Simulated validation of intron-less transgene detection using DELLY for gene-doping control in horse sports

Gene doping is prohibited in horseracing. In a previous study, we developed a method for non-targeted transgene detection using DELLY, which is based on split-read (SR) and paired-end (PE) algorithms to detect structural variants, on WGS data. In this study, we validated the detection sensitivity of DELLY using artificially generated sequence data of 12 target genes. With DELLY, at least one intron was detected as a deletion in eight targeted genes using the 150 bp PE read WGS data, whereas all targeted genes were detected by DELLY using the 100 bp PE read data. The detection sensitivity was higher in 100 bp PE reads than in 150 bp PE reads, despite a lower total sequence coverage, probably because of mismatch tolerance between the mapped reads and reference genome. In addition, it was observed that the average intron size detected by SR alone was 293 bp and that that detected by both SR and PE was 8924 bp. Thus, we showed that transgenes with various intron-exon structures could be detected using DELLY, suggesting its application in gene-doping control in horses.

A candidate-SNP retrospective cohort study for fracture risk in Japanese Thoroughbred racehorses

Fractures are medical conditions that compromise the athletic potential of horses and/or the safety of jockeys. Therefore, the reduction of fracture risk is an important horse and human welfare issue. The present study used molecular genetic approaches to determine the effect of genetic risk for fracture at four candidate SNPs spanning the myostatin (MSTN) gene on horse chromosome 18. Among the 3706 Japanese Thoroughbred racehorses, 1089 (29.4%) had experienced fractures in their athletic life, indicating the common occurrence of this injury in Thoroughbreds. In the case/control association study, fractures of the carpus (carpal bones and distal radius) were statistically associated with g.65809482T/C (P = 1.17 x 10^-8 ), g.65868604G/T (P = 2.66 x 10^-9 ), and g.66493737C/T (P = 6.41 x 10^-8 ). In the retrospective cohort study using 1710 racehorses born in 2000, the relative risk (RR) was highest for male horses at g.65868604G/T, based on the dominant allele risk model (RR = 2.251, 95% confidence interval 1.407-3.604, P = 0.00041), and for female horses at g.65868604G/T, based on the recessive allele risk model (RR = 2.313, 95% confidence interval 1.380-3.877, P = 0.00163). Considering the association of these SNPs with racing performance traits such as speed, these genotypes may affect the occurrence of carpus fractures in Japanese Thoroughbred racehorses as a consequence of the non-genetic influence of the genotype on the distance and/or intensity of racing and training. The genetic information presented here may contribute to the development of strategic training programs and racing plans for racehorses that improve their health and welfare.

Genetic diversity and relationships among native Japanese horse breeds, the Japanese Thoroughbred and horses outside of Japan using genome-wide SNP data

Eight horse breeds-Hokkaido, Kiso, Misaki, Noma, Taishu, Tokara, Miyako and Yonaguni-are native to Japan. Although Japanese native breeds are believed to have originated from ancient Mongolian horses imported from the Korean Peninsula, the phylogenetic relationships among these breeds are not well elucidated. In the present study, we compared genetic diversity among 32 international horse breeds previously evaluated by the Equine Genetic Diversity Consortium, the eight Japanese native breeds and Japanese Thoroughbreds using genome-wide SNP genotype data. The proportion of polymorphic loci and expected heterozygosity showed that the native Japanese breeds, with the exception of the Hokkaido, have relatively low diversity compared to the other breeds sampled. Phylogenetic and cluster analyses demonstrated relationships among the breeds that largely reflect their geographic distribution in Japan. Based on these data, we suggest that Japanese horses originated from Mongolian horses migrating through the Korean Peninsula. The Japanese Thoroughbreds were distinct from the native breeds, and although they maintain similar overall diversity as Thoroughbreds from outside Japan, they also show evidence of uniqueness relative to the other Thoroughbred samples. This is the first study to place the eight native Japanese breeds and Japanese Thoroughbred in context with an international sample of diverse breeds.

A Kirschner wire as a transverse-axis guide to improve acetabular cup positioning

PURPOSE

To compare cup-positioning accuracy in total hip arthroplasty (THA) with or without use of a Kirschner wire as a transverse-axis guide for pelvic alignment.

METHODS

Records of 18 men and 73 women (mean age, 60 years) who underwent primary THA with (n=49) or without (n=42) use of a Kirschner wire as a transverse-axis guide for pelvic alignment were reviewed. A 2.4-mm Kirschner wire as a transversea-xis guide was inserted to the anterior superior iliac spine and was parallel to a line linking the left and right anterior superior iliac spine. The safe zone for cup positioning was defined as 30º to 50° abduction and 10º to 30º anteversion. Of the 5 operative surgeons, 2 were classified as experienced (total surgical volume >300) and 3 as inexperienced (total surgical volume of <50). The proportion of patients with the cup in the safe zone was compared in patients with or without use of the transverse-axis guide and in experienced and inexperienced surgeons.

RESULTS

For inexperienced surgeons, the use of the transverse-axis guide significantly improved the proportion of patients with the cup in the safe zone from 90% to 100% for abduction, from 50% to 82.4% for anteversion, and from 40% to 82.4% for both. Patients with the cup inside or outside the safe zone were comparable in terms of body height, weight, BMI, subcutaneous fat thickness, incision length, and acetabular cup size.

