Comprehensive genetic screening for vascular Ehlers-Danlos syndrome through an amplification-based next-generation sequencing system

Vascular Ehlers-Danlos syndrome (vEDS) is a hereditary connective tissue disorder (HCTD) characterized by arterial dissection/aneurysm/rupture, sigmoid colon rupture, or uterine rupture. Diagnosis is confirmed by detecting heterozygous variants in COL3A1. This is the largest Asian case series and the first to apply an amplification-based next-generation sequencing through custom panels of causative genes for HCTDs, including a specific method of evaluating copy number variations. Among 429 patients with suspected HCTDs analyzed, 101 were suspected to have vEDS, and 33 of them (32.4%) were found to have COL3A1 variants. Two patients with a clinical diagnosis of Loeys-Dietz syndrome and/or familial thoracic aortic aneurysm and dissection were also found to have COL3A1 variants. Twenty cases (57.1%) had missense variants leading to glycine (Gly) substitutions in the triple helical domain, one (2.9%) had a missense variant leading to non-Gly substitution in this domain, eight (22.9%) had splice site alterations, three (8.6%) had nonsense variants, two (5.7%) had in-frame deletions, and one (2.9%) had a multi-exon deletion, including two deceased patients analyzed with formalin-fixed and paraffin-embedded samples. This is a clinically useful system to detect a wide spectrum of variants from various types of samples.

A novel ZC4H2 variant in a female with severe respiratory complications

INTRODUCTION

An X-linked ZC4H2 variant is associated with a variety of phenotypes that have abnormalities related to external malformation and neurodevelopment. There have been no reports on severe respiratory dysfunction resulting in surgical treatments not being possible due to the deformity resulting from in this disease. Here we report a female with arthrogryposis multiplex congenita with a severe respiratory complication.

CASE

A two-year-old girl had arthrogryposis multiplex congenita at delivery and subsequently had hypotonia and feeding difficulty. A novel ZC4H2 frameshift variant was identified by whole-exome sequencing in her genome. At eight months, she had recurrent aspiration pneumonia. A tracheostomy and gastrostomy were required; however, surgical intervention was not possible because of her short neck and complicated airway.

CONCLUSION

We compared this case with previous reports. The truncation group had more described phenotypes than the non-truncation group. The patient had the most severe respiratory dysfunction in truncating variant.

Twin pregnancy with untyped Ehlers-Danlos syndrome requiring prompt genetic testing: A case report

Ehlers-Danlos syndrome is a rare genetic disorder that presents with a variety of pathologies depending on the disease type. Among them, vascular Ehlers-Danlos syndrome requires extremely careful management as there have been many reports of fatal perinatal complications such as uterine rupture. Although hypermobile Ehlers-Danlos syndrome is less likely to cause fatal complications, symptoms such as arthralgia, hip dislocation, and depression may be seen throughout pregnancy. We report here a case of twin pregnancy in which Ehlers-Danlos syndrome was first suspected at 19 weeks of gestation. Vascular Ehlers-Danlos syndrome could not be ruled out based on family medical history, making it difficult to determine the perinatal management strategy. Prompt genetic testing did however rule out the vascular type and the patient was diagnosed with hypermobile Ehlers-Danlos syndrome from the clinical symptoms, enabling us to manage the pregnancy safely until 34 weeks of gestation.

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In the case of twin pregnancy reported, Ehlers-Danlos syndrome was suspected at 19 weeks of gestation.

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Vascular-type Ehlers-Danlos syndrome could not be ruled out based on family medical history.

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Twin pregnancies with vascular-type Ehlers-Danlos syndrome have a high maternal risk of mortality.

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Prompt genetic testing enabled us to manage the pregnancy safely.

A de novo CHD3 variant in a child with intellectual disability, autism, joint laxity, and dysmorphisms

BACKGROUND

Chromodomain helicase DNA-binding (CHD) proteins play important roles in developmental processes. CHD3, a member of the CHD family of proteins, was reported to be a cause of a neurodevelopmental syndrome by Snijders Blok et al., but only a small number of probands have been reported.

CASE REPORT

The patient was a 9-year-old female with severe intellectual disability, speech impairment, autism, joint laxity and dysmorphisms. Whole exome sequencing revealed a de novo missense variant in CHD3 (NM_001005273:exon18: c.2896C > T:p.R966W).

CONCLUSION

We report a case with a pathogenic variant in the CHD3 gene. Our report indicates that CHD3 analysis is helpful for diagnosis of the cases with neurodevelopmental disorders, joint laxity, and coarse facial phenotype.

Case series of three patients with hereditary diffuse gastric cancer in a single family: Three case reports and review of literature

BACKGROUND

Hereditary diffuse gastric cancer (HDGC) is a familial cancer syndrome often associated with germline mutations in the CDH1 gene. However, the frequency of CDH1 mutations is low in patients with HDGC in East Asian countries. Herein, we report three cases of HDGC harboring a missense CDH1 variant, c.1679C>G, from a single Japanese family.

