Tongue-palatal contact changes in patients with skeletal mandibular prognathism after sagittal split ramus osteotomy: an electropalatography study

The purpose of this study was to investigate the changes in tongue-palatal contact patterns using electropalatography (EPG) before and after sagittal split ramus osteotomy (SSRO) in patients with mandibular prognathism. Nine clients who underwent SSRO for mandibular setback and seven control subjects were participated in this study. Tongue-palatal contact patterns for /t/, /s/ and /k/ production were investigated using EPG before surgery and 3 months after surgery. The mean value of whole total of palate contact (WT) in the maximum contact frame was examined before and after SSRO. The correlation quantity between the change of center of gravity (COG) value and the amount of mandibular setback was also evaluated. The mean value of WT for /t/ and /s/ significantly increased after SSRO, and the EPG pattern became normal. However, a remarkable change in WT for /k/ was not observed, and the mean value was significantly larger in the SSRO group before and after surgery than in the control group. A negative correlation between COG variation and the amount of mandibular setback for /t/ and positive correlation for /s/ was observed. This study demonstrated that tongue-palatal contact patterns for /t/ and /s/ articulation improved clearly after SSRO. There was a significant correlation between COG variation and the amount of mandibular setback. However, no significant change was detected through perceptual assessment before and after SSRO. Further investigation is needed to determine whether these results will change over time.

Pharmacological evaluation of pioglitazone and candesartan cilexetil in a novel mouse model of non-alcoholic steatohepatitis, modified choline-deficient, amino acid-defined diet fed low-density lipoprotein receptor knockout mice

AIM

Low-density lipoprotein receptor knockout (LDLR-KO) mice fed a modified choline-deficient and amino acid-defined (mCDAA) diet show non-alcoholic steatohepatitis (NASH)-like pathophysiology. In order to pharmacologically benchmark this model, effects of pioglitazone (a thiazolidinedione) and candesartan cilexetil (an angiotensin II type 1 receptor blocker) on steatosis and liver fibrosis were examined.

METHODS

Pioglitazone (10 mg/kg) and candesartan cilexetil (3 mg/kg) were given orally once daily to LDLR-KO mice under mCDAA diet for 7 weeks. Blood biochemistry and hepatic histology were assessed, and hepatic gene expression levels and triglyceride content were measured.

RESULTS

Pioglitazone suppressed hepatic COL1A1 gene expression by 43% and attenuated hepatic fibrosis areas by 49%. Pioglitazone also decreased plasma alanine aminotransferase levels, liver weight, hepatic triglyceride content, and hepatic expression of other fibrosis-related genes such as TGFB1, SPP1, TIMP1, and IL6. Candesartan cilexetil suppressed hepatic COL1A1 gene expression by 33%, whereas the other end-points including hepatic fibrosis areas were not affected.

CONCLUSIONS

Pioglitazone showed anti-fibrotic effects accompanied by improving hepatic transaminase activity and hepatic lipid accumulation, but the effect of candesartan cilexetil was only limited, unlike previous reports for angiotensin II type 1 receptor blockers. As the pharmacological effects of pioglitazone in the current animal model are similar to those reported in patients with NASH, this model may represent some aspects of the pathophysiology of NASH. Further profiling using other agents or mechanisms that have been tested in the clinic will better clarify the utility of the animal model.

Osborne-Mendel rats simultaneously develop cardiac and renal dysfunction, left atrial thrombosis, peripheral artery occlusion, and ascending aortic dissection

Although chronic kidney disease (CKD) is strongly associated with onsets of cardiovascular disease (CVD), the pathogenic mechanism between these diseases has not been fully understood. To develop and validate new therapeutic strategies for this complication, appropriate experimental models that reflect the complexity of the underlying pathophysiology are needed. The Osborne-Mendel (OM) rat was identified as an atherosclerosis-prone and a premature-death rat strain among 16 inbred rat strains when fed high-cholesterol containing diet. When fed high-cholesterol diet, OM rats showed simultaneous occurrence of aortic aneurysm, aortic dissection, peripheral artery occlusion, and left atrial thrombosis. OM rats had significantly lower max dP/dt and higher min dP/dt than F344 rats did, indicating impaired left ventricle contractility and relaxation. OM rats developed renal dysfunction, showing increased urinary albumin excretion. OM rats also showed mild hypertension, decreased endothelial function, and enhanced coagulation and platelet aggregation, compared with F344 rats. We now report that OM rat would be a novel spontaneous animal model which simultaneously demonstrates cardiac and renal dysfunction, and CVD events. This model could be a useful model for the pre-clinical testing of pharmacological therapies and could provide new insight into potential targets and pathways for the treatment of CKD and CVD.

Inositol Hexakisphosphate Kinase 3 Regulates Metabolism and Lifespan in Mice

Inositol hexakisphosphate kinase 3 (IP6K3) generates inositol pyrophosphates, which regulate diverse cellular functions. However, little is known about its own physiological role. Here, we show the roles of IP6K3 in metabolic regulation. We detected high levels of both mouse and human IP6K3 mRNA in myotubes and muscle tissues. In human myotubes, IP6K3 was upregulated by dexamethasone treatment, which is known to inhibit glucose metabolism. Furthermore, Ip6k3 expression was elevated under diabetic, fasting, and disuse conditions in mouse skeletal muscles. Ip6k3(-/-) mice demonstrated lower blood glucose, reduced circulating insulin, deceased fat mass, lower body weight, increased plasma lactate, enhanced glucose tolerance, lower glucose during an insulin tolerance test, and reduced muscle Pdk4 expression under normal diet conditions. Notably, Ip6k3 deletion extended animal lifespan with concomitant reduced phosphorylation of S6 ribosomal protein in the heart. In contrast, Ip6k3(-/-) mice showed unchanged skeletal muscle mass and no resistance to the effects of high fat diet. The current observations suggest novel roles of IP6K3 in cellular regulation, which impact metabolic control and lifespan.