CONCLUSION

The use of the transverse-axis guide improved the accuracy of cup positioning by inexperienced surgeons.

Heritability estimates for racing performance in Japanese Thoroughbred racehorses using linear and non-linear model analyses

This study evaluated the differences between linear and non-linear modelled heritability estimates of racing performance based on lifetime earnings (LE) and lifetime ranking (LR) in Japanese Thoroughbred racehorses. The heritability estimate (h(2) = 0.25) obtained from a non-linear model based on formal Japan Racing Association ranking was much higher than that obtained from a linear model based on the original trait phenotype (h(2) = 0.11). The linear models showed slightly higher heritability estimates under the trait categorizations than under the original phenotypes, while the non-linear categorical trait models showed much higher heritability estimates than the linear models, especially for binary trait categorizations (h(2) = 0.34) with non-winning and winning horses. The binary trait categorizations were consistent with the case and control classifications in the previous genome-wide association study (GWAS), which identified possible sequence variants on ECA18 that affect racing performance in Japanese Thoroughbred racehorses. Those findings suggested that the different heritability estimates obtained from several trait categorizations would reflect the possible presence of susceptibility gene segregations in the analyzed population, indicating that heritability estimates from non-linear models are useful for the selection of case and control populations in GWAS.

Development of a method for simultaneously genotyping multiple horse coat colour loci and genetic investigation of basic colour variation in Thoroughbred and Misaki horses in Japan

In order to develop a genotyping method that can be used in the registration procedure for Thoroughbreds, we developed a method for simultaneously genotyping multiple coat colour genes on the basis of single nucleotide polymorphism typing by using the SNaPshot(TM) technique. This method enabled precise and reasonable detection of causal mutations; it was effective for genotyping of MC1R, ASIP, and SLC45A2 at the Extension (E), Agouti (A), Cream dilution (C) loci, and the possibility of identification of rare variants of MC1R, EDNRB and KIT at the E, Overo (O) and Sabino 1 (SB1) loci, respectively, was also indicated. It was considered that this genotyping method would provide information not only for the registration of Thoroughbreds but also for the preservation of phenotypic characters, such as coat colour, of endangered Misaki native horses in Japan. Therefore, genetic variations at the five coat colour loci were investigated in 1111 Thoroughbred and 99 Misaki native horses. Allele frequencies at the polymorphic E and A loci were estimated, and the proportions of basic coat colours that could be expected in the Thoroughbred population were bay, 0.662; black, 0.070; chestnut, 0.268. In the Misaki population, they were bay, 0.792; black, 0.129; chestnut, 0.080. The data presented were the first of its kind on genetic coat colour variation, and will be important with regard to the registration of Thoroughbreds and the management of Misaki horses.

Genetic diagnosis of sex chromosome aberrations in horses based on parentage test by microsatellite DNA and analysis of X- and Y-linked markers

REASONS FOR PERFORMING STUDY

Sex chromosome aberrations are often associated with clinical signs that affect equine health and reproduction. However, abnormal manifestation with sex chromosome aberration usually appears at maturity and potential disorders may be suspected infrequently. A reliable survey at an early stage is therefore required.

OBJECTIVES

To detect and characterise sex chromosome aberrations in newborn foals by the parentage test and analysis using X- and Y-linked markers.

METHODS

We conducted a genetic diagnosis combined with a parentage test by microsatellite DNA and analysis of X- and Y-linked genetic markers in newborn light-breed foals (n = 17, 471). The minimum incidence of sex chromosome aberration in horses was estimated in the context of available population data.

RESULTS

Eighteen cases with aberrations involving 63,XO, 65,XXY and 65,XXX were found. The XO, XXY (pure 65,XXY and/or mosaics/chimaeras) and XXX were found in 0.15, 0.02 and 0.01% of the population, respectively, based solely on detection of abnormal segregation of a single X chromosome marker, LEX003.

CONCLUSIONS AND POTENTIAL RELEVANCE

Detection at an early age and understanding of the prevalence of sex chromosome aberrations should assist in the diagnosis and managment of horses kept for breeding. Further, the parental origin of the X chromosome of each disorder could be proved by the results of genetic analysis, thereby contributing to cytogenetic characterisation.

Antibiotic selection patterns in acutely febrile new outpatients with or without immediate testing for C reactive protein and leucocyte count

BACKGROUND

Excessive use of broad spectrum antibiotics is related to the spread of drug resistant bacterial strains in the community.

AIM/METHODS

The effects of immediate testing for C reactive protein (CRP) and white blood cell count (WBC) on physicians' choices of antibiotic was investigated in patients with acute infection. Acutely febrile new outpatients were randomised into two groups: group 1 (147 patients) underwent CRP and WBC testing before initial consultation (advance testing). Prescriptions were compared with those in group 2 (no advance testing; 154 patients).