CASE SUMMARY

A 26-year-old female (Case 1) and a 51-year-old male (father of Case 1), who had a strong family history of gastric cancer, were diagnosed with advanced diffuse gastric cancer. After genetic counselling, a 25-year-old younger brother of Case 1 underwent surveillance esophagogastroduodenoscopy that detected small signet ring cell carcinoma foci as multiple pale lesions in the gastric mucosa. Genetic analysis revealed a CDH1 c.1679C>G variant in all three patients.

CONCLUSION

It is important for individuals suspected of having HDGC to be actively offered genetics evaluation. This report will contribute to an increased awareness of HDGC.

A case report of cutaneous polyarteritis nodosa in siblings

Cutaneous polyarteritis nodosa (CPAN) is characterized by a necrotizing vasculitis of small and medium-sized arteries in the skin, which can be associated with fever, arthralgia, myalgia, and neuropathy, but, unlike polyarteritis nodosa (PAN), there is no visceral involvement. CPAN is rare in childhood. We report two siblings who developed CPAN during childhood. Interestingly, both had Mediterranean fever gene (MEFV) mutation, i.e. heterozygous E148Q. They also shared HLA-A24, -DR15 alleles. Simultaneous occurrence of MEFV mutation and HLA alleles with CPAN has never been reported in Japan. These cases could provide some hereditary clue for the development of CPAN.

Use of multiplex PCR and real-time PCR to detect human herpes virus genome in ocular fluids of patients with uveitis

AIM

To measure the genomic DNA of human herpes viruses (HHV) in the ocular fluids and to analyse the clinical relevance of HHV in uveitis.

METHODS

After informed consent was obtained, a total of 111 ocular fluid samples (68 aqueous humour and 43 vitreous fluid samples) were collected from 100 patients with uveitis. The samples were assayed for HHV-DNA (HHV1-8) by using two different polymerase chain reaction (PCR) assays, qualitative PCR (multiplex PCR) and quantitative PCR (real-time PCR).

RESULTS

In all of the patients with acute retinal necrosis (n = 16) that were tested, either the HSV1 (n = 2), HSV2 (n = 3), or VZV (n = 11) genome was detected. In all patients, high copy numbers of the viral DNA were also noted, indicating the presence of viral replication. In another 10 patients with anterior uveitis with iris atrophy, the VZV genome was detected. When using multiplex PCR, EBV-DNA was detected in 19 of 111 samples (17%). However, real-time PCR analysis of EBV-DNA indicated that there were only six of the 19 samples that had significantly high copy numbers. The cytomegalovirus (CMV) genome was detected in three patients with anterior uveitis of immunocompetent patients and in one immunocompromised CMV retinitis patient. In addition, one patient with severe unilateral panuveitis had a high copy number of HHV6-DNA. There was no HHV7- or HHV8-DNA detected in any of the samples.

CONCLUSIONS

A qualitative multiplex PCR is useful in the screening of viral infections. However, the clinical relevance of the virus infection needs to be evaluated by quantitative real-time PCR.

Residue level of polycyclic aromatic hydrocarbons in Japanese paddy soils from 1959 to 2002

The residue level of 21 polycyclic aromatic hydrocarbons (PAHs) and the temporal changes in this level were investigated in paddy soils collected from particular experimental sites in Japan from 1959 to 2002. The average total PAH concentration in all the samples was 496 microg kg(-1), and it ranged from 52.9 to 2180 microg kg(-1). The residue level of the PAHs was the highest during the 1960s, rapidly decreased during the 1970s, and remained almost constant thereafter. Relatively high PAH concentrations were observed in soils from areas that experienced heavy snowfall and that had relatively low air temperature. The predominant PAHs were phenanthrene, fluoranthene, naphthalene, and pyrene, and their concentration overall and in relation to that of the total PAHs decreased each year since the 1960s. Similarities in the PAH profiles among the locations were determined using the concentration correlation matrix and cluster analysis, and ratios of the levels of specific PAH pairs were also calculated to determine their origin. The collected data suggested that the origins of soil PAHs changed chronologically from the burning of agricultural wastes such as stubble before the mid-1970s to the combustion of fossil fuel and its secondary products after the mid-1970s.

Reactive oxygen species in mechanical stress-induced cardiac hypertrophy

Mechanical stress induces various hypertrophic responses including activation of mitogen-activated protein kinases (MAPKs) in cardiac myocytes. Here we examined the role of the small GTP-binding proteins of Rho family and reactive oxygen species (ROS) in stretch-induced activation of p38MAPK in cardiomyocytes. Overexpression of dominant-negative mutants of Rac1 (D.N. Rac1), D.N.RhoA and D.N.Cdc42 suppressed stretch-induced activation of p38MAPK. Overexpression of constitutively active mutants of Rac1 (C.A.Rac1) and C.A.Cdc42 increased the p38MAPK activity in the absence of mechanical stress. Pretreatment with N-acetyl-L-cysteine and N-(2-mercaptopropionyl)-glycine (NAC) suppressed stretch-induced activation of p38MAPK. Mechanical stretch increased intracellular ROS generation, which was abrogated by overexpression of D.N.Rac1 and attenuated by overexpression of D.N.RhoA and D.N.Cdc42. An increase in protein synthesis evoked by mechanical stretch was suppressed by overexpression of D.N.Rac1 and pretreatment with NAC. These results suggest that mechanical stress induces cardiac hypertrophy through the Rac1-ROS-p38MAPK pathway in cardiac myocytes.

Molecular biological markers and micrometastasis in resected non-small-cell lung cancer. Prognostic implications

OBJECTIVES

Recent advances in molecular biology and genetics have created new diagnostic and treatment possibilities in clinical oncology. We evaluated the usefulness of molecular biological factors in primary tumor and micrometastasis in the bone marrow and pathological negative (pN0) lymph nodes as prognostic parameters in non-small-cell lung cancer (NSCLC) patients.

METHODS

Pathological specimens were collected from 129 NSCLC patients to analyze molecular biological markers, including K-ras, p53, Rb, p16, loss of heterozygosity (LOH) at 3p, vascular endothelial growth factor (VEGF), and telomerase activity. Bone marrow samples from 250 NSCLC patients and pN0 lymph nodes from 85 of these patients were collected for micrometastasis detection by immunohistochemistry against cytokeratin.

RESULTS

p53 abnormalities and 3p LOH were significantly associated with reduced patient survival in adenocarcinoma, whereas VEGF expression was significantly associated with reduced survival in a squamous cell carcinoma histological subtype by univariate or multivariate analysis. We identified micrometastatic tumor cells in bone marrow of 78 (31.2%) of 250 patients and in pN0 lymph nodes of 26 (30.6%) of 85 patients. Both bone marrow and lymph nodal micrometastases were associated with decreased survival among patients with stage I, however, only lymph nodal micrometastasis had a significant impact on survival.

CONCLUSIONS

Molecular biological features of primary tumor and micrometastatic status appear useful in defining groups of patients with a poor prognosis who could benefit from adjuvant systemic treatment.

Calcineurin plays a critical role in the development of pressure overload-induced cardiac hypertrophy

BACKGROUND

Although activation of the Ca(2+)-dependent phosphatase calcineurin has been reported to induce cardiomyocyte hypertrophy, whether calcineurin is involved in pressure overload-induced cardiac hypertrophy remains controversial.

METHODS AND RESULTS

We examined in the present study the role of calcineurin in pressure overload-induced cardiac hypertrophy using transgenic mice that overexpress the dominant negative mutant of calcineurin specifically in the heart. There were no significant differences in body weight, blood pressure, heart rate, heart weight, and the cardiac calcineurin activity between the transgenic mice and their littermate wild-type mice at basal state. The activity of calcineurin was markedly increased by pressure overload produced by constriction of the abdominal aorta in the heart of wild-type mice but less increased in the heart of the transgenic mice. Pressure overload induced increases in heart weight, wall thickness of the left ventricle, and diameter of cardiomyocytes; reprogramming of expressions of immediate early response genes and fetal-type genes; activation of extracellular signal-regulated protein kinases; and fibrosis. All these hypertrophic responses were more prominent in the wild-type mice than in the transgenic mice.

CONCLUSIONS

These results suggest that calcineurin plays a critical role in the development of pressure overload-induced cardiac hypertrophy.

Molecular cloning of groESL locus, and purification and characterization of chaperonins, GroEL and GroES, from Bacillus brevis

The groESL locus of a protein-hypersecreting bacterium, Bacillus brevis, was cloned by PCR using primers designed based on the DNA sequence of a B. subtilis homolog. GroEL protein was purified to apparent homogeneity and its ATPase activity was characterized: it hydrolyzed ATP, CTP, and TTP in this order of reaction rate, and its specific activity for ATP was 0.1 micromole/min/mg protein. Purified GroEL forms a tetradecamer. GroEL was estimated to contain 22% alpha-helix, 24% beta-sheet, and 19% turn structures, by CD measurement. GroES protein was also highly purified to examine its chaperonin activity. GroEL protected from thermal inactivation of and showed refolding-promoting activity for malate dehydrogenase, strictly depending on the presence of ATP and GroES.

Pentalenolactone I and hygromycin A, immunosuppressants produced by Streptomyces filipinensis and Streptomyces hygroscopicus

Immunosuppressants isolated from Streptomyces filipinensis and S. hygroscopicus were identified with pentalenolactone I and hygromycin A, respectively. The compounds as well as cyclosporin A showed immunosuppressant activity in the mixed lymphocyte reaction, and pentalenolactone I and cyclosporin A suppressed IL-2 production, however, hygromycin A did not. Hygromycin A may have immunosuppressant activity by a different mechanism from pentalenolactone I, cyclosporin A and tacrolimus.

[Calcineurin inhibitor attenuates the development and induces the regression of cardiac hypertrophy in rats with salt-sensitive hypertension]

BACKGROUND

It remains unclear how hemodynamic overload induces cardiac hypertrophy. Recently, activation of calcium-dependent phosphatase, calcineurin, has been elucidated to induce cardiac hypertrophy. In the present study, we examined the role of calcineurin in load-induced cardiac hypertrophy by using Dahl salt-sensitive (DS) rats, which develop both pressure and volume overload when fed a high salt diet.

METHODS AND RESULTS

In the DS rat heart, the activity of calcineurin was increased and cardiac hypertrophy was induced by high salt diet. Treatment of DS rats with the calcineurin inhibitor FK506 (0.1 or 0.01 mg/kg every second day) from the age of 6 weeks to 12 weeks inhibited the activation of calcineurin in the heart in a dose-dependent manner and attenuated the development of load-induced cardiac hypertrophy and fibrosis without change of hemodynamic parameters. Additionally, treatment with 0.1 mg/kg every second day but not with 0.01 mg/kg every second day of FK506 from the age of 12 weeks to 16 weeks induced regression of cardiac hypertrophy in DS rats. Load-induced reprogramming of gene expression was also suppressed by the FK506 treatment.

CONCLUSIONS

These results suggest that calcineurin is involved in the development of cardiac hypertrophy in rats with salt-sensitive hypertension and that inhibition of calcineurin could induce regression of cardiac hypertrophy.

Functional analyses of three Csx/Nkx-2.5 mutations that cause human congenital heart disease

A homeodomain-containing transcription factor Csx/Nkx-2.5 is an important regulator of cardiogenesis in mammals. Three different mutants, Gln170ter (designated A) and Thr178Met (designated B) in the helix 2 of the homeodomain and Gln198ter mutation (designated C) just after homeodomain, have been reported to cause atrial septal defect with atrial ventricular block. We here examined the functions of these three mutants of Csx/Nkx-2.5. The atrial natriuretic peptide (ANP) promoter was activated by wild type Csx/Nkx-2.5 (WT, approximately 8-fold), B ( approximately 2-fold), and C ( approximately 6-fold) but not by A. When A, B, or C was cotransfected into COS-7 cells with the same amount of WT, WT-induced activation of the ANP promoter was attenuated by A and B (A > B), whereas C further enhanced the activation. Immunocytochemical analysis using anti-Myc tag antibody indicated that transfected Myc-tagged WT, B, and C were localized in the nucleus of both COS-7 cells and cardiomyocytes of neonatal rats, whereas A was distributed diffusely in the cytoplasm and nucleus in COS-7 cells. Electrophoretic mobility shift assay showed that Csx/Nkx-2.5-binding sequences were bound strongly by WT and C, weakly by B, but not by A. Immunoprecipitation and GST pull-down assay revealed that WT and all mutants interacted with GATA-4. The synergistic activation of the ANP promoter by WT and GATA-4 was further enhanced by C but was inhibited by A and B. In the cultured cardiomyocytes, overexpression of C but not WT, A, or B, induced apoptosis. These results suggest that although the three mutants induce the same cardiac phenotype, transactivation ability and DNA binding ability are different among the three mutants and that apoptosis may be a cause for C-induced cardiac defect.

Calcineurin inhibitor attenuates the development and induces the regression of cardiac hypertrophy in rats with salt-sensitive hypertension

BACKGROUND

It remains unclear how hemodynamic overload induces cardiac hypertrophy. Recently, activation of calcium-dependent phosphatase, calcineurin, has been elucidated to induce cardiac hypertrophy. In the present study, we examined the role of calcineurin in load-induced cardiac hypertrophy by using Dahl salt-sensitive (DS) rats, which develop both pressure and volume overload when fed a high salt diet.

METHODS AND RESULTS

In the DS rat heart, the activity of calcineurin was increased and cardiac hypertrophy was induced by high salt diet. Treatment of DS rats with the calcineurin inhibitor FK506 (0.1 or 0.01 mg/kg twice daily) from the age of 6 weeks to 12 weeks inhibited the activation of calcineurin in the heart in a dose-dependent manner and attenuated the development of load-induced cardiac hypertrophy and fibrosis without change of hemodynamic parameters. Additionally, treatment with 0.1 mg/kg twice daily but not with 0.01 mg/kg twice daily of FK506 from the age of 12 weeks to 16 weeks induced regression of cardiac hypertrophy in DS rats. Load-induced reprogramming of gene expression was also suppressed by the FK506 treatment.

CONCLUSIONS

These results suggest that calcineurin is involved in the development of cardiac hypertrophy in rats with salt-sensitive hypertension and that inhibition of calcineurin could induce regression of cardiac hypertrophy.

Ca2+/calmodulin-dependent kinase II and calcineurin play critical roles in endothelin-1-induced cardiomyocyte hypertrophy

Endothelin-1 (ET-1) induces cardiac hypertrophy. Because Ca(2+) is a major second messenger of ET-1, the role of Ca(2+) in ET-1-induced hypertrophic responses in cultured cardiac myocytes of neonatal rats was examined. ET-1 activated the promoter of the beta-type myosin heavy chain gene (beta-MHC) (-354 to +34 base pairs) by about 4-fold. This activation was inhibited by chelation of Ca(2+) and the blocking of protein kinase C activity. Similarly, the beta-MHC promoter was activated by Ca(2+) ionophores and a protein kinase C activator. beta-MHC promoter activation induced by ET-1 was suppressed by pretreatment with the calmodulin inhibitor, W7, the Ca(2+)/calmodulin-dependent kinase II (CaMKII) inhibitor, KN62, and the calcineurin inhibitor, cyclosporin A. beta-MHC promoter activation by ET-1 was also attenuated by overexpression of dominant-negative mutants of CaMKII and calcineurin. ET-1 increased the activity of CaMKII and calcineurin in cardiac myocytes. Pretreatment with KN62 and cyclosporin A strongly suppressed ET-1-induced increases in [(3)H]phenylalanine uptake and in cell size. These results suggest that Ca(2+) plays a critical role in ET-1-induced cardiomyocyte hypertrophy by activating CaMKII- and calcineurin-dependent pathways.

Structural conversion from non-native to native form of recombinant human epidermal growth factor by Brevibacillus choshinensis

Brevibacillus choshinensis (Bacillus brevis) HPD31 is a very efficient producer of recombinant human epidermal growth factor (EGF). The produced EGF is secreted into the medium with high efficiency. However part of the EGF that accumulates in the medium, exists as multimeric forms which are biologically inactive. We found the bacterium has the activity to structurally convert multimeric forms to the monomeric, native ones. Optimal temperature and pH for the conversion were 40 degrees C and pH 9, respectively. The reaction was promoted in the presence of reduced glutathione or cysteine. But the cells which had been sonicated or exposed to moderate heat treatment completely lost the activity. Thus, it was presumed that the activity might be due to the enzyme(s) that catalyze the protein disulfide exchanging reaction, and that they resides on the surface of viable cells.

Removal of cadmium from scallop hepatopancreas by microbial processes

A microbial process for removing cadmium from a homogenate of hepatopancreas, a waste of scallop processing, was devised to use this waste for value-added protein resources. Microorganisms were screened on the basis of the ability to remove cadmium from a medium with the initial concentration of 10 mg/l of cadmium. One soil isolate, identified as Xanthomonas sp. UR No. 2 by its taxonomical characteristics, removed 98% of the cadmium in the medium in 2 d. During cultivation of this strain in the homogenates of hepatopancreas digested by endopeptidases, 90% of cadmium was removed, while this strain had little effect on the simple non-digested homogenates. The mass balance of cadmium during homogenizations of the hepatopancreas tissues and cultivations in the protease-treated homogenate were examined. The content of crude proteins of culture supernatant treated by Xanthomonas sp. UR No. 2 was equivalent to those of various feedstuffs on the market.

Molecular cloning of the dnaK locus, and purification and characterization of a DnaK protein from Bacillus brevis HPD31

Using part of the dnaK gene from Bacillus subtilis as a probe, a 4. 4-kbp SacI-BglII fragment of chromosomal DNA of Bacillus brevis, a protein-hypersecreting bacterium, was cloned. Nucleotide sequencing revealed 3 open reading frames in the order of grpE-dnaK-dnaJ homologues. We purified DnaK protein to homogeneity from B. brevis HPD31 harboring a multi-copy dnaK expression plasmid. Purified DnaK showed ATPase activity which was synergistically stimulated 14-fold by the addition of glutathione S-transferase-DnaJ and glutathione S-transferase-GrpE fusion proteins. DnaK hydrolyzed not only ATP but also CTP, UTP, and GTP at about 40% of the efficiency of ATP. The specific activity of DnaK-ATPase was 7.25x10-3 unit/mg protein (the turnover number against ATP was 0.47 min-1) under our assay conditions. The DnaK dimers dissociated into monomers on addition of ATP, GTP, CTP, UTP and ATPgammaS, but not ADP or AMP. DnaK formed a stable complex with permanently unfolded carboxymethylated alpha-lactalbumin but not with native alpha-lactalbumin, and this complex was dissociated by addition of ATP/Mg. Formation of this complex was inhibited in the presence of inorganic phosphate.

[Analysis of abnormal findings observed on brain MRI T 2 weighted image in a system for the detection of asymptomatic brain disease in 1,200 cases]

In this study we described the significance of asymptomatic cerebral infarction (ACI) and periventricular hyperintensity (PVH) observed on brain MRI in a system for detection of asymptomatic brain disease with 1,200 cases. The risk factors (RF), population in each age bracket of ACI and PVH, among groups with hypertension (HTG) and without RF (no-RFG), were investigated. The RF of ACI were hypertension (HT), diabetes mellitus (DM), and aging. Without DM, those are common RF of PVH. The population of PVH and ACI with PVH increased with aging in no -RFG. On the other hand, only the population of ACI with PVH increased with aging in HTG. The rate of these abnormal findings in HTG was significantly higher than that in no-RFG. In addition, HT accelerated the occurrence of these findings by 10-20 years. When patients were over 60 years old, ACI increased rapidly. Accordingly, we concluded that (1) PVH and ACI had a common background. (2) Long term follow up concerning the incidence of ACI in the group with only PVH was necessary. (3) It was desirable that treatment for RF should be effected before the age of sixty.

Rehabilitation of spinal cord injury in the national rehabilitation center for the disabled of Japan: profile of a spinal service

The National Rehabilitation Center for the Disabled (hereunder abbreviated NRC) in Japan was established in 1979. It consists of four divisions: the hospital, the rehabilitation training center, the research institute, and the information service section. The spinal unit has been functioning and cooperating corelatively with all of these divisions. There were 1047 patients with a spinal cord injury treated in the 15 years from September, 1980 to August, 1994; consisting of 924 males (88.3%), and 123 females (11.7%). The breakdown of causes of injury were traffic accidents 44.9%, having a fall 14.7%, sports accidents 6.7%, and other causes of spinal paralysis 10.5%. The sites of the spinal cord lesions were cervical 372 (35.5%), thoracic 547 (52.5%), and lumbar spinal cord 128 patients (12.3%). The incidence of complete paralysis in those with a cervical spinal cord injury (SCI) was 68.8%, and for thoracic and lumbar SCI 79% each. The time for completion of activities of daily living (ADL) was 12.0 +/- 1.54 months in those with tetraplegia, and 5.6 +/- 1.71 months for those with paraplegia. The rate of employment for reentry into society was 59% in those with a cervical spinal cord injury, and 74% each in those with a thoracic or lumbar spinal cord injury.

Simultaneous alignment of optical axes by monitoring reflected light from core and cladding

We propose a method of aligning optical axes by monitoring reflected light from the core and the cladding at the coupling end. This method enables the simultaneous alignment of optical axes at multiple coupling ends because it is not necessary to monitor the transmitted light through the couplings. Experimental results show that this method can be used for coupling between cleaved single-mode fibers and between fibers with slant ends. The simultaneous alignment of two coupling ends is also achieved, and it is shown to obtain the optical power transmitted through the coupling, which is enough to begin the precise alignment. Moreover, we confirm fundamentally that one can use this method for precise alignment of optical axes by monitoring the optical beam profiles of the reflected light.

Free-space optical module configuration using a guide-frame assembly method

A new assembly method is described for easy construction of optical modules consisting of guide frames, spacer frames, and a housing frame. This method is used to assemble a two-dimensional optical-fiber collimator and a digital discrete correlator, which are fundamental parts of free-space optical computing systems. We show that a multistage optical system can be constructed simply by stacking of several optical functional blocks. Moreover, these compact modules do not need a conventional optical bench, they are compact, and assembly time is reduced. We demonstrated by experiment that the accuracy of optical modules assembled with this method is within the specifications of the optical system.

Relationship between functional levels and movement in tetraplegic patients. A retrospective study

The aim of the present study was to set targets for each spinal lesion level after determining the relationship between the spinal lesion level and movement abilities in patients with tetraplegia following injury to the cervical cord. A total of 109 patients, 96 men and 13 women were included in the study. We mainly examined locomotion and transfer capabilities according to Zancolli's classification. The results of this study showed that 50% of the patients classified as C6A, 75% of C6B1 and 96% of the patients classified C6B2 accomplished bed transfer. The number of patients who could manage toilet transfer was 53% in the group classified as C6B1 and 85% in group C6B2. These results suggest that achievement of those classified as C6B2 is a clue to the assumption that the patient will achieve toilet transfer capability and can perform ADL independently.

[The effects of short and long duration of hypothyroidism on prolactin secretion in rats]

The aim of the present study was to evaluate the time-dependent effect of an experimentally induced hypothyroid state on prolactin (PRL) secretion in rats. Treatment with radioactive iodine and propylthiouracil (PTU) resulted in reduced serum concentrations of total thyroxine and triiodothyronine, and increased serum TSH concentrations in rats one week after the start of the treatment. Basal serum PRL concentrations were not significantly altered in 1-, 2- and 4-week hypothyroid rats, whereas in 8-week hypothyroid rats, serum PRL concentrations were significantly reduced and remained depressed throughout 24 weeks of PTU ingestion. The PRL response to i.p. administration of haloperidol (0.5mg/kg) was significantly reduced after one week of PTU ingestion. When the duration of hypothyroidism was increased, there was a progressive fall in the PRL response to haloperidol that reached the lowest value after 12 weeks of PTU ingestion. The PRL response to an i.v. bolus injection of vasoactive intestinal peptide (VIP, 150 mu g/kg) was markedly reduced in hypothyroid rats after one week of PTU ingestion and reached the lowest value after two weeks. The PRL response to VIP was progressively recovered after treatment for 4 weeks with PTU, and reached the highest value in 24-week hypothyroid rats. However, the PRL response to VIP in 24-week hypothyroid rats was significantly lower than that in euthyroid rats. Serum PRL response to an i.v. bolus injection of beta -endorphin (450 mu g/kg) was significantly reduced in 8-week hypothyroid rats. Dopamine (DA) concentrations in the pituitary and the hypothalamus were not significantly altered in 2-week hypothyroid rats. In contrast, DA concentrations were significantly increased in both the pituitary and hypothalamus in 8- and 24-week hypothyroid rats. These findings observed in hypothyroid rats were reversed by the administration of thyroxine and triiodothyronine for 9 days. The present results support a modulatory role for thyroid status in regulating the concentration of DA in the pituitary and the hypothalamus, and consequently on PRL secretion by the pituitary. This suggests that PRL releasing factors do not appear to play a major role in PRL secretion in hypothyroid rats. These data also indicate that alterations in PRL secretion and DA concentrations in the pituitary and the hypothalamus in the hypothyroid state become more prominent as the duration of hypothyroidism increases.

Movement of intrapancreatic calcium in dogs with experimental pancreatic lithiasis. With special reference to the process of pancreatic calculus formation

This study was performed to clarify the movement of calcium in the pancreas of dogs with chronic pancreatitis, using scanning and transmission electron microscopes (SEM, TEM) equipped with X-ray elemental microanalyzers. Eleven adult mongrel dogs underwent incomplete ligation of the pancreatic duct. After the procedure, the levels of pancreatic enzymes in the serum did not change for 9 mo, but the endocrine function was reduced gradually. Of all dogs, 5 revealed pancreatic sclerosis, and 2 at 9 mo had calculi, 2-4 mm in size, in the small pancreatic duct. SEM examination revealed the intralobular fibrosis and irregularity of the pancreatic duct wall, and TEM examination revealed the intralobular fibrosis and irregularity of the pancreatic duct wall, and TEM examination demonstrated the amorphous or crystalloid substances and secreted granules in the acinar lumen or ductule. In elemental analysis spectra using SEM, a high calcium peak was seen in the pancreatic duct wall. In elemental analysis spectra using TEM, a high calcium peak was observed in the amorphous or crystalloid substances, and a high ratio of Ca/K was seen in these substances. Calcium was also detected in the secreted granules or microvilli. These results suggest that there is a process of calculus formation based on the congregation of the intraductular substances containing a large quantity of calcium.

Identification and characterization of a plaque forming avian rotavirus isolated from a wild bird in Japan

From fresh faeces of a wild bird (Melanitta fusca), a virus that showed granular cytopathic effects (CPE) on chicken kidney cell (CKC) cultures was isolated. By indirect immunofluorescence analyses (IFA), this isolate reacted with an antiserum against a bovine rotavirus. The isolate produced clear plaques on CKC by conventional techniques, without trypsin. Three virus plaques were selected by plaque size (small, medium, and large) and cloned by three successive plaque cloning. In the SDS-PAGE analyses, dsRNA bands showed a typical profile of avian rotavirus and quite different from that of avian reovirus. With dsRNA patterns, IFA results, CPE, and a morphological property, the clones were identified as avian rotaviruses of group A rotavirus. The clones killed chicken embryos, when they were inoculated to yolk sac.

Negative inotropic effects of disopyramide on guinea-pig papillary muscles

1. The inhibitory effects of disopyramide on electromechanical responses were investigated in guinea-pig papillary muscles driven by electrical stimuli. Disopyramide up to 10(-5) M did not cause a negative inotropic effect, while the maximum upstroke velocity of the action potential (dV/dtmax) was significantly decreased. 2. At higher concentrations, this drug dose-dependently inhibited the contraction, and dV/dtmax was further decreased. This inhibition of contraction was accompanied by a depression of the slow action potential in partially depolarized preparations by increasing [K+]0 (26 mM). 3. In preparations pretreated with nifedipine (10(-6) M) and ryanodine (10(-6) M), the contraction was almost completely inhibited. In such preparations, ouabain (2 x 10(-6) M) markedly increased the contraction, probably through the Na(+)-Ca2+ exchange mechanism. This contraction was inhibited by disopyramide above 10(-8) M, and an almost complete inhibition was caused at 3 x 10(-5) M. 4. A similar inhibitory effect was observed on the contraction increased by the lowering of [Na+]0 (36 mM). 5. These results suggest that disopyramide at high concentrations inhibits Ca influx through slow Ca2+ channels and at low concentrations, it reduces the contraction increased through the Na(+)-Ca2+ exchange mechanism. Disopyramide had a greater effect on cardiac contractility mediated by the Na(+)-Ca2+ exchange mechanism.

Anticholinergic action of disopyramide in intestinal smooth muscle of the guinea pig: inhibition of muscarinic receptors (M1 and M2)

Antimuscarinic actions of disopyramide were investigated by measuring the contractile responses of intestinal smooth muscles and ligand binding in cardiac and intestinal membrane preparations. Disopyramide caused a parallel shift of the dose-response curves for acetylcholine, McN-A-343, and carbachol to the right in the guinea pig taenia caeci; pA2 values were 5.4 for acetylcholine, 5.5 for McN-A-343 and 5.9 for carbachol. In the guinea pig ileum, disopyramide competitively antagonized acetylcholine in the contractile responses, having the pA2 value of 6.1. In microsomal fractions of the guinea pig taenia caecum and heart, disopyramide was capable of replacing 3H-QNB; K1 values were 7 x 10(-6) M for the taenia and 2 x 10(-6) M for the heart. These results suggest that disopyramide exerts antimuscarinic action through M1 and M2 receptors with a potency approximately 3 times greater for M2 than M1.

Cloning and sequencing of RNA-1 cDNA from cucumber mosaic virus strain O

The complete nucleotide (nt) sequence (3369 nt) of RNA 1 of cucumber mosaic virus strain O (CMV-O) was determined. One open reading frame (ORF; 993 aa) could be deduced from the nt sequence. The homologies of the ORF between CMV-O and CMV-Q or CMV-Fny were calculated to be 85% or 97%, respectively. For CMV-O and CMV-Q, the first one-third of the ORF showed a higher degree of homology (89%), as compared with the other portions (82-85%); the first 224 aa showed more than 93% homology. A comparative study of the three viruses revealed that CMV-O is more homologous to CMV-Fny (subgroup I) [corrected]) than to CMV-Q (subgroup II) [corrected].

Complete nucleotide sequence of RNA 3 from cucumber mosaic virus (CMV) strain O: comparative study of nucleotide sequences and amino acid sequences among CMV strains O, Q, D and Y

The complete nucleotide sequence (2217 residues) of RNA 3 of cucumber mosaic virus strain O (CMV-O) was determined. Two open reading frames were identified, encoding a 3A protein (279 amino acid residues) in the 5'-proximal region and a coat protein (218 amino acid residues). The amino acid sequence of the coat protein C terminus was determined directly from purified protein, and confirmed the presence of the coat protein open reading frame in CMV-O RNA 3. Comparison of nucleotide sequences and amino acid sequences of CMV strains O, Q, D and Y indicated the close relationship between these strains. A tRNA-like structure could be adopted by the 3' non-coding region, and this resembled a similar structure in CMV-Q in spite of nucleotide substitutions or deletions.

Chronic instrumentation and its lack of effect on the hemodynamics and regional myocardial blood flow of conscious dogs

The effects of chronic instrumentation on regional myocardial performance and regional myocardial blood flow were studied in 8 mongrel dogs. Regional segment lengths were measured by an ultrasonic dimension gauge technique at two areas of the left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX). Regional myocardial blood flow was measured by a tracer microsphere technique. These measurements were repeated while the animals were conscious on the 4th, 11th, 21st and 28th days after instrumentation. On the 4th day, the heart rate was rather high and regional shortening at both the LAD and LCX areas remained suppressed. After the 11th day, hemodynamic variables such as heart rate, left ventricular pressure and regional wall motion were fairly constant. Regional myocardial blood flow and its distribution were also constant throughout the experimental period. Fibrosis of the epicardium invariably induced by surgical procedures did not affect the distribution of regional blood flow as compared with that of the interventricular septum. Thus, a stable hemodynamic state was recorded after the 11th day following surgical manipulation and the implantation of sensors and catheters did not affect the level of regional myocardial blood flow or its distribution at rest. Such long term reproducible measurements of regional wall motion and regional myocardial blood flow may facilitate chronic studies of cardiovascular physiology.