tenocytes into four groups: the control group; regular glucose with apocynin (RG apo+); high glucose with apocynin (HG apo+); and high glucose without apocynin (HG apo–). Reactive oxygen species production, cell proliferation, apoptosis and messenger RNA (mRNA) expression of NOX1 and 4, and interleukin-6 (IL-6) were determined in vitro.

Results

Expression of NOX1, NOX4, and IL-6 mRNA in the HG groups was significantly higher compared with that in the RG groups, and NOX1, NOX4, and IL-6 mRNA expression in the HG apo+ group was significantly lower compared with that in the HG apo– group. Cell proliferation in the RG apo+ group was significantly higher than in the control group and was also significantly higher in the HG apo+ group than in the HG apo– group. Both the ROS accumulation and the amounts of apoptotic cells in the HG groups were greater than those in the RG groups and were significantly less in the HG apo+ group than in the HG apo– group.

Conclusion

Apocynin reduced ROS production and cell death via NOX inhibition in high-glucose conditions. Apocynin is therefore a potential prodrug in the treatment of diabetic tendinopathy.

Cite this article:Bone Joint Res 2020;9(1):23–28.

Postoperative changes in cerebral metabolites associated with cognitive improvement and impairment after carotid endarterectomy: a 3T proton MR spectroscopy study

BACKGROUND AND PURPOSE

Cognitive function can improve or decline after carotid endarterectomy. Proton MR spectroscopy can be used evaluate cerebral metabolites, such as N-acetylaspartate, choline, and creatine, in vivo. The purpose of the present study was to determine whether postoperative changes in cerebral metabolites measured by using 3T proton MR spectroscopy were associated with changes in cognitive function after CEA.

MATERIALS AND METHODS

In 100 patients undergoing CEA for ipsilateral cervical internal carotid artery stenosis (≥70%), brain proton MR spectroscopy was performed before and after surgery. NAA/Cr and Cho/Cr ratios were measured in regions of interest placed in the centrum semiovale of both cerebral hemispheres. Neuropsychological testing was also performed preoperatively and 1 month postoperatively. Multivariate statistical analysis of factors related to postoperatively changed cognition was performed, and odds ratios with 95% confidence intervals were calculated.

RESULTS

On the basis of the neuropsychological assessments, 10 (10%), 80 (80%), and 10 (10%) patients were defined as having postoperatively improved, unchanged, and impaired cognition, respectively. A positive and high ΔNAA/Cr ratio (postoperative value-preoperative value) in the cerebral hemisphere ipsilateral to the operative site was significantly associated with postoperatively improved cognition (95% CI, 13.3-21.3; P = .0016). Negative and high absolute values of the ΔNAA/Cr ratio (95% CI, 0.018-0.101; P = .0039) and ΔCho/Cr ratio (95% CI, 0.042-0.135; P = .0046) in the ipsilateral cerebral hemisphere were significantly associated with postoperatively impaired cognition.

CONCLUSIONS

Postoperative changes in cerebral metabolites measured by using proton MR spectroscopy were associated with changes in cognitive function after CEA.

Simple assessment of cerebral hemodynamics using single-slab 3D time-of-flight MR angiography in patients with cervical internal carotid artery steno-occlusive diseases: comparison with quantitative perfusion single-photon emission CT

BACKGROUND AND PURPOSE

Visualization of the peripheral arteries on single-slab 3D time-of-flight (TOF) MR angiography (MRA) can reflect blood flow velocity. The velocity in the middle cerebral artery (MCA) may correlate with cerebrovascular reactivity (CVR) to acetazolamide, which can be used to assess hemodynamic impairment. The goal of this study was to compare the signal intensity of the MCA on MRA versus CVR quantified by perfusion single-photon emission CT (SPECT).

MATERIALS AND METHODS

The signal intensity of the MCA on single-slab 3D time-of-flight MRA was graded according to the ability to visualize the MCA in 108 cerebral hemispheres of 87 patients with unilateral or bilateral cervical internal carotid artery (ICA) steno-occlusive diseases. SPECT-CVR was also calculated by measuring cerebral blood flow before and after acetazolamide challenge. Ten healthy subjects were studied to obtain control SPECT-CVR values. All subjects provided written informed consent before the study.

RESULTS

CVR was significantly lower in cerebral hemispheres with reduced MCA signal intensity than in those with normal intensity (P < .05). When the reduced signal intensity of the MCA on MRA was defined as abnormal, and when a CVR less than the mean--2 SD of healthy subjects was defined as reduced, MRA grading resulted in a 86.2% sensitivity and 69.6% specificity, with 51.0% positive-predictive and 93.2% negative-predictive values to detect reduced CVR.

CONCLUSIONS

This simple MRA method can assess hemodynamic impairment with a high negative-predictive value.