RESULTS

In non-pneumonic acute respiratory tract infections, 61 (58%) and 122 (91%) of group 1 and 2 patients were prescribed antibiotics, respectively. Cefcapene pivoxil (third generation cephalosporin) and amoxicillin were the most frequently chosen drugs for group 1 and 2, respectively. Total prescriptions of newer, extended spectrum antibiotics (cefcapene pivoxil and clarithromycin (advanced macrolide)) were reduced by 25% in group 1, although they increased in rate (41 (67%) v 55 (45%) prescriptions) because of the decreased prescription of amoxicillin. In group 1, cefcapene pivoxil was preferentially selected when WBC values were greater than 9 x 10(9)/litre. Prescription shifted to macrolides (mainly clarithromycin) in patients without leucocytosis. Patient treatment outcome did not significantly differ between the two groups.

CONCLUSIONS

The availability of CRP and WBC data during initial consultation greatly reduced prescription of amoxicillin, but had a lesser effect on newer, potent, broad spectrum antibiotics.

Population study and validation of paternity testing for Thoroughbred horses by 15 microsatellite loci

Microsatellite 15 TKY System was characterized for parentage verification of horse registry. The Microsatellite 15 TKY System was constructed by using 15 microsatellites, TKY279, TKY287, TKY294, TKY297, TKY301, TKY312, TKY321, TKY325, TKY333, TKY337, TKY341, TKY343, TKY344, TKY374, and TKY394, to provide stringent PCR-based microsatellite typing specifically optimized for multicolor fluorescence detection. The Microsatellite 15 TKY System showed good resolutions for 250 unrelated Thoroughbred horses, and the probability of exclusion (PE) at each microsatellite ranged from 0.437 to 0.621, resulting in a total PE value of 99.998% for Thoroughbred horses. These results indicated that the Microsatellite 15 TKY System is useful for paternity testing of Thoroughbred horses. A paternity testing case for a Thoroughbred horse family, in which candidate sires had close relations, was analyzed using the Microsatellite 15 TKY System. In this case, the Microsatellite 15 TKY System excluded paternity of a false sire. We concluded that the Microsatellite 15 TKY System can give sufficient and reliable information for paternity testing.

A morphological and morphometric study of the peripheral process of the human vestibular nerve following posterior cranial fossa neurectomy

Three vestibular nerve specimens removed at transmeatal neurectomy were studied in order to understand better retrograde degeneration and regeneration after vestibular neurectomy in the posterior cranial fossa. In two cases this procedure followed retrolabyrinthine retrosigmoid posterior fossa vestibular neurectomy. The subjects, three patients with Menière's disease, were compared with one another and two autopsy controls with no known otological problem. The specimens were obtained at the distal end of the internal auditory canal and transversely sectioned. Many collapsed Schwann cell basement membranes were observed. The ratio of small-diameter nerve fibres increased significantly after neurectomy. Onion bulb formation around myelinated nerve fibres with small diameters and Schwann cell proliferation around the soma of vestibular ganglion cells reflected remyelination. We conclude that peripheral processes of vestibular nerve fibres can undergo retrograde degeneration and subsequent regeneration after transection of the central process.

[Effect of inflation of the eustachian tube on tinnitus]

The purposes of this study were to evaluate the effect of inflating the Eustachian tube in patients with tinnitus, and to identify diseases in which tubal inflation is indicated. Fifty-four ears of as many patients complaining of tinnitus were examined by pure tone audiometry and decreases in pitch and loudness associated with tinnitus were also evaluated by tinnitus audiometry (Danac-100, DanaJapan). Tinnitus was associated with sensorineural hearing loss (SNHL) in 44 ears and not associated in the remaining 10. The subjects were classified further into two groups: the higher tone group showed a pitch range with tinnitus of 1000 Hz or higher, and the lower tone group showed a pitch range of less than 1000 Hz. In the higher tone tinnitus group with SNLH, the tubal inflation was effective in 3 of 31 ears (10%), and in the lower tone group, 10 of 13 ears (77%). On the other hand, in the tinnitus group with no hearing loss, the method relieved tinnitus in 6 of 10 ears (60%). In the higher tone tinnitus group with no hearing loss, the tubal inflation was effective in 3 of 6 ears (50%), and in the lower tone group, 3 of 4 ears (75%). In this study, however, no ears were permanently relieved of tinnitus with tubal inflation. In the higher tone group, the duration of the reduced tinnitus was less than 10 minutes. In 69% of the lower tone group, the reduction was from 20 minutes to 2 hours. The effect did not continue for more than 2 hours at the longest. In conclusion, Eustachian tubal inflation is indicated in diseases with tinnitus as follows: 1. Lower tone tinnitus with SNHL, particularly in Meniere's disease and acute onset low-tone type SNHL, may be temporarily relieved with tubal inflation. 2. Tinnitus in an ear without SNHL that may gain transitory relief from ringing with the tubal inflation.