Lack of GPR40/FFAR1 does not induce diabetes even under insulin resistance condition

AIMS

G protein-coupled receptor/free fatty acid receptor 1 (GPR40/FFAR1 ) regulates free fatty acid-induced insulin secretion. This study has been performed to clarify whether or not loss of GPR40/FFAR1 function exacerbates diabetes, that is, whether GPR40 has an essential physiological role in the development of diabetes or not.

METHODS

We generated GPR40/FFAR1 knockout (KO) mice and analysed their phenotypes in vitro and in vivo under the condition of dietary or genetically induced insulin resistance.

RESULTS

GPR40/FFAR1 KO mice kept on a high-fat diet became obese, developed glucose intolerance to a similar degree as GPR40/FFAR1 wild-type (WT) mice. In addition, the phenotype of KO mice harbouring diabetogenic KK background genes showed glucose intolerance at a level similar to level for control KK mice. In both mouse models with insulin resistance, insulin secretion after oral glucose load and homeostasis model assessment-insulin resistance (HOMA-IR) did not change between GPR40/FFAR1 KO and WT mice. Although glucose-induced insulin secretion under high palmitate concentration was significantly lower in KO than in WT islets, pancreatic insulin content and insulin secretion stimulated with glucose alone were not different between KO and WT mice.

CONCLUSIONS

GPR40/FFAR1 has a major role in regulating fatty-acid-mediated insulin secretion, but the lack of GPR40/FFAR1 does not exacerbate glucose intolerance and insulin resistance induced by high-fat diet or diabetogenic KK gene. Our findings indicate that loss of GPR40/FFAR1 function does not play an important role in inducing or exacerbating diabetes.

Relaxin-3-deficient mice showed slight alteration in anxiety-related behavior

Relaxin-3 is a neuropeptide belonging to the relaxin/insulin superfamily. Studies using rodents have revealed that relaxin-3 is predominantly expressed in neurons in the nucleus incertus (NI) of the pons, the axons of which project to forebrain regions including the hypothalamus. There is evidence that relaxin-3 is involved in several functions, including food intake and stress responses. In the present study, we generated relaxin-3 gene knockout (KO) mice and examined them using a range of behavioral tests of sensory/motor functions and emotion-related behaviors. The results revealed that relaxin-3 KO mice exhibited normal growth and appearance, and were generally indistinguishable from wild genotype littermates. There was no difference in bodyweight among genotypes until at least 28 weeks after birth. In addition, there were no significant differences between wild-type and KO mice in locomotor activity, social interaction, hot plate test performance, fear conditioning, depression-like behavior, and Y-maze test performance. However, in the elevated plus maze test, KO mice exhibited a robust increase in the tendency to enter open arms, although they exhibited normal performance in a light/dark transition test and showed no difference from wild-type mice in the time spent in central area in the open field test. On the other hand, a significant increase in the acoustic startle response was observed in KO mice. These results indicate that relaxin-3 is slightly involved in the anxiety-related behavior.

Apelin-transgenic mice exhibit a resistance against diet-induced obesity by increasing vascular mass and mitochondrial biogenesis in skeletal muscle

BACKGROUND

Apelin is an endogenous ligand for the G-protein-coupled 7-transmembrane receptor, APJ. The administration of apelin-13, a truncated 13-amino acid apelin peptide, in diet-induced obese mice is reported to result in a decrease in adiposity due to the increase of energy expenditure with an increase in the expression of uncoupling proteins.

METHODS

We systematically compared the phenotype of human apelin-transgenic (apelin-Tg) mice fed standard or high-fat diets (HFD) with that of non-Tg control mice to clarify the effect of apelin on obesity. The beneficial effects of apelin were evaluated by multiple assay methods including indirect calorimetrical measurements, gene expression analysis, and immunohistochemical staining.

RESULTS

Apelin-Tg mice inhibited HFD-induced obesity without altering food intake and exhibited increased oxygen consumption and body temperature compared to non-Tg controls. Interestingly, the mRNA expressions of angiopoietin-1 (Ang1), a key molecule for vascular maturation, and its receptor, endothelium-specific receptor tyrosine kinase 2 (Tie2), were significantly upregulated in the skeletal muscle of HFD-fed apelin-Tg mice, and the areas of anti-CD31 antibody-positive endothelial cells also increased. Furthermore, both the aerobic type-I muscle fibre ratio and the DNA copy number of mitochondrial NADH dehydrogenase subunit 1 increased 2.0- and 1.4-fold in skeletal muscle, respectively.

CONCLUSIONS

These findings suggest that apelin stimulates energy expenditure via increase vascular mass and mitochondrial biogenesis in skeletal muscle.

GENERAL SIGNIFICANCE

Apelin is a prerequisite factor for anti-obesity by stimulating energy expenditure via regulating homeostatic energy balance.

Overexpression of GPR40 in pancreatic beta-cells augments glucose-stimulated insulin secretion and improves glucose tolerance in normal and diabetic mice

OBJECTIVE

GPR40 is a G protein-coupled receptor regulating free fatty acid-induced insulin secretion. We generated transgenic mice overexpressing the hGPR40 gene under control of the mouse insulin II promoter and used them to examine the role of GPR40 in the regulation of insulin secretion and glucose homeostasis.

RESEARCH DESIGN AND METHODS

Normal (C57BL/6J) and diabetic (KK) mice overexpressing the hGPR40 gene under control of the insulin II promoter were generated, and their glucose metabolism and islet function were analyzed.