Prediction of cerebral hyperperfusion after carotid endarterectomy using cerebral blood volume measured by perfusion-weighted MR imaging compared with single-photon emission CT

BACKGROUND AND PURPOSE

Cerebral hyperperfusion syndrome is a rare but serious complication of carotid revascularization, including carotid endarterectomy (CEA) and carotid stent placement, which can occur in patients with preoperative impairments in cerebral hemodynamics. The purpose of this study was to determine whether preoperative cerebral blood volume (CBV) measured by perfusion-weighted MR imaging (PWI) could identify patients at risk for cerebral hyperperfusion after CEA.

MATERIALS AND METHODS

CBV was measured by using PWI before CEA in 70 patients with unilateral internal carotid artery (ICA) stenosis (>or=70%) and without contralateral ICA steno-occlusive disease. Cerebral blood flow (CBF) was also measured by using single-photon emission CT before and immediately after CEA and on the 3rd postoperative day.

RESULTS

A significant correlation was observed between preoperative CBV and increases in CBF immediately after CEA (r = 0.785, P < .0001). Whereas hyperperfusion immediately after CEA (CBF increase of >or=100% compared with preoperative values) was observed in 7 of 15 patients (47%) with elevated preoperative CBV, no patients with normal preoperative CBV exhibited post-CEA hyperperfusion. Furthermore, elevated preoperative CBV was the only significant independent predictor of post-CEA hyperperfusion. Finally, hyperperfusion syndrome developed on the 5th postoperative day in 2 of the 7 patients who displayed hyperperfusion immediately after CEA.

CONCLUSION

Measurements of preoperative CBV by PWI might help to identify patients at risk for cerebral hyperperfusion after CEA in the absence of contralateral ICA steno-occlusive disease.

Gene expression of glucose transporter (GLUT) 1, 3 and 4 in bovine follicle and corpus luteum

Glucose is the main energy substrate in the bovine ovary, and a sufficient supply of it is necessary to sustain the ovarian activity. Glucose cannot permeate the plasma membrane, and its uptake is mediated by a number of glucose transporters (GLUT). In the present study, we investigated the gene expression of GLUT1, 3 and 4 in the bovine follicle and corpus luteum (CL). Ovaries were obtained from Holstein x Japanese Black F1 heifers. Granulosa cells and theca interna layers were harvested from follicles classified into five categories by their physiologic status: follicular size (>or= 8.5 mm: dominant; < 8.5 mm: subordinate), ratio of estradiol (E(2)) to progesterone in follicular fluid (>or= 1: E(2) active;<1: E(2) inactive), and stage of estrous cycle (luteal phase, follicular phase). CL were also classified by the stage of estrous cycle. Expression levels of GLUT1, 3 and 4 mRNA were quantified by a real-time PCR. The mRNA for GLUT1 and 3 were detected in the bovine follicle and CL at comparable levels to those in classic GLUT-expressing organs such as brain and heart. Much lower but appreciable levels of GLUT4 were also detected in these tissues. The gene expression of these GLUT showed tissue- and stage-specific patterns. Despite considerable differences in physiologic conditions, similar levels of GLUT1, 3 and 4 mRNA were expressed in subordinate follicles as well as dominant E(2)-active follicles in both luteal and follicular phases, whereas a notable increase in the gene expression of these GLUT was observed in dominant E(2)-inactive follicles undergoing the atretic process. In these follicles, highly significant negative correlations were observed between the concentrations of glucose in follicular fluid and the levels of GLUT1 and 3 mRNA in granulosa cells, implying that the local glucose environment affects glucose uptake of follicles. These results indicate that GLUT1 and 3 act as major transporters of glucose while GLUT4 may play a supporting role in the bovine follicle and CL.

Clinical outcomes of multilevel anterior corpectomy and fusion as a revision surgery of the cervical spine: report of seven cases

STUDY DESIGN

Report of seven cases.

OBJECTIVE

There is no general consensus on the best surgical procedures for late-onset complications of cervical operations. We reported seven patients who had been treated effectively by multilevel anterior corpectomy and fusion (ACF) as revision surgery of the cervical spine.

SETTING

Gifu University Hospital, Gifu, Japan.

METHOD

Multilevel ACF using autogenous fibular strut graft as revision surgery was performed on seven patients: four patients having disorders of adjacent discs after anterior discectomy and fusion and three patients having postlaminoplasty disorders. Japanese Orthopedic Association scores (JOA scores) of the cervical myelopathy and severity of radicular and axial pains were used to evaluate outcomes.

RESULTS

Rigid osseous fusion was achieved in all patients. JOA scores of the cervical myelopathy and the radicular pain, which had worsened just before the revision surgery, were improved significantly.

CONCLUSION

In the present seven patients who had variety of pathological conditions with various previous surgeries, multilevel ACF using strut graft was effective as a revision procedure in ameliorating their symptoms.