[The effects of premedication on induction doses of propofol and hemodynamic responses during induction]

We chose five sedatives for premedication and investigated the effect of these drugs on the induction doses of propofol. One hundred patients were allocated into one of five groups of 20. These groups consisted of control group (C) given only atropine 0.5 mg i.m.; CL group (plus clonidine 0.15 mg orally); H group (plus hydroxyzine 25 mg i.m.); M group (plus midazolam 3 mg i.m.) and D group (plus diazepam 10 mg orally). The induction dose was measured using loss of count technique. Arterial pressure and heart rate were measured, before and after propofol induction as well as after intubation. We also calculated rate pressure products (RPP) at each point. The induction doses were significantly lower in M-group than those in C-group. On the other hand, in hemodynamic responses, RPP was unchanged in any groups after propofol induction and after the intubation. Both propofol and midazolam have been known to have a depressive effect on the central nervous system via GABA-A receptor-mediated inhibition, although the exact receptor for propofol is unknown. We thought, therefore, that when the interaction occurred, both midazolam and propofol had the same effect on the GABA-A receptor and increased chloride ion flux through the channels. Hydroxyzine and clonidine, however, do not share a common receptor or exert effect on the GABA-A receptor. We consider that this was one of the reasons why induction doses of both H and CL group could not decrease significantly. We concluded that midazolam 3 mg decreased propofol induction dose significantly. Both midazolam 3 mg and clonidine 0.15 mg decreased RPP before induction and hemodynamic responses to induction and intubation were stable.

Genetic relationship between equine apolipoproteins A4 and A1

Genetic polymorphism of equine apolipoprotein (APO) A4 was investigated using two-dimensional electrophoresis in four horse breeds, including Japanese native horses. A linkage relationship between the equine APOA4 and APOA1 structural loci was assumed from the segregation data of these loci in one family line of the Japanese Hokkaido native breed.

Auditory epithelial migration. III: An immunohistologic study using anti-BrdU antibody on tympanic membrane in mouse

A localization pattern of epidermal cells on the tympanic membrane (TM) and their migratory patterns were studied in mice, by means of immunohistologic technique using an anti-bromodeoxyuridine (BrdU) antibody. The BrdU was instilled intraperitoneally and the animals were painlessly sacrificed between 1 hour and 10 days after the injection. An immunostaining technique using anti-BrdU antibodies was applied on whole mount TM tissues. One hour after injection, BrdU-labeled cells were found in the handle of the malleus (HM) region and in the annular region of the pars tensa of the TM. Some labeled cells were observed in the intermediate region of the upper half of the superior quadrant, but no labeled cells were found in the remaining part of the intermediate region. Labeled cells were also evident in the pars flaccida without any particular pattern of distribution. As time elapsed after the injection, the labeled cells first appearing in the HM region had migrated laterally and inferiorly from the HM toward the annulus, while those in the annular region had considerably decreased in number. Results of the present study are the following: 1) the proliferation center of epidermal cells in the pars tensa is located in two different areas, i.e., the HM region and annular region, 2) newly generated cells in the HM region migrated from the HM region toward the annular region, whereas those in the annular region migrate from the the annular region to the external auditory canal, and 3) no specific generation center is located in the pars flaccida. On the basis of these results, we discuss the relationship between the site of the proliferation center of epidermal cells and their migratory patterns.

Auditory epidermal cell migration. VII. Antigen expression of proliferating cell nuclear antigens, PCNA and Ki-67 in human tympanic membrane and external auditory canal

A location of proliferating cells was investigated in eight human normal tympanic membranes (TMs) and external auditory canals (EACs) by an immunohistochemical method using two different types of antibodies for nuclear antigens in proliferating cells: anti-PCNA monoclonal antibody, and anti-Ki-67 polyclonal antibody. Four specimens prepared for cryostat sections were immunostained by both antibodies. Another four were fixed in 4% formaldehyde solution, embedded in paraffin wax and were reacted only with anti-PCNA antibodies. The expression pattern of Ki-67 was basically the same as of PCNA. In the pars tensa (PT), immunoreactivities were expressed in the nuclei of basal layer cells and cells just overlying the basal layer of epidermis both in the handle of the malleus (HM) and annular regions. In the intermediate region of the PT, no immunoreactivity was found basically, apart from a few labelled cells observed in the upper-third of the superior quadrant. In the pars flaccida (PF) and in both the osseous and cartilaginous regions of the EAC, positive cells were also situated in the basal layer and the deeper aspect of the suprabasal layers without any specific distributing pattern. It was certified that the generation centre of epidermal cells (keratinocytes) in the PT was located in both the HM and annular regions, and that stem cells in the PF and the EAC were uniformly scattered in the basal layer and the deeper aspect of the spinous layer. According to these findings, the migratory patterns of auditory epidermal cells in the human TM and EAC were discussed.

Auditory epithelial migration. II: Morphological evidence for auditory epidermal cell migration in rat

Morphology of the tympanic membrane (TM) and external auditory canal (EAC) was studied in healthy, intact rat ears. TM-perforated ears (3 days after making the perforation) and TM-perforation-healed ears (14, 28 and 42 days after making the perforation). In intact ears, the epidermis in the annular region of the EAC displayed a characteristic appearance with cytoplasmic protrusions. We termed these protrusions as "finger-like projections". In contrast to the rat, the annular region of the EAC in the guinea-pig did not show "finger-like projections". Following a perforation in the centre of the anterior or the posterior quadrant of the pars tensa in rats the "finger-like projections" disappeared from the annular region on the perforated side of the EAC, while the projections remained on the malleus side of the perforation edge. In perforation-healed ears analysed 42 days after the perforation, the "finger-like projections" had recurred in the annular region on the perforated side of the EAC. The "finger-like projections" are likely to express maturation (keratinization) and desquamation of epidermal cells in the pars tensa and also could constitute morphological evidence of their migration on the TM.