RESULTS

In comparison with nontransgenic littermates, hGPR40 transgenic mice exhibited improved oral glucose tolerance with an increase in insulin secretion. Although islet morphologic analysis showed no obvious differences between hGPR40 transgenic and nontransgenic mice, isolated islets from hGPR40 transgenic mice had enhanced insulin secretion in response to high glucose (16 mmol/l) compared with those from nontransgenic mice, and they both had similar low glucose (3 mmol/l)-stimulated insulin secretion. In addition, hGPR40 transgenic islets significantly increased insulin secretion against a naturally occurring agonist palmitate in the presence of 11 mmol/l glucose. hGPR40 transgenic mice were also found to be resistant to high-fat diet-induced glucose intolerance, and hGPR40 transgenic mice harboring KK background showed augmented insulin secretion and improved oral glucose tolerance compared with nontransgenic littermates.

CONCLUSIONS

Our results suggest that GPR40 may have a role in regulating glucose-stimulated insulin secretion and plasma glucose levels in vivo and that pharmacological activation of GPR40 may provide a novel insulin secretagogue beneficial for the treatment of type 2 diabetes.

Transgenic rats overexpressing the human MrgX3 gene show cataracts and an abnormal skin phenotype

The human MrgX3 gene, belonging to the mrgs/SNSRs (mas related genes/sensory neuron specific receptors) family, was overexpressed in transgenic rats using the actin promoter. Two animal lines showed cataracts with liquification/degeneration and swelling of the lens fiber cells. The transient epidermal desquamation was observed in line with higher gene expression. Histopathology of the transgenic rats showed acanthosis and focal parakeratosis. In the epidermis, there was an increase in cellular keratin 14, keratin 10, and loricrin, as well as PGP 9.5 in innervating nerve fibers. These phenotypes accompanied an increase in the number of proliferating cells. These results suggest that overexpression of the human MrgX3 gene causes a disturbance of the normal cell-differentiation process.

Circulating KL-6 levels in patients with drug induced pneumonitis

BACKGROUND

The circulating level of KL-6/MUC1 is a sensitive marker for various interstitial lung diseases. Previous case reports have suggested that KL-6 may also be increased in some patients with drug induced pneumonitis. A study was undertaken to determine whether serum KL-6 could be a marker for particular types of drug induced pneumonitis.

METHODS

The findings of high resolution computed tomographic (HRCT) chest scans of 30 patients with drug induced pneumonitis were reviewed separately by two independent observers. The pneumonitis was classified into four predominant patterns: widespread bilateral consolidation (diffuse alveolar damage, DAD; n=7), fibrosis with or without consolidation (chronic interstitial pneumonia, CIP; n=11), consolidation without fibrosis (bronchiolitis obliterans organising pneumonia or eosinophilic pneumonia, BOOP/EP; n=8), and diffuse ground glass opacities without fibrosis (hypersensitivity pneumonitis, HP; n=4). Serum KL-6 levels were measured by a sandwich enzyme linked immunosorbent assay.

RESULTS

The overall sensitivity of serum KL-6 in detecting drug induced lung disease was 53.3%, which was lower than its sensitivity in detecting other interstitial lung diseases. However, the KL-6 level was increased in most patients with a DAD or CIP pattern (16/18; 88.9%) and was closely correlated with their clinical course. In contrast, serum KL-6 levels were within the normal range in all patients with a BOOP/EP or HP pattern.

CONCLUSIONS

Particular patterns detected by HRCT scanning, such as DAD and CIP but not the BOOP/EP or HP patterns, are associated with increased circulating KL-6 levels in drug induced pneumonitis. Serum KL-6 levels may reflect the clinical activity of the particular disorders.

Experimental and theoretical studies of the effect of electrode polarisation on capacitances of blood and potassium chloride solution

The effects of electrode polarisation on the observed capacitances of electrolytic solutions, including whole blood, plasma and potassium chloride solution, have been investigated experimentally in the frequency region from 10 to 10(5) Hz, by varying the area of the electrodes using plate and mesh electrodes, by varying the electrode distance, and by varying the concentration of KCl in the potassium chloride solution. The effects of the electrode polarisation on the observed capacitances were most significant in the frequencies lower than 10(2) Hz, but cannot be neglected in any frequency region. The so-called alpha dispersion observed in the frequencies lower than about 10(3) Hz was reproduced theoretically with an equivalent circuit model, using constant values independent of frequency for the four circuit parameters: sample capacitance, sample conductivity, electrode polarisation capacitance and electrode polarisation conductivity. It was concluded that the observed alpha dispersion is not a real one that represents the specific features of the samples themselves, but an apparent one that represents the characteristics of the whole measurement system, including the electrode polarisation.

Increased antibody levels to desmogleins 1 and 3 after administration of carbamazepine

Desmoglein (Dsg) 1 and Dsg3 are recognized as the autoantigens in pemphigus foliaceus and pemphigus vulgaris. Pemphigus-like syndromes have been reported to occur in individuals after exposure to a variety of drugs, but pemphigus caused by carbamazepine is not common. We found that anti-Dsg1 and anti-Dsg3 antibody titres were increased in three individuals administered carbamazepine. Antibody titres against Dsgs 1 and 3 were measured by enzyme-linked immunosorbent assay (ELISA). Of 42 serum samples (25 patients administered carbamazepine, eight patients administered valproic acid and nine healthy volunteers) tested by ELISA, three patients administered carbamazepine showed positive reactivity against both Dsg1 and Dsg3. The patient with the highest titre against Dsg1 and Dsg3 (the index values of anti-Dsg1 and anti-Dsg3 were 79.3 and 86.4, respectively) was a 23-year-old woman (Case 1). The other two patients with positive reactivity were a 5-year-old boy (Case 2) and a 65-year-old man (Case 3). In addition, indirect immunofluorescence study showed intercellular antibodies to the cell surface of the whole epidermis with a titre of 1 : 64 in Case 1 and 1 : 2 in Cases 2 and 3. However, no skin or mucosal involvement was found in any of these cases. There was no difference in the serum concentrations of carbamazepine between the three positive cases and the 22 negative cases of carbamazepine administration. From these facts, the lack of skin diseases may be explained by relatively low values of anti-Dsg 1 and 3 antibodies in Cases 2 and 3. However, it cannot be excluded that undefined exogenous and/or endogenous factors are involved in an outbreak of pemphigus. Furthermore, these findings might be helpful for preventing susceptible individuals from exposure to the suspect drugs.