Metabolic derangements in interstitial brain edema with preserved blood flow: selective vulnerability of the hippocampal CA3 region in rat hydrocephalus

Hydrocephalus induces interstitial brain edema, which causes neurological deficits, even if the intracranial pressure is maintained within the normal range, and the cerebral blood flow (CBF) does not decline to an ischemic level. The precise mechanisms underlying such edema-induced neuronal dysfunction remain unclear. In the present study, in an attempt to elucidate the metabolic derangements in brain tissue with interstitial edema, we evaluated the changes in CBF and oxidative/glucose metabolism using a rat model of kaolin-induced hydrocephalus. Hydrocephalus was produced in male Wistar rats by intrathecal injection of 0.1 ml aluminum silicate suspension (200 mg/ml) via the cisterna magna. CBF was determined by 14[C]-iodoantipyrine autoradiography. Oxidative metabolism was evaluated by cytochrome oxidase (CYO) histochemistry, and glucose metabolism by hexokinase (HK) histochemistry. CBF declined with the development of hydrocephalus, but did not reach an ischemic level. The CYO activity was diffusely depressed in both the cortex and hippocampus. The HK activity was preserved at the early stage of hydrocephalus. At the advanced stage, the HK activity was reduced in the hippocampal CA3 region first, and diffusely thereafter. In conclusion, interstitial brain edema impairs oxidative metabolism even at the early stage of hydrocephalus, and shifts the metabolism to anaerobic glycolysis despite a preserved CBF. Impairment of glucose metabolism was first observed in the CA3 region, suggesting that the CA3 is metabolically vulnerable, and CA3 dysfunction may contribute to the memory deficits seen in hydrocephalus.

Sudden onset of paraparesis caused by hypertrophy of the thoracic posterior longitudinal ligament

STUDY DESIGN

Case report of a rare form of hypertrophy of the thoracic posterior longitudinal ligament (HPLL), causing paraparesis.

OBJECTIVE

To describe this very rare pathological condition in the thoracic spine and the results of surgical intervention.

SETTING

A department of orthopaedic surgery in Japan.

METHODS

A 61-year-old man presented with acute paraparesis associated with HPLL in the thoracic region. A radiographic and pathological review of the case was conducted. Anterior decompression was performed, and he was followed for 3 years after the operation.

RESULTS

Pathologic examination of the surgical specimen revealed proliferation of fibrocartilage and calcification. The patient's paraparesis ameliorated after the operation.

CONCLUSION

For this case of myelopathy due to HPLL in the thoracic spine, urgent decompression gave excellent results. Clinical awareness of HPLL may aid correct diagnosis and prompt therapy.

Intramedullary teratoma of the spine: report of two adult cases

STUDY DESIGN

Two case reports of intramedullary teratoma in the spinal cord of adults, and a review of the literature.

OBJECTIVE

To investigate and describe unusual cases of spinal teratoma using MRI to define features that may be used to avoid misdiagnosis.

SETTING

A department of orthopedic surgery in Japan.

METHODS

One patient, a 37-year-old woman, was referred because of gait disturbance. She was evaluated by myelography, CT scan with myelography, and MRI. T12 through L1 laminoplasty was performed and the tumor was subtotally removed. The other patient, a 56-year-old man, was referred because of muscle weakness and sensory disturbance. MRI revealed multiple spinal tumors. C4 through C6 laminoplasty and T12 through L2 laminoplasty were performed, and the tumors in these regions were subtotally removed.

RESULTS

In Case 1, the postoperative course was excellent, and histological examination of the resected specimen revealed a spinal teratoma consisting of ectodermal and mesodermal elements. In Case 2, the symptoms were resolved after surgery, and ectodermal, mesodermal and endodermal elements were revealed.

CONCLUSIONS

Although intramedullary teratomas are very rare in adults, they need to be considered in differential diagnosis.

Auditory brainstem response and temporal bone pathology findings in a brain-dead infant

The criteria for assessing adult brain death have been already established, but those for infant brain death have not been yet established in Japan. We report auditory brainstem response (ABR) and postmortem pathology of the temporal bone and brain of a brain-dead 9-month-old female. During the comatose state, her ABR showed only waves I and II bilaterally. Autopsy revealed the presence of a left cerebellar astrocytoma, herniation and anoxic encephalopathy. The pathological examination of the temporal bone revealed the destruction of the inner ear particularly on the left side. In the auditory pathway of brain-dead patients, degeneration occurs first in the cerebrum, followed by the cochlear nerve. Thus, ABR is one of the useful means to assess brain death even in infants.

Radical hysterectomy: An anatomic evaluation of parametrial dissection

OBJECTIVES

This study was designed to demonstrate a reduction in the amount of blood loss for vesicouterine ligament dissection and to investigate the intrapelvic autonomic nerve pathway and its preservation by means of anatomic analysis.

METHODS

The anchoring mechanism of the pelvic viscera to the pelvic wall was divided into a supporting system facing laterally and a suspensory system facing dorsoventrally. An operative procedure was designed in which both systems were separated and dissected independently.