Auditory epidermal cell migration. V. Transmission electron-microscopic study of tympanic membrane and external auditory canal in the mouse

The morphology of the tympanic membrane (TM) and external auditory canal (EAC) in mice was examined by transmission electron microscopy, in seven different regions: the handle of the malleus (HM) region, the intermediate and annular regions of the pars tensa (PT), the region of the pars flaccida (PF), the annular and osseous regions of the EAC and the cartilaginous region of the EAC. Each region displayed its own unique findings. In most regions of the TM and EAC-except the intermediate region of the PT-basal layer cells formed cytoplasmic processes (CPs) on their basal surface and adhered to the basement membrane (BM) by means of hemidesmosomes (HDs). This observation may suggest the presence of stem cells. In contrast, basal cells in the intermediate region of the PT did not extend any CPs from the basal surface but attached to the BM by a few characteristic spots of HD-like density but lacking the characteristics of HDs. It is concluded that stem cels are not present there and that basal cells connect loosely with the BM, thus providing the necessary morphological conditions to migrate laterally toward the annular region. The outermost layer of the epidermis in the annular region of the EAC showed numerous cytoplasmic projections (so-called 'finger-like projections'), representing keratinization and desquamation of epidermal cells (keratinocytes). These projections are believed to be the terminal differentiation of epidermal cells originating from the general centre in the HM region of the PT. The epidermis of the PF is an extension of the upper wall of the EAC, but the two regions differ morphologically.

Morphological changes in rat submandibular gland mucous cells during fixation with 10% formalin

The features of mucous cells in 10% formalin (FA)-fixed submandibular glands differ markedly from those fixed in glutaraldehyde (GA). We therefore studied morphological changes in mucous cells during 10% FA fixation. Mucous cells were fixed in either 10% FA, neutral sodium-phosphate-buffered (Na-PBed) 10% FA, ice-cold 10% FA or an ice-cold fixative mixture of 2.0% paraformaldehyde (PA) and 0.5% GA. Two different methods were used: immersion fixation and venous perfusion fixation. The 10% FA-fixed tissues had elliptical or flattened nuclei, a clear cytoplasm and no secretory granules. Tissues fixed with the fixative mixture displayed almost round nuclei, a broad endoplasmic reticulum and abundant secretory granules in the cytoplasm. Tissues immersion-fixed with neutral Na-PBed 10% FA or perfusion-fixed with ice-cold 10% FA had almost the same light microscopic appearance as that of the mixture-fixed tissues. To elucidate the process of morphological changes during 10% FA fixation at room temperature, samples immersed in 10% FA for varying periods of time were postfixed immediately in the fixative mixture and exposed to microwave irradiation. This method produced a variety of findings, even within the same section. There was a significant difference in the findings seen in the center of the section and at the periphery. The initial changes caused by 10% FA were rupture of the secretory granules located in the perinuclear region and destruction of the perinuclear organelles such as Golgi apparatus, mitochondria and endoplasmic reticulum. Absorption of the endoplasmic reticulum progressed so that the perinuclear region became translucent. To obtain a better structure in mucous cells from the fixed submandibular gland tissues, an appropriate fixative such as GA should be used and the fixative should infiltrate into the tissues as quickly as possible.

Auditory epithelial migration. IV. Light- and scanning electron-microscopic studies of the tympanic membrane and external auditory canal in the mouse

The fine structures of the tympanic membrane and external auditory canal (EAC) were observed in the mouse under both the light microscope and scanning electron microscope. According to the differences in morphological features of the epidermis and epidermal cells, they were grossly classified into 8 types of region: (1) the region of the handle of the malleus, (2) the intermediate region of the pars tensa (PT), (3) the annular region of the PT, (4) the region of the pars flaccida, (5) the annular region of the anterior, inferior and posterior walls of the EAC, (6) the osseous region of the anterior, inferior and posterior walls of the EAC, (7) the region of the upper wall of the EAC and (8) the cartilaginous region of the anterior, inferior and posterior walls of the EAC. The specific structure "finger-like projections' was visualized throughout in the annular region of the EAC. The morphology of the region of the upper wall of the EAC was almost identical with that of the cartilaginous region of the anterior, inferior and posterior walls of the EAC.

Relationship between regional abnormality of left ventricular rapid filling and coronary microcirculation disturbance in hypertrophic cardiomyopathy

BACKGROUND AND HYPOTHESIS

To investigate the mechanism of regional left ventricular diastolic filling disturbance in hypertrophic cardiomyopathy (HCM), we assessed the relationship between abnormalities of regional ventricular rapid filling and regional coronary microcirculation using radionuclide ventriculography and exercise 201thallium (201TI) myocardial scintigraphy with sector analysis.