A mechanism of the high frequency AC iontophoresis

The efficiency and the voltage dependence of the AC iontophoresis were studied in vitro. Two cylindrical glass cells separated by a cellophane film were used, where the donor cell was filled with the solution of target electrolytes and the receptor cell with distilled water. The sinusoidal AC voltage with a frequency of 1 kHz was applied between the two platinum plates located at the opposite ends of two cells. The time variation of the ion concentration was evaluated by measuring the impedance of the solution in the receptor cell. The transportation velocity of the ions increased with the amplitude of the voltage applied between two platinum plate electrodes apart 20 mm up to approximately 15 V, and leveled off above approximately 15 V. A theoretical model is proposed on the AC iontophoresis, where each ion moves together with the surrounding water molecules when it is hydrated. The effective Stokes radius of an ion is assumed to be half of the whole size of the ion with hydrating water molecules. When the external alternating electric field strongly vibrates the ion, the ion-dipole interactions between the ion and water molecules are broken, resulting in the reduced effective Stokes radius, which leads to the increase of the diffusion efficiency.

Skeletal muscle apoptosis after burns is associated with activation of proapoptotic signals

Critical illness is associated with muscle wasting and muscle weakness. Using burn injury as a model of local and systemic inflammatory response, we tested the hypothesis that thermal injury causes apoptosis in muscle. After a 40% body surface area burn to rats, abdominal muscles beneath the burn and limb muscles distant from the burn were examined for apoptosis at varying times after burn. Ladder assay, ELISA, and histological methods showed evidence of apoptosis in the abdominal muscles within 4-12 h with peak changes occurring at 3-7 days. Maximal apoptosis was also evident at distant limb muscles at 3-7 days. Investigation of proapoptotic pathways indicated mitochondrial membrane potential to be altered by 1 h after burn. Starting at 15 min after burn, cytochrome c was released from the mitochondria into the cytosol, followed by increased activity of caspase-3, starting at 6 h after burn. These studies suggest that mitochondria and caspase-mediated apoptotic pathways may be an additional mechanism of muscle weight loss in burns and may be potential therapeutic targets for prevention of muscle wasting.

Relationship between regional severity of emphysema and coronary heart disease

We analyzed the relationship between regional severity of emphysema, which was evaluated by three-dimensional fractal analysis (3D-FA) of Technegas SPECT images, and coronary heart disease (CHD). For 22 patients with emphysema who underwent Technegas SPECT, we followed up CHD events. The follow-up period was 5.4+/-0.5 (mean +/- SD) years. We defined the upper-lung fractal dimension (U-FD) and lower-lung fractal dimension (L-FD) obtained with 3D-FA of Technegas SPECT images as the regional severity of emphysema. FD became greater with the progression of emphysematous change. During the follow-up period, CHD events occurred in 6 (27%) of the 22 patients. The ratio of U-FD to L-FD for patients with CHD events (0.87+/-0.22) was significantly smaller than for patients without CHD events (1.52+/-0.38) (p = 0.0015). These findings suggest that severer emphysema in the lower lung indicates a higher risk of CHD than that in the upper lung.

Quantitative analysis of technegas SPECT: evaluation of regional severity of emphysema

The purpose of this study was to quantify the regional severity of emphysema by 3-dimensional fractal analysis of technegas (99mTc-carbon particle radioaerosol) SPECT images.

METHODS

Technegas SPECT was performed on 22 patients with emphysema. The lungs were delineated using 4 cutoff levels (15%, 20%, 25%, and 30% of the maximal pixel radioactivity), and the total number of pixels was measured in the areas surrounded by the contours obtained with each cutoff level. We calculated fractal dimensions from the relationship between the total number of pixels and cutoff levels transformed into logarithms. Fractal dimension for total or regional lung was defined as the severity of emphysema.

RESULTS

Total lung fractal dimension (T-FD), upper lung fractal dimension (U-FD), and lower lung fractal dimension (L-FD) for patients with emphysema were 1.84 +/- 0.46 (mean +/-SD), 2.22 +/- 0.61, and 1.77 +/- 0.49, respectively. U-FD was significantly greater than was L-FD. Patients with the ratio of U-FD to L-FD of <1.16 had a significantly greater percentage forced vital capacity (FVC) than did patients with the ratio of >1.16. Patients with an L-FD of <1.8 had a significantly greater forced expiratory volume in 1 s (FEV1)/FVC than did patients with that of >1.8. No significant difference was found between patient groups stratified by U-FD.

CONCLUSION

The regional severity of emphysema was well shown by these fractal dimensions.

Curved planar reformatted CT angiography: usefulness for the evaluation of aneurysms at the carotid siphon

BACKGROUND AND PURPOSE

Three-dimensional CT angiography uses the data obtained on a contrast-enhanced CT brain scan to generate 3D images of the intracranial vasculature. We describe the methodology of curved planar reformatting (CPR) for CT angiography and characterize its usefulness in the evaluation of aneurysms at the carotid siphon, comparing it with the shaded surface display technique (SSD).

METHODS

Eighty-seven patients with suspected intracranial aneurysms at CT angiography were examined by conventional cerebral angiography, and the patients with aneurysm(s) at the carotid siphon were selected for study. For these patients, the visibility of the neck and fundus of the aneurysms on CT angiograms was compared for those obtained with SSD and those with CPR, and observer reproducibility was evaluated with the kappa statistic.

RESULTS

Eighteen patients were confirmed to have an aneurysm at the carotid siphon on conventional angiograms. Seventeen aneurysms were depicted at CT angiography with SSD; 18 aneurysms with CPR. The number of visible aneurysmal necks and fundi was nine and 12, respectively, with SSD; 18 and 18, respectively, with CPR.

CONCLUSION

CPR allows better demonstration of the body and neck of an aneurysm at the carotid siphon, which has a tortuous course and is surrounded by complex bony structures. CPR may be a useful adjunct for the evaluation of aneurysms in this region.

Quantitative analysis of pulmonary emphysema: three-dimensional fractal analysis of single-photon emission computed tomography images obtained with a carbon particle radioaerosol

OBJECTIVE

The purpose of this study was to quantify the heterogeneous distribution of a carbon particle radioaerosol in the lungs of patients with pulmonary emphysema using single-photon emission computed tomography (SPECT) and fractal analysis.

SUBJECTS AND METHODS

Ventilation SPECT was performed on 19 patients with pulmonary emphysema, seven patients with suspected pulmonary emphysema, and 14 healthy volunteers. We delineated the lungs using five cutoff levels (15%, 20%, 25%, 30%, and 35% of the maximal pixel radioactivity) and measured the total number of pixels in the areas surrounded by the contours obtained with each cutoff level. We calculated fractal dimensions from the relationship between the total number of pixels and cutoff levels transformed into logarithms.

RESULTS

The fractal dimensions increased with the severity of pulmonary emphysema. The fractal dimensions for patients with pulmonary emphysema, patients with suspected pulmonary emphysema, and healthy volunteers were 2.03+/-0.61 (mean +/- SD), 0.77+/-0.09, and 0.59+/-0.06, respectively. A significant difference (p < .0005) in the fractal dimension was found when any of these three groups was compared with any other group of subjects.

CONCLUSION

Three-dimensional quantitative evaluation of the emphysematous lung was possible using SPECT and fractal analysis. Our results suggest that fractal analysis can quantify the heterogeneity of the distribution of a carbon particle radioaerosol in the lung. Fractal analysis appears to be applicable for routine clinical use because it is simple and the fractal dimensions can be obtained easily without using special software.

Three-dimensional endoscopic mode for observation of laryngeal structures by helical computed tomography

We produced high-quality three-dimensional (3D) endoscopic images of the larynx using helical scanning computed tomography. Subjects included two normal volunteers and 10 patients: five with laryngeal cancer, four with unilateral recurrent laryngeal nerve (RLN) palsy, and one with atrophied vocal folds. Two vertically split hemilaryngeal images were displayed together with the oral and tracheal views. Although motion artifacts were seen in four patients, laryngeal structures including the vocal fold, ventricular fold, and ventricle were clearly identified in all subjects. In the patients with cancer, axial images showing the extent of the tumor in each patient provided more information than 3D endoscopic images. In the patients with RLN palsy and atrophied vocal fold, combination of 3D endoscopic and cross-sectional images offered more diagnostic information than axial images alone.

Mapping of change in cerebral glucose utilization using fluorine-18 fluorodeoxyglucose double injection and the constrained weighted-integration method

The authors developed a method for mapping the change in cerebral glucose utilization at two different physiological states using [(18 )F]fluorodeoxyglucose (FDC) double infection and the constrained weighted-integration method. The authors studied young normal subjects without (baseline-baseline group, n=5) and with (baseline-stimulation group, n=5) vibrotactile stimulation of the fingertips of the right hand. Dynamic scans were performed using positron emission tomography (PET) following an initial dose (the first session, 0-30 min) and an additional dose (the second session, 30-60 min). The parametric images of the net clearance of FDG from blood to brain (K*), unidirectional blood-to-brain clearance (K(1)*), and cerebral metabolic rate of glucose (CMR(glc)) of the two sessions were generated. The averaged subtraction (second minus first session) and t-statistic images were generated, which were rendered into Talairach's stereotaxic coordinates and merged with the averaged magnetic resonance imaging (MRI) image. In the baseline-baseline group, regional K*, K(1)* and CMR(glc) in the first and second sessions were strongly correlated (r(2)=0.953, 0.935, and 0.951, respectively, n=330). In the baseline-stimulation group, significant increases in these estimates were obtained in the contralateral primary somatosensory cortex (SI) (from 3.43+/-0.78 to 4.02+/-1.01 ml/100 g/min for K*, 7.85+/-1.88 to 9.09+/-1.71 ml/100 g/min for K(1)*, and 280+/-5.9 to 32.3+/-5.5 mumol/100 g/min for CMR(glc)), while there were no significant changes in the ipsilateral SI (from 3.45+/-0.83 to 359+/-0.72 ml/100 g/min for K*, 8.17+/-2.33 to 837+/-1.75 ml/100 g/min for K(1 )* and 29.5+/-8.1 to 29.1+/-8.2 mumol/100 g/mln for CMR (glc)), Significant increases in K* and CMR(glc) in the contralateral SI were clearly demonstrated in the t-statistic image. In conclusion, the proposed method allows mapping of changes in cerebral glucose utilization during physiological stimulation of the brain, and will be useful for studying the relationship between neural activity and regional cerebral glucose metabolism.

Molecular cloning of insect pro-phenol oxidase: a copper-containing protein homologous to arthropod hemocyanin

Pro-phenol oxidase [pro-PO; zymogen of phenol oxidase (monophenol, L-dopa:oxygen oxidoreductase, EC 1.14.18.1)] is present in the hemolymph plasma of the silkworm Bombyx mori. Pro-PO is a heterodimeric protein synthesized by hemocytes. A specific serine proteinase activates both subunits through a limited proteolysis. The amino acid sequences of both subunits were deduced from their respective cDNAs; amino acid sequence homology between the subunits was 51%. The deduced amino acid sequences revealed domains highly homologous to the copper-binding site sequences (copper-binding sites A and B) of arthropod hemocyanins. The overall sequence homology between silkworm pro-PO and arthropod hemocyanins ranged from 29 to 39%. Phenol oxidases from prokaryotes, fungi, and vertebrates have sequences homologous to only the copper-binding site B of arthropod hemocyanins. Thus, silkworm pro-PO DNA described here appears distinctive and more closely related to arthropod hemocyanins. The pro-PO-activating serine proteinase was shown to hydrolyze peptide bonds at the carboxyl side of arginine in the sequence-Asn-49-Arg-50-Phe-51-Gly-52- of both subunits. Amino groups of N termini of both subunits were indicated to be N-acetylated. The cDNAs of both pro-PO subunits lacked signal peptide sequences. This result supports our contention that mature pro-PO accumulates in the cytoplasm of hemocytes and is released by cell rupture, as for arthropod hemocyanins.

Regional striatal DOPA transport and decarboxylase activity in Parkinson's disease

METHODS

We measured blood-brain barrier transport and decarboxylation of 6-[18F]fluoro-L-DOPA (FDOPA) using PET in patients with Parkinson's disease (n = 7, 57 +/- 7 yr) and age-matched control subjects (n = 7, 60 +/- 6 yr). To visually present regional changes of FDOPA uptake in Parkinson's disease, we introduced maps of FDOPA uptake relative to occipital cortex, averaged across control subjects and Parkinson's disease patients in an MRI-based stereotaxic coordinate space.

RESULTS

There was no significant changes in the blood-to-brain transport of FDOPA (KD1) in Parkinson's disease. The KD1 values of the head of caudate were lower than those of putamen in both normal subjects and Parkinson's disease patients. In Parkinson's disease, the activity of L-DOPA decarboxylase (DDC) was differentially reduced in subdivisions of striatum. The residual DDC activity was 63% of the control value in the head of caudate nucleus, 54% in the anterior putamen and 39% in the posterior putamen. The DDC activity in frontal and occipital cortices remained unchanged by the disease. Subtraction of averaged FDOPA uptake maps (control minus Parkinson's disease) visualized a spatial pattern of pathological changes in FDOPA uptake common to Parkinson's disease patients.

CONCLUSION

The striatal blood-to-brain transport of FDOPA remained unchanged while the DDC activity was differentially reduced within the striatum in Parkinson's disease. We found the FDOPA uptake maps useful in identifying altered patterns of FDOPA metabolism common in Parkinson's disease.

Reexamination of properties of prophenoloxidase isolated from larval hemolymph of the silkworm Bombyx mori

Prophenoloxidase in hemolymph of the silkworm (Bombyx mori) was purified by the method of Ashida (Ashida, M. (1971) Arch. Biochem. Biophys. 144, 749-762) with slight modifications to further increase the purity, and its properties were reinvestigated. The purified prophenoloxidase gave two discrete bands in isoelectric focusing-polyacrylamide gel electrophoresis (IEF-PAGE) (pI 4.95 and 4.98) and in native-polyacrylamide gel electrophoresis with 4.5% separating gel. Each band in IEF-PAGE was separated into two bands in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with mobilities corresponding to 71.5- and 71-kDa polypeptides. In HPLC on octadecyl column the prophenoloxidase preparation gave two well-separated symmetrical peaks (proPO polypeptide I and proPO polypeptide II). The molecular masses of the proPO polypeptides I and II were determined to be 71.5 and 71 kDa in SDS-PAGE and 78,880 and 81,105 Da by matrix-assisted laser desorption ionization mass spectrometry, respectively. Native prophenoloxidase was eluted at a position corresponding to 126-kDa protein in gel permeation chromatography. Amino acid compositions and peptide mappings of proPO polypeptides indicated that both polypeptides differ in their primary structures. These results are discussed in relation to the subunit structure, the presence of bicopper cluster, and the polymorphism of prophenoloxidase in silkworm hemolymph.

Elevated dopa decarboxylase activity in living brain of patients with psychosis

The hypofrontality theory of the pathogenesis of schizophrenia predicts that cortical lesions cause psychosis. During a search for abnormalities of catecholaminergic neurotransmission in patients with complex partial seizures of the mesial temporal lobe, we discovered an increase of the rate of metabolism of an exogenous dopa tracer (6-[18F]fluoro-L-dopa) in the neostriatum of a subgroup of patients with a history of psychosis. When specifically assayed for this abnormality, patients with schizophrenia revealed the same significant increase of the rate of metabolism in the striatum. The finding is consistent with the theory that a state of psychosis arises when episodic dopamine excess is superimposed on a trait of basic dopamine deficiency in the striatum. The finding is explained by the hypothesis that cortical insufficiency, a proposed pathogenetic mechanism of both disorders, causes an up-regulation of the enzymes responsible for dopa turnover in the neostriatum as well as the receptors mediating dopaminergic neurotransmission.

Striatal L-dopa decarboxylase activity in Parkinson's disease in vivo: implications for the regulation of dopamine synthesis

L-DOPA is a large neutral amino acid subject to transport out of, as well as into, brain tissue. Competition between dopamine synthesis and L-DOPA egress from striatum must favor L-DOPA egress if decarboxylation declines relatively more than transport in Parkinson's disease. To test this hypothesis, we injected patients with Parkinson's disease with a radiolabeled analogue of L-DOPA and recorded regional brain radioactivity as a function of time by means of positron emission tomography. We simultaneously estimated the activity of the decarboxylating enzyme and the amino acid transport. In the striatum of patients, we found the L-DOPA decarboxylase activity to be reduced in the head of the caudate nucleus and the putamen. However, the rate of egress of the DOPA analogue was unaffected by the disease and thus inhibited dopamine synthesis more than predicted in the absence of L-DOPA egress.

Unusual cranial metastasis from hepatoma presenting as isolated unilateral hypoglossal nerve paresis--case report

A 45-year-old male presented with a rare right hypoglossal nerve paresis due to an unusual cranial metastatic tumor from hepatoma. Despite multi-drug chemotherapy and arterial embolization, he died about 1 year later. Such metastasis should be considered as the cause of isolated unilateral hypoglossal nerve paresis.

[Evaluation of the discriminative stimulus effect of an enkephalin analog, EK-399, in the rat]

Four groups of rats were trained to discriminate between the no-drug conditions (saline, s.c.) and the effect of s.c. injection of the novel enkephalin analog Tyr-D-Met (O)-Gly-EtPhe-NHNHCOCH3.AcOH (EK-399, 1 mg/kg), morphine (3 mg/kg), ethylketocyclazocine (EKC, 0.3 mg/kg) or N-allylnormetazocine (NANM, 3 mg/kg) in a two-lever choice, water reinforced procedure. All groups of animals acquired the ability to discriminate EK-399, morphine, EKC or NANM from saline. Naloxone (0.03-0.3 mg/kg, s.c.) completely antagonized the discriminative stimulus effects of EK-399, morphine and EKC, but not that of NANM. In stimulus generalization tests, morphine (10 mg/kg) and buprenorphine (0.03 mg/kg), mu-opioid receptor agonists, completely substituted for EK-399 in groups trained with EK-399, whereas EK-399 (0.1-3 mg/kg) only partially substituted for morphine in rats trained with morphine. EKC (0.01-0.1 mg/kg), a kappa-opioid receptor agonist, partially substituted for EK-399, and EK-399 (0.1-3 mg/kg) partially substituted for EKC. NANM (0.3-10 mg/kg), a sigma-receptor agonist, partially substituted for EK-399, but EK-399 (0.1-3 mg/kg) did not substitute for NANM. These results suggest that the discriminative stimulus effect of EK-399 in rats mainly involves mu-opioid receptor-mediating action and also involves, to a lesser extent, other receptor (probably delta-opioid receptor)-mediating actions.

Clinical significance of the measurement of hepatic blood flow using xenon 133 and balloon catheter in patients undergoing treatment for hepatocellular carcinoma

Total hepatic blood flow and portal blood flow were measured separately using a modified xenon 133 clearance method during angiography in 71 patients with chronic liver diseases, including 40 with proven hepatocellular carcinoma, and in 12 patients without detectable chronic liver injury who served as controls. Total hepatic and portal blood flow rates in controls were 805 +/- 149 ml/min and 667 +/- 206 ml/min, respectively. Total hepatic blood flow was significantly decreased in patients with compensated and decompensated liver cirrhosis (519 +/- 156 ml/min and 317 +/- 153 ml/min, respectively; P less than 0.01), as was portal blood flow (399 +/- 134 ml/min and 271 +/- 134 ml/min, respectively; P less than 0.01). Following transcatheter arterial embolization or hepatic resection (in 35 and 13 patients, respectively), hepatic failure occurred in 3 cases each. Embolization appeared contraindicated when hepatic portal blood flow was under 125 ml/min, and safe hepatic resection required an anticipated residual hepatic portal blood flow of at least 250 ml/min.

[Transcatheter arterial embolization of hemangiomas in the perioral region]

This paper presents four cases with successful transcatheter arterial embolization (TAE) for oral and perioral hemangiomas. Four TAEs were performed without major complications and the tumors disappeared in one case and decreased in size in the other 3 cases.

A measurement of regional portal blood flow with Xe-133 and balloon catheter in man

This investigation was undertaken to measure regional portal blood flow of the liver. The measurement was performed by injecting 133Xe into the proper hepatic artery through a balloon catheter and then occluding the proper hepatic artery with an inflated balloon. Data were collected using a gamma camera, and washout curves were generated. They were analyzed by the initial slope method and Kety Schmidt equation. The average regional portal blood flows were: 59.31 +/- 13.04 ml/100 g per min, 58.71 +/- 14.14 ml/100 g per min and 37.12 +/- 10.11 ml/100 g per min in hospital controls (11), patients with chronic hepatitis (10) and those with liver cirrhosis (56), respectively. In the patients with cirrhosis, the regional portal blood flow was significantly reduced (P less than 0.01). The reproducibility of this method was satisfactory. The measurement of regional portal blood flow will be useful to evaluate underlying liver injuries and determine indications of a transcatheter arterial embolization of the liver.

[Visualization of epileptic lesions using single photon emission computed tomography (SPECT) with N-isopropyl-p-(123I) iodoamphetamine after intravenous loading of bemegride--report of a case]

Single photon emission computed tomography (SPECT) was performed 30 minutes and 4 hours after injection of 111 MBq (3 mCi) N-isopropyl-p-(123I) iodoamphetamine (IMP) which was injected 5 minutes after the completion of intravenous bemegride loading. A 31-year-old female with simple partial seizures evolving to complex partial seizures evolving to generalized tonic-clonic convulsive seizures with a history of hospitalization, suffering from low-grade fever, generalized convulsive seizures, and impaired consciousness at the age of 27 years was studied. Angiographic examinations, X-CT, MRI, CSF examinations, and interictal neurological examinations were normal. She suffered from clonic convulsions in her right shoulder and arm, and hallucinations and dysmnesia which were characteristic of temporal lobe epilepsy. More recently she suffered from impaired consciousness once or twice a month. While the controlled IMP-SPECT study was normal, the IMP-SPECT study examined after the activation by intravenous bemegride loading showed the pattern of a regional increased uptake of IMP in the epileptic lesions corresponding with the epileptic symptoms, and a surrounding border of decreased uptake which might be the inhibition of surrounding neuronal activity and metabolism. In conclusion, the bemegride loading IMP-SPECT study could be a potential diagnostic method in patients with seizures whose epileptic lesions were not determined by the conventional methods or in whom the surgical interventions were considered, by reason of its capability to demonstrate positively the epileptic lesions.

Alleviation of gallbladder complications by treatment of hepatic arterial embolization with caerulein

Transcatheter arterial embolization (TAE) with the concurrent use of caerulein was assessed for the purpose of preventing gallbladder complications often seen after TAE of hepatic carcinoma. Ninety-six cases with primary hepatic carcinoma, who had undergone TAE in the right hepatic arterial region over the past 4 years, were divided into three groups: 22 cases for which embolization was possible on a selective basis by passing the catheter to the peripheral side beyond the bifurcated region of the cystic artery; 40 cases who had undergone TAE in which caerulein was not administered, from the central side of the bifurcated region of the cystic artery; and 34 cases given 20 micrograms caerulein 15-30 min before TAE. A comparison was made using the abdominal pain, pyrexia, rate of leukocytosis and the US findings of the gallbladder as the indices of the gallbladder complications. As a result, it became evident that it was possible to prevent or alleviate gallbladder complications if caerulein were administered before TAE in cases where the embolizing substances were infused in the right hepatic artery from the central side of the bifurcated region of the cystic artery. It was conclusively shown that the gallbladder blood flow decreases if the organ is contracted by caerulein, which in turn causes a decrease in the inflow of the embolizing substances whereby complications are alleviated.

SPECT volume measurement using an automatic threshold selection method combined with a V filter

The volume measurement of various organs by single photon emission computed tomography (SPECT) has generally been performed by summing up the voxels lying within the outer edge of the organ determined by thresholding as a function of the maximum reconstructed counts within a volume of interest. The optimum threshold level, however, is influenced by various factors. To eliminate this problem, Mortelmans et al. (1986) proposed to use an automatic threshold selection method (ATSM) based on discriminant criteria and to correct the errors induced by the imperfect system response using the method based on linear regression analysis, which has some problems in practical application. We tried to use ATSM combined with a V filter. The correlation coefficient (r) and the regression equation between the true (x) and the calculated volume (y) obtained by experimentation using 22 phantoms with a volume ranging between 26 ml and 380 ml were as follows: r = 0.994 and y(ml) = 1.015 x +1.09 using ATSM combined with a V filter, while r = 0.993 and y(ml) = 1.110 x +30.55 using only ATSM. The relative error between the true and the calculated volumes decreased significantly (P less than 0.01) from 37.7% +/- 26.9% to 5.5% +/- 4.2%. The results suggest that ATSM combined with a V filter is useful for correcting the errors caused by an imperfect system response, and is available and reliable for SPECT volume determination even when the organ volume is small.

Monte Carlo estimates of absorbed dose rate in various tissues and organs

A computer program based on the Monte Carlo technique was developed for calculation of absorbed dose rate in various tissues and organs. The accuracy of the program was tested by reproducing Berger's values of the specific absorbed fractions for point isotropic sources in water, and a good agreement with those obtained by the moments method was found within an error of several percent. In comparing with experiment and other Monte Carlo results, good agreement was also obtained within the range of statistical error. The absorbed dose rate for an 123I, 124I, 125I, 126I and 99mTc point source and their specific dose constants in various tissues and organs were calculated using this program. This computer program has the mass energy absorption and attenuation coefficients for 69 tissues and organs as a database file, and can be extended to various radionuclides used in nuclear medicine by adding their nuclear data to the program.

[Usefulness of caerulein in suppressing post-TAE complications of the gallbladder]

While transcatheter hepatic arterial embolization (TAE) has been extensively performed as a form of treatment for nonresectable malignant hepatic tumors, complications, such as abdominal pain, fever or leukocytosis due to gallbladder infarction by embolic materials frequently occur and have not yet been overcome. We devised a new procedure for reducing the incidence of gallbladder infarction by administering caerulein prior to TAE. Between 1984 and 1986, 63 patients with hepatocellular carcinoma were treated by TAE with the use of Gelfoam. These patients were divided into 3 groups. Fourteen patients underwent TAE in which the tip of the catheter was placed in the right hepatic artery distal to the origin of the cystic artery (group A). In the other patients the tip of the catheter was placed proximal to the origin of the cystic artery; 40 patients were not treated by caerulein (group B); 9 patients were administered caerulein 20 micrograms intramuscularly 15 to 30 minutes prior to TAE. The incidence of complications after TAE, such as abdominal pain, fever over 38 degrees C, leukocytosis and ultrasonographical abnormalities of the gallbladder was compared in these 3 groups. The results showed that in group C (TAE after administration of caerulein), the incidence of complications was significantly decreased compared with group B(TAE without caerulein). The authors