RESULTS

Between the two systems, an artificial space was developed, which required a new dissection method for the parametrium and revealed a new anatomic pathway for the ureter and autonomic nerve. The amount of blood loss (mean +/- SD) during dissection of the vesicouterine ligament was ultimately 260.1 +/- 114.8 ml. Postoperatively, the maximum capacity of the bladder was 393.9 +/- 40.4 ml, maximum detrusor pressure 6.3 +/- 4.1 cm H(2)O, mean compliance >10 ml/cm H(2)O, residual urine 23.8 +/- 9.4 ml, and maximum flow rate 25. +/- 8 2.2 ml/s, respectively.

CONCLUSION

A new classification for the parametrium and its dissection method have been established. Development of this new operative procedure has also contributed to a decrease in blood loss and preservation of bladder function.

Experimental metastasis is suppressed in MMP-9-deficient mice

Matrix metalloproteinases (MMPs) are thought to play a key role in tumor invasion and metastasis. The role of MMP-9 (gelatinase B) in tumor metastasis was examined in MMP-9-deficient mice produced by gene targeting using embryonic stem cells. MMP-9-deficient mice develop normally and are fertile. In these mice, the number of metastatic colonies of B16-BL6 melanoma cells or Lewis lung carcinoma cells that were implanted intravenously fell by 45% for B16-BL6 melanoma and 59% for Lewis lung carcinoma (p = 0.03 and p = 0.0043, respectively). Gelatin zymography showed that both tumor cell lines did not secrete MMP-9 by themselves but the host cells surrounding the tumor cells secrete MMP-9 in vivo. These results indicated that host-derived MMP-9 plays an important role in the process of tumor metastasis.

Immunologic abnormalities exhibited in IL-7 transgenic mice with dermatitis

Interleukin (IL)-7 transgenic mice, which we established previously, developed severe dermatitis characterized by massive infiltration of gammadelta T cells in the dermal lesion. To fully understand the pathology of this intriguing skin disease, we examined several immunologic features of dermis infiltrating lymphocytes from the lesional skin of IL-7 transgenic mice. We observed a moderate response to mitogens, a poor response to alloantigens, and the absence of cytotoxic activities to several tumor cell lines and skin derived cells regardless of the presence of IL-2 or IL-7. On the other hand, dermis infiltrating lymphocytes could proliferate with exogenous IL-2 and IL-7. Moreover, reverse transcriptase polymerase chain reaction and fluorescence activated cell sorter analysis revealed that dermis infiltrating lymphocytes expressed various cytokines including IL-4 and IL-7, and several activation markers for T cells (CD44, CD69, IL-2R alpha), in addition to IL-7R alpha. In the sera of the affected mice, hyper epsilon-globulinemia was observed. These findings suggested that dermis infiltrating lymphocytes proliferated in an activated state in the skin lesion in an autocrine and/or paracrine manner and produced Th2 type cytokines that might evoke immunologic abnormalities. This study and previous findings suggest that IL-7 transgenic mouse with dermatitis offer the potential of serving as a useful tool for investigating the immunologic role of cutaneous gammadelta T cells, especially their participation in IgE production in vivo.

Previously undescribed spondyloepiphyseal dysplasia associated with craniosynostosis, cataracts, cleft palate, and mental retardation: report of four sibs

We report on four Japanese sibs (three brothers and one sister) with a previously unreported syndrome of spondyloepiphyseal dysplasia, craniosynostosis, cataracts, cleft palate, and mental retardation. Most clinical manifestations were evident neonatally, but skeletal changes and cataracts became substantial in early childhood. Radiological anomalies comprised coronal synostosis, mild epiphyseal dysplasia, particularly in the distal tibiae, strikingly delayed patellar ossification, mild metaphyseal splaying, hypoplastic ilia with iliac flare, and platyspondyly with ovoid-shaped or posteriorly humped vertebral bodies. The nonconsanguineous parents were mildly mentally retarded, and sibs of both gender were equally affected; thus, inheritance was likely autosomal recessive.

Skeletal overgrowth in transgenic mice that overexpress brain natriuretic peptide

Longitudinal bone growth is determined by the process of endochondral ossification in the cartilaginous growth plate, which is located at both ends of vertebrae and long bones and involves many systemic hormones and local regulators. Natriuretic peptides organize a family of three structurally related peptides: atrial natriuretic peptide, brain natriuretic peptide (BNP), and C-type natriuretic peptide. Atrial natriuretic peptide and BNP are cardiac hormones that are produced predominantly by the atrium and ventricle, respectively. C-type natriuretic peptide occurs in a wide variety of tissues, where it acts as a local regulator. These peptides can influence body fluid homeostasis and blood pressure control through the activation of two guanylyl cyclase (GC)-coupled natriuretic peptide receptor subtypes-GC-A and GC-B. We report here marked skeletal overgrowth in transgenic mice that overexpress BNP. Transgenic mice with elevated plasma BNP concentrations exhibited deformed bony skeletons characterized by kyphosis, elongated limbs and paws, and crooked tails. Bone abnormalities resulted from a high turnover of endochondral ossification accompanied by overgrowth of the growth plate. Studies using an in vitro organ culture of embryonic mouse tibias revealed that BNP increases the height of cartilaginous primordium directly, thereby stimulating the total longitudinal bone growth. The present study demonstrates that natriuretic peptides can affect the process of endochondral ossification.

Reduced angiogenesis and tumor progression in gelatinase A-deficient mice

Matrix proteolysis is thought to play a crucial role in several stages of tumor progression, including angiogenesis, and the invasion and metastasis of tumor cells. We investigated the specific role of gelatinase A (matrix metalloproteinase 2) on these events using gelatinase A-deficient mice. In these mice, tumor-induced angiogenesis was suppressed according to dorsal air sac assay. When B16-BL6 melanoma cells or Lewis lung carcinoma cells were implanted intradermally, the tumor volumes at 3 weeks after implantation in the gelatinase A-deficient mice decreased by 39% for B16-BL6 melanoma and by 24% for Lewis lung carcinoma (P < 0.03 for each tumor). The number of lung colonies of i.v. injections fell by 54% for B16-BL6 melanoma and 77% for Lewis lung carcinoma (P < 0.014 and P < 0.0015, respectively). These results indicated that host-derived gelatinase A plays an important role in angiogenesis and tumor progression, suggesting the usefulness of gelatinase A inhibitors for anticancer chemotherapy.

Interleukin 7 transgenic mice develop chronic colitis with decreased interleukin 7 protein accumulation in the colonic mucosa

We have demonstrated that intestinal epithelial cells produce interleukin 7 (IL-7), and IL-7 serves as a potent regulatory factor for proliferation of intestinal mucosal lymphocytes expressing functional IL-7 receptor. To clarify the mechanism by which locally produced IL-7 regulates the mucosal lymphocytes, we investigated IL-7 transgenic mice. Here we report that transgenic mice expressing murine IL-7 cDNA driver by the SRalpha promoter developed chronic colitis in concert with the expression of SRalpha/IL-7 transgene in the colonic mucosa. IL-7 transgenic but not littermate mice developed chronic colitis at 4-12 wk of age, with histopathological similarity to ulcerative colitis in humans. Southern blot hybridization and competitive PCR demonstrated that the expression of IL-7 messenger RNA was increased in the colonic mucosal lymphocytes but not in the colonic epithelial cells. IL-7 protein accumulation was decreased in the goblet cell-depleted colonic epithelium in the transgenic mice. Immunohistochemical and cytokine production analysis showed that lymphoid infiltrates in the lamina propria were dominated by T helper cell type 1 CD4+ T cells. Flow cytometric analysis demonstrated that CD4+ intraepithelial T cells were increased, but T cell receptor gamma/delta T cells and CD8alpha/alpha cells were not increased in the area of chronic inflammation. Increased IL-7 receptor expression in mucosal lymphocytes was demonstrated in the transgenic mice. These findings suggest that chronic inflammation in the colonic mucosa may be mediated by dysregulation of colonic epithelial cell-derived IL-7, and this murine model of chronic colitis may contribute to the understanding of the pathogenesis of human inflammatory bowel disease.

[HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome and acute pancreatitis complicated with severe preeclampsia]

A pregnant woman with severe preeclampsia developed HELLP syndrome and acute pancreatitis. She underwent an emergency caesarean section. In this patient, attention had to be paid to complicating cranial hemorrhage, rupture of liver subcapsular hematoma, acute renal failure, DIC, hypovolemic shock and sepsis. Therefore, we used a calcium blocker, diuretics and a protease inhibitor and examined the liver and pancreas by abdominal X ray-CT.

A new proposal for radical hysterectomy

OBJECTIVE

The authors revised the surgical procedure for radical hysterectomy utilizing detailed observation of the venous system, connective fascial sheets, and neural pathways within the uterine supports.

STUDY DESIGN

The anterior, middle, and posterior uterine supports were reclassified into two systems, supporting or fascial and drainage or areoral. Supporting system consisted of the superficial layer of the vesicouterine ligament, fascial part of the Mackenrodt ligament, sacrouterine ligament, and rectovaginal ligament, whereas drainage system consisted of the deep layer of the vesicouterine ligament, vascular part of the Mackenrodt ligament, and the so-called mesoureter. The operative procedure was planned according to the continuity of these ligaments and executed first by excising the fascia and then dissecting the denuded areoral tissue.

RESULTS

Among the 15 patients who underwent surgery for uterine cancer during a 2-year period the mean (SD) time required for the operation was 305.5 +/- 30.5 min and the mean (SD) total volume of blood loss 592.0 +/- 238.2 ml. A mean (SD) period of 14.3 +/- 3.8 postoperative days was required until the volume of the residual urine decreased to less than 50 mL.

CONCLUSION

The present operation has been structured more three-dimensionally and systematically than before. Further, safety of the operation was significantly improved including prevention of hemorrhage and preservation of bladder function.

Photoelectron holography of the si(001) surface

Three-dimensional images of the near-surface atom arrangement were calculated from two-dimensional photoelectron diffraction data by several imaging algorithms: (i) a basic method with a Fourier transformation at one kinetic energy over k space, considering the phase factor due to the path-length difference; (ii) energy summation of the above results; (iii) Fourier transformation within small k-space windows; and (iv) their combinations. Atomic images produced by these methods from the experimental Si 2p photoelectron diffraction patterns of an Si(001) surface are compared with the crystal geometry. The results show that the energy-summed small-window method, called SWEEP, gives the best images.

[Simplified avidity assay of rubella IgG antibody in rubella virus infection]

Simplified avidity assay of rubella IgG antibody with urea was evaluated to distinguish primary rubella from reinfection. In this method urea washing was done once for 10 minutes. The avidity index (AI) was calculated as the optical density percentage for the urea-washed well when compared to that of the non-treated well. We examined 292 sera from 50 patients with primary infection collected 6 to 2,259 days after the rash appeared, 29 sera from 11 patients with rubella reinfection and 69 sera from 68 pregnant women without fetal infection and having a high hemagglutination inhibition (HI) antibody. In primary infection AI increased gradually from 0%, and reached a plateau of about 60% four months after the rash appeared, whereas the mean AIs of patients after reinfection and with high HI antibody were as high as 87.1% and 89.9%, respectively. These results indicate that the simplified avidity assay in rubella IgG antibody is also valuable in diagnosing recent primary rubella in pregnant women with a high HI antibody.

[A case of miliary tuberculosis during pregnancy in a patient on hemodialysis]

A 33-year-old woman had been on hemodialysis since she was 25 years old. In September, 1993, she had cough, which gradually increased in severity, and was accompanied by slight fever. No abnormality was observed on the chest radiography taken on November 2. However, bilateral diffuse miliary shadows were observed on the radiograph taken on November 30. Tubercle bacilli were detected by the examination of sputum smear. As she was pregnant 20 weeks, therapeutic abortion was done on December 8. A case of miliary tuberculosis occurring during pregnancy in a patient on hemodialysis has not been documented in Japan to date, and the first case in Japan was reported with a review of the literature.

De novo apparently balanced reciprocal translocation between 5q11.2 and 17q23 associated with Klippel-Feil anomaly and type A1 brachydactyly

We report on a girl with Klippel-Feil anomaly, type A1 brachydactyly, and minor facial anomalies. She has an apparently balanced de novo reciprocal translocation between 5q11.2 and 17q23. The possible significance of this chromosomal abnormality is discussed.

Metachronous ovarian dysgerminoma after a suprasellar germ-cell tumor treated by radiation therapy. Case report

A case of suprasellar germ-cell tumor in a 9-year-old girl who later developed ovarian dysgerminoma is reported. The clinical course of the case is described and a double-primary tumor, rather than metastasis from either tumor to the other, is suggested by the authors to explain the oncogenesis in this patient. The authors strongly encourage that patients with intracranial germinoma be examined for associated extraneural lesions before, as well as after, the completion of the initial therapy.

Immunoelectron microscopic localization of MHC class 1 and 2 antigens on bile duct epithelial cells in patients with primary biliary cirrhosis

We studied the distribution of class 1 and class 2 major histocompatibility complex (MHC) antigens on bile duct epithelial cells in liver from patients with primary biliary cirrhosis (PBC) by an immunohistochemical method using monoclonal antibodies to HLA-ABC products and HLA-D subregion products (HLA-DR, -DP, -DQ). By light microscopy, the expression of MHC class 1 antigens (HLA-ABC antigens) was enhanced in PBC compared with controls. While negligible staining of MHC class 2 antigens was detected on the bile duct in controls, de novo expression of MHC class 2 antigens, as well as the coexpression of HLA-DR, HLA-DQ, and HLA-DP antigens on the bile duct epithelial cells, was observed in PBC. By electron microscopy, HLA-ABC and HLA-DR antigens were present preferentially along the basolateral domain of the cell surface of the bile duct epithelial cells and on the membrane of the endoplasmic reticulum in the cytoplasm, suggesting that these MHC antigens are synthesized by the bile duct epithelial cells in PBC. The distribution of these MHC antigens on the basolateral surface of the bile duct epithelial cells, where they are easily accessible to immunocytes, supports the idea that MHC-restricted cytotoxic T lymphocytes are involved in the bile duct injury in PBC.

Massive intracerebral hematoma in a child with Klippel-Trenaunay syndrome

The authors describe a child who suffered from massive intracerebral bleeding due to rupture of a cerebral arteriovenous malformation associated with Klippel-Trenaunay syndrome (KTS). Neurovascular lesions have been regarded as uncommon in KTS; however, our case may indicate the need for neurovascular scrutiny in patients with this syndrome.

Magnetic resonance angiography in the management of childhood moyamoya disease: first choice for neurovascular scrutiny

We performed magnetic resonance angiography (MRA) in 12 children with a suspected or angiographically proven moyamoya disease. MRA was performed by the three-dimensional, time-of-flight technique and, successfully depicted the primary abnormalities in the distal carotid arteries in 10 out of the 12 patients. In the other two patients, poor visualization of the intracranial vasculature strongly suggested the presence of the disease. On MRA, moyamoya vessels were visible in eight patients. The presence of anastomoses was also confirmed by MRA in seven of the 10 patients who had undergone encephalo-duro-arterio-synangiosis. Our findings suggest that MRA may be the tool of choice for selecting patients to undergo conventional angiography. However, establishing a definite diagnosis still requires some improvements in the delineation of the fine vasculature.

Molecular cloning of the complementary DNA and gene that encode mouse brain natriuretic peptide and generation of transgenic mice that overexpress the brain natriuretic peptide gene

Brain natriuretic peptide (BNP) is a cardiac hormone that occurs predominantly in the ventricle. To study the roles of BNP in chronic cardiovascular regulation, we isolated mouse BNP cDNA and genomic clones, and generated transgenic mice with elevated plasma BNP concentration. The mouse BNP gene was organized into three exons and two introns. Two BNP mRNA species were identified, which were generated by the alternative mRNA splicing. The ventricle was a major site of BNP production in mice. Mouse preproBNP was a 121- (or 120-) residue peptide, and its COOH-terminal 45-residue peptide was the major storage form in the heart. Transgenic mice carrying the human serum amyloid P component/mouse BNP fusion gene were generated so that the hormone expression is targeted to the liver. In the liver of these mice, considerable levels of BNP mRNA and peptide were detected, reaching up to 10-fold greater than in the ventricle. These animals showed 10- to 100-fold increase in plasma BNP concentration accompanied by elevated plasma cyclic GMP concentration, and had significantly lower blood pressure than their nontransgenic littermates. The present study demonstrates that these mice provide a useful model system with which to assess the roles of BNP in cardiovascular regulation and suggests the potential usefulness of BNP as a long-term therapeutic agent.

Histopathological study of anterior segments of the eye with the intraocular lens in the posterior chamber

We conducted a histopathological study of the anterior segments of the eye of a female who died 2 years after insertion of an intraocular lens (IOL), which had one end of the supporting loop inserted in the lens capsule bag and the other in the ciliary sulcus. No changes were noted in the iris and ciliary body located within the capsule. However, in the part in the ciliary sulcus, the iris root was bent towards the chamber angle and the trabecular meshwork was depressed. Moreover, the ciliary body exhibited hyaloid degeneration. A secondary cataract had formed in the periphery of the IOL. These findings suggest that the ideal site of IOL insertion might be within the capsule.

Morphological study of the cataractous lens of the senescence accelerated mouse

A murine model of accelerated aging, the senescence accelerated mouse (SAM), has been developed. There are three accelerated senescence-resistant (SAM-R) strains and eight senescence-prone (SAM-P) strains. The SAM-P strains have an earlier onset and more rapid advancement of senescence resulting from a significantly shorter lifespan compared with the SAM-R strains. Spontaneous cataracts have been found in some individuals of the SAM-P/9 strain. The SAM-P/1 strain, which was used in the present study, has such systemic senescent characteristics as senile amyloidosis and alopecia, but it was previously thought that cataract does not occur in this strain. However, we found cataractous changes in the lens of these animals at early stages of their life. The earliest change was the appearance of a ripple-mark body at about 3 months of age. The number of rippled rings increased with age. These changes later induced refractive distortion of retinal vessels. Whole-mount flat preparations of the epithelium showed that the number of cells was markedly decreased at the advanced stages of cataract. At the late stages of life the lens cortex became liquefied and developed into a mature cataract. Cataract formation in this strain may be related to reduced viability of the lens epithelium.

[Avidity of rubella IgG antibody in rubella virus infection]

The avidity assay of rubella IgG antibody with urea was evaluated to distinguish the early convalescent phase of primary rubella from the late one and reinfection. We examined 116 sera from 23 patients with primary infection collected 7 to 1,477 days after the rash appeared and 25 sera from 8 patients with rubella reinfection and 16 sera from 15 pregnant women without fetal infection having high hemagglutination inhibition (HI) antibody or weak positive rubella IgM antibody. The avidity index (AI) was calculated as the ratio of the optical density from the urea-washed well to that of the non-treated well, expressed as a percentage. In primary infection AI were lower than 30% within 30 days after the rash appeared, then gradually increased and reached a plateau of 60 to 80% three months later, whereas the AIs of patients after reinfection, with high HI antibody and weak positive IgM antibody were as high as 79.2 +/- 7.5%, 93.5 +/- 4.1% and 90.6 +/- 5.0%, respectively. These results indicate that the measurement of avidity in rubella IgG antibody is valuable in diagnosing recent primary rubella in pregnant women having a high HI antibody or IgM antibody.

The development of dermatitis infiltrated by gamma delta T cells in IL-7 transgenic mice

Transgenic mice constitutively expressing IL-7 developed severe dermatitis with erythroderma and alopecia. The skin lesions were characterized by massive infiltration of mononuclear cells. Immunofluorescence staining showed that most of the infiltrating cells were T cells with the majority bearing the gamma delta TCR other than the V gamma 5 moiety. Furthermore, the number of gamma delta T cells had increased in the lymphoid organs of the dermatitis animals. These findings indicate the strong relationship between the expression of IL-7 and the development of gamma delta T cells in vivo and the pathological involvement of proliferated and/or activated gamma delta T cells in skin disease.

Localization of hepatitis C viral RNA and capsid protein in human liver

In the livers of patients whose sera contained antibodies to C100-3 antigen (anti-HCV) and hepatitis C virus (HCV) RNA, the presence of HCV RNA and HCV capsid protein (CP) antigen was demonstrated by in situ hybridization and immunohistochemistry, respectively. It was found that occasional hepatocytes in four of ten livers from patients whose sera were positive for both anti-HCV and HCV RNA hybridized with antisense as well as sense oligonucleotide DNA probes, whereas the probes did not hybridize with livers from patients whose sera were negative for anti-HCV and HCV RNA. Monoclonal antibody against a synthetic oligopeptide with amino acid sequence of HCV CP reacted with occasional hepatocytes in six of 14 livers from patients whose sera contained these HCV markers, but not with livers from patients whose sera were negative for both of them. These results suggest that HCV proliferates within hepatocytes since both antisense and sense probes hybridized with cytoplasm of the hepatocytes and that the virus matures in the cytoplasm as the capsid proteins were also found in the hepatocytes.

Suppression of sidelobe levels for guided-wave acousto-optic tunable filters using weighted coupling

An analysis of guided-wave acousto-optic tunable filters (AOTFs) that employ simple acousto-optic (AO) weighted coupling techniques for sidelobe reduction and the calculated and experimental results from a specific example that involves only variation of the width of a surface acoustic wave (SAW) slot waveguide are presented. The calculations on single- and multi-stage AOTFs consisting of an optical channel waveguide and a SAW slot waveguide in LiNbO(3) substrate show that waveguide width weighting using generalized Hamming functions would provide significant improvement in sidelobe suppression. Calculated results together with the design, fabrication, and measured performance characteristics of a single-stage AOTF that utilizes a weighted-aperture SAW slot waveguide in YX-LiNbO(3) substrate at the optical wavelength of 1.55 mum and the acoustic center frequency of 175 MHz are reported. The measured sidelobe level is -13.6 dB and the measured FWHM bandwidth is 26 A, as compared to the theoretical values of -15.0 dB and 15 A, respectively. The RF drive power was measured to be 1.0 W at a mode-conversion efficiency of 100%

Anorectal anomaly in Pfeiffer syndrome

A Japanese girl with Pfeiffer syndrome is described. She has clinical and radiological manifestations typical of the syndrome. In addition, she had an imperforate anus not described previously in the syndrome. This seems to expand the phenotype associated with Pfeiffer syndrome or represent a new acrocephalosyndactyly syndrome.

Hepatitis type C virus infection in patients with type B chronic liver disease

Anti-c100-3 (Ortho) was determined in the sera of 152 patients with HBs antigen-positive chronic liver diseases to assess coinfection of hepatitis B virus (HBV) and hepatitis C virus (HCV). Eleven patients (7.2%) were positive for anti-c100-3. Anti-CP-9 (Okamoto) and HCV-RNA (RT-PCR) were also examined in these 11 patients. Anti-CP-9 was detected in 7 patients and HCV-RNA was detected in all 11 patients. Four of the 11 anti-c100-3-positive patients were positive for HBe antigen (HBeAg) and others were negative. In 8 of the 11 patients, HCV was suspected to be superinfected by blood transfusion. In HBeAg-positive patients, serum glutamic pyruvic transaminase (SGPT) was elevated in relation to active replication of HBV shown by DNA-polymerase activity. The histological findings showed chronic active hepatitis, with or without cirrhosis. On the other hand, in HBeAg-negative patients, SGPT fluctuated without evidence of active replication of HBV. Active inflammation in the liver was observed in 3 of 5 HBeAg-negative patients by liver biopsy. These findings suggest that HBV might play an important role in chronic active inflammation in HBeAg-positive patients coinfected with HCV, and that HCV might be responsible for continuous inflammation in HBeAg-negative patients coinfected with HCV.