METHODS

Thirty patients with HCM and 14 patients with atypical chest pain syndrome (controls) were studied. Left ventricular images (left anterior oblique view) were obtained by electrocardiogram-gated 99mtechnetium radionuclide angiography and were divided into three sectors radiating from the geometric center. The time-activity curves and their first derivative curves were analyzed, and the peak filling rate (PFR), the ratio of the time-to-peak filling rate per diastolic interval (TPFR/T) were calculated for the global left ventricle and for the lateral and septal sectors. Exercise stress 201TI myocardial scintigraphy was also performed, and early and delayed images were obtained. The regional washout rate (WR) was then evaluated for the lateral and septal sectors.

RESULTS

In HCM patients, the regional PFR in the septal sector (corresponding to the region of hypertrophic myocardium) was 285 +/- 76%/s, and was significantly lower than that in the controls (398 +/- 90%/s, p < 0.01). The regional TPFR/T in the septal sector (32 +/- 10%) was prolonged compared with the value of 21 +/- 5% in the controls (p < 0.05). The regional WR in the septal sector was 21 +/- 9%, and was significantly lower than that in the controls (43 +/- 5%, p < 0.01). Moreover, regional WR correlated positively with regional PFR (r = 0.5, p < 0.05) and showed a weak negative relationship with regional TPFR/T (r = -0.4, p < 0.07) in the septal sector.

CONCLUSIONS

These results suggest that regional impairment of rapid filling might be related to a disturbance of the coronary microcirculation in HCM.

Auditory epithelial migration: I. Macroscopic evidence of migration and pathways in rat

Auditory epithelial migration (AEM) was studied in the rat for up to 42 days following the application of dye on the tympanic membrane (TM) and external auditory canal (EAC). Migratory pathways were similar to those in the human. In the pars tensa (PT), pathways were radially and centrifugally oriented from the handle of the malleus (HM) toward the annulus. However, the pathway along the HM from the umbo to the pars flaccida (PF), as reported in the human, was not observed in the rat; instead, a shallow downward pathway along the HM. In the PF, the radial spread of dye-markings from the proximal part of the HM to the upper wall of the EAC, as found in the human, was also observed in the rat. We conclude that the TM and EAC of the rat constitute an appropriate experimental model with which to study the human type of AEM.

Cytokeratin expression patterns by one- and two-dimensional electrophoresis in pars flaccida cholesteatoma and pars tensa cholesteatoma

Expression patterns of cytokeratins (CKs) in normal skin, in pars flaccida type cholesteatoma (PFTC), and in pars tensa type cholesteatoma (PTTC) were examined by means of one- and two-dimensional electrophoretic techniques. Both CKs 14 and 5 pair (CKs 14/5) and CKs 10/1 were found in all materials. Neither CKs 16/6 nor 19 was found in the skin. CKs 16/6 and 19 were both found in 3 out of 5 PFTCs, only CKs 16/6 in 1 out of 5 and neither CKs 16/6 nor 19 in 1 out of 5. CKs 16/6 and 19 were both found in 1 out of 3 PTTCs, only CKs 16/6 in 1 out of 3 and neither CKs 16/6 nor 19 in 1 out of 3. There was no significant difference in the CKs expression patterns between PFTC and PTTC. The expression of CKs 16/6 and 19 suggested that their matrix epithelia were hyperproliferative. However, not all of the cholesteatomas were always hyperproliferative. Patterns of the terminal differentiation of CKs 1, 5, 10 and 14 in the PFTC or the PTTC were basically the same as those in the skin. In the cholesteatoma, eack CK gradually diminished in molecular weight in the cornified layer and debris. Desmosomal proteins were abundant in skin but not in cholesteatomas.

Plasma thrombomodulin levels in coronary sinus blood in patients with coronary artery disease

Plasma thrombomodulin (TM) levels in coronary sinus blood were measured in 15 patients with coronary artery disease who underwent elective PTCA (group A). TM was also measured in eight patients with coronary artery disease (group B) and six patients without coronary artery disease (group C), who only underwent diagnostic coronary angiography. The baseline level was 21.6 +/- 3.4 U/ml in group A, and 21.0 +/- 4.9 in group B, and both levels were slightly higher (P < 0.05) than those in group C (15.1 +/- 3.3). In group A, the level increased to 27.5 +/- 8.3 (P < 0.01) immediately after PTCA and then returned to 22.2 +/- 5.1 by 24 h. In groups B and C, levels showed no change immediately after angiography. In group A, the percentage increase in the TM level immediately after PTCA from that before the procedure correlated with the number of balloon inflations (r = 0.76, P < 0.01). In conclusion, the plasma TM level in coronary sinus blood might indicate endothelial damage due to atherosclerotic coronary artery disease and an increase in the level after PTCA might directly indicate vascular injury by balloon inflation.

Unusual D system inheritance in Anglo-Arab horse

An unusual D system phenogroup appeared in one family line of Anglo-Arab horse. This phenogroup probably originated from inheritance with an apparent absence of factors and was transmitted through successive generations.

Vasodilatory capacity of coronary resistance vessels in dilated cardiomyopathy

Both the endothelium-dependent and endothelium-independent vasodilatory responses of coronary resistance vessels were studied in patients with dilated cardiomyopathy (DCM). A 3F coronary Doppler catheter was placed in the proximal left anterior descending artery in 14 patients with DCM and in 10 patients with chest pain syndrome and a normal heart (control subjects). The ratio of maximum mean coronary blood flow velocity after intracoronary administration of the endothelium-independent vasodilator papaverine (10 mg) to resting mean coronary blood flow velocity (Vp/Vo) in patients with DCM was diminished compared with that in control subjects (2.2 +/- 0.6 vs 4.1 +/- 0.9, p < 0.001). The ratio after administration of the endothelium-dependent vasodilator acetylcholine (40 micrograms) (Va/Vo) in 10 DCM patients was also diminished compared with that in seven control subjects (1.3 +/- 0.5 vs 2.4 +/- 0.8, p < 0.01). In DCM patients, Vp/Vo was correlated with left ventricular end-diastolic pressure (r = -0.48, p < 0.05), left ventricular end-diastolic volume index (r = -0.68, p < 0.01), ejection fraction (r = 0.75, p < 0.01), and left ventricular end-diastolic wall stress (r = -0.73, p < 0.01). However, Va/Vo was not correlated with any of these parameters. These results indicate that impairment of the vasodilatory capacity of coronary resistance vessels in DCM may be related to endothelial dysfunction and to an extravascular factor resulting from left ventricular dysfunction.

The blood vessels in Reissner's membrane of the rat

Blood vessels on Reissner's membrane were electron-microscopically found in 24 out of 30 rats of the Wistar strain. The vessels were noted in the upper turns, mainly in the third turn of the cochlea. They originated from radiating arterioles in the upper spiral ligament and took straight courses radially down to the spiral limbus, and further to the modiolus, running along the surface of the scala vestibuli side of the membrane. Their diameter was approximately 4 microns. Bifurcated blood vessels were occasionally detected in 3 out of the 24 rats that possessed the vessels in the membrane. From the morphological point of view the blood vessels in Reissner's membrane may possibly have some function in the inner ear of the rat.

[The effects of fresh gas flow rate on the work of breathing during semi-closed circuit anesthesia]

To evaluate the effects of fresh gas flow rate on the work of breathing during semi-closed circuit anesthesia, we measured respiratory frequency, tidal volume, inspiratory work of breathing, peak inspiratory and expiratory flow rate and fluctuations in airway pressure during breathing with fresh gas flow of 6 l.min-1, 3 l.min-1 and 1.5 l.min-1. There was no significant difference among three flow rates in terms of tidal volume, respiratory frequency, inspiratory work of breathing, peak inspiratory flow rate and fluctuation in airway pressure at inspiration. On the other hand, in the expiratory phase, peak expiratory flow rate was lower and fluctuation in airway pressure at expiration was higher at 6 l.min-1 than those at 3 l.min-1 and 1.5 l.min-1, which may be indicative of increased expiratory work of breathing. The present study shows that low fresh gas flow rate does not increase the inspiratory work of breathing and high fresh gas flow rate may increase the expiratory work of breathing, implying that lowering the fresh gas flow is profitable for the work of breathing during semi-closed circuit anesthesia.

[The circulatory responses to tracheal intubation using the timing principle]

The circulatory responses to tracheal intubation using timing principle were investigated in 40 adult patients who underwent elective surgery. They were randomly assigned to one of two groups; 1) timing principle group, and 2) SCC group. In timing principle group, vecuronium 0.15 mg.kg-1 was administered. At the onset of clinical muscle weakness, thiopental 5 mg.kg-1 was given promptly. Sixty seconds after thiopental, patients were intubated. In SCC group, thiopental 5 mg.kg-1 was administered, and when patients lost consciousness, SCC 1 mg.kg-1 was given. After fasciculation, patients were intubated. The increases in systemic blood pressure, heart rate and rate pressure product were significantly lower in patients in timing principle group than in those in SCC group. Intubating conditions were almost excellent in both groups, and there were no complications in this study. In timing principle group, intubation was done 60 seconds after thiopental administration, and its timing coincided with the peak cerebral concentration of thiopental. We considered this coincidence was one of the reasons of fewer responses in patients in timing group than in those in SCC group.

Coronary flow reserve in patients with dilated cardiomyopathy

Coronary flow reserve was studied in patients with dilated cardiomyopathy. A 3F coronary Doppler catheter was placed in the proximal left anterior descending artery in each of 10 patients with dilated cardiomyopathy (CDM group), seven patients with coronary artery disease that involved only the left anterior descending artery (CAD group), and seven patients with chest pain syndrome and normal hearts (control group). Coronary flow reserve was calculated as the ratio of the maximum mean coronary blood flow velocity after intracoronary administration of papaverine (10 mg) to resting flow velocity (M/R). The time until maximum flow velocity was reached after papaverine administration (Tmax) was also measured. M/R was lower in the DCM (p < 0.001) and CAD (p < 0.001) groups when compared with the control group. Tmax was not abnormal in the DCM group but was prolonged in the CAD group (p < 0.05). In the DCM group, the M/R ratio correlated with the left ventricular end-diastolic pressure (r = -0.69; p < 0.05), the left ventricular end-diastolic volume index (r = -0.7; p < 0.05), the ejection fraction (r = 0.82; p < 0.01), the left ventricular mass (r = -0.7; p < 0.05), and the left ventricular end-diastolic wall stress (r = -0.84; p < 0.001). These results indicate that coronary flow reserve was decreased in patients with dilated cardiomyopathy and that the mechanism of its reduction may differ from that in patients with coronary artery disease.

Ultrastructural findings in the inner ear of Jackson shaker mice

The ultrastructural characteristics of the inner ear of Jackson shaker mice were analyzed. We used 12 Jackson shaker mutants (js/js) with ages ranging from 10 to 47 days and 10 heterozygotes of the Jackson shaker (js/+) with ages ranging from 10 to 30 days. The most striking findings observed were incomplete differentiation of the stereocilia of the outer hair cells and the maculae, although outer and macular hair cell cytoplasm, including the nerve terminals, became fully developed. Most outer hair cells did not show regular W-shaped configuration of the stereocilia throughout the entire turns of the cochlea except for a few hair cells. In many hair cells of the utricular and saccular maculae, the classical pipe organ configuration of the stereocilia was not observed. The Jackson shaker mice have been reported to have a gene abnormality on chromosome 11, and its gene locus was close to that of our new-mutant mice which showed deranged stereocilia of the outer and macular hair cells. Therefore, future studies can provide additional information on the cytodifferentiation of the stereocilia as a function of the gene on chromosome 11.

Synthesis of myo-inositol derivatives required for the total synthesis of surugatoxin, prosurugatoxin, and neosurugatoxin

Two myo-inositol derivatives (4) and (5), required for the total synthesis of surugatoxin, prosurugatoxin, and neosurugatoxin, were prepared. Synthesis of (+/-)-2,3-O-cyclohexylidene-4,5-O-isopropylidene-1-O-methoxymethyl-myo-i nositol (4) was achieved from (+/-)-1-O-benzoyl-2,3-O-cyclohexylidene-4,5-O-isopropylidene-myo-inosito l (6) in 4 steps, and (-)-2,3-O-cyclohexylidene-1,4-di-O-methoxymethyl-5-O-[2',3',4'-tri-O-ace tyl- beta-D-xylopyranosyl]-myo-inositol (5) was synthesized from (+/-)-1-O-benzoyl-2,3-O-cyclohexylidene-5,6-O-isopropylidene-myo-inosito l (12) in 7 steps.

Effectiveness of continuous arteriovenous hemofiltration for patients with refractory heart failure

Continuous arteriovenous hemofiltration (CAVH) was carried out in 8 patients with refractory congestive heart failure. All these patients had heart failure and oliguria for over 24 hours and intensive treatment with digitalis, diuretics, catecholamines and vasodilators was prescribed. Hemodynamics were followed closely during CAVH. During CAVH, pulmonary arterial pressure and pulmonary capillary wedge pressure were significantly reduced in all patients, the right atrial pressure decreased in 6 with right cardiac failure, the heart rate decreased in 3 with tachycardia and the blood pressure and cardiac index were elevated in 3 with hypotension. These observations show that CAVH can be performed safely and effectively in patients with congestive heart failure, oliguria and hypotension.

Acute profound deafness in Ramsay Hunt syndrome. Two case reports

Two patients with sudden progressive profound hearing loss resulting from Ramsay Hunt syndrome are reported. Case 1: A 63-year-old woman was admitted to Jichi Medical School Hospital with sudden, progressing deafness of the left ear, vertigo, sore throat, and hoarseness. An otoscopic examination revealed the external ear and the tympanic membrane to be normal. Pure-tone audiometry revealed profound deafness in the left ear. A horizontal nystagmus in the non-affected direction was observed by gaze nystagmus test. An endoscopic examination revealed herpetic vesicles and shallow ulcers on the left side of the pharynx and the larynx. There was complete paralysis of the left recurrent nerve. Hearing acuity of the left ear did not recover at all with steroid hormone therapy. Case 2: A 75-year-old man was referred to the ENT Clinic by a dermatologist for hearing evaluation in Ramsay Hunt syndrome. The man had noticed severe otalgia and sudden progressive deafness of the right ear approximately 2 weeks prior to admission. Physical examination revealed herpetic vesicles and ulcers in the right external ear and lateral neck. Complete paralysis of the right facial nerve was noted. Profound hearing loss in the affected ear was observed by pure-tone audiometry. A gaze nystagmus test revealed a horizontal nystagmus in the non-affected direction. No recovery of the cochlear function was noted following administration of antiviral drug. The pertinent literature is briefly reviewed.

A histological study of formation and growth of nasal polyps

Chronic infection and allergy are considered to be the two major etiologic factors of nasal polyps. Whatever its cause may be, the initial phase of nasal polyp formation is represented by increased exudation from vessels, edema of the lamina propria and the bulging of the nasal mucosa. Nasal polyps were histologically classified into three types: edematous type, glandular and cystic type (ductal type) and fibrous type. Those of the edematous type and the glandular and cystic type are in the active stage of tissue reaction because of permeation of vascular fluid and marked infiltration of round cells. Contrastingly, the fibrous type polyps are in the healing stage of tissue reaction because of marked proliferation of fibroblasts and collagen fibers. The morphological structure of the nasal glands involved in the bulging mucosa determines the type of nasal polyps, whether edematous type or glandular and cystic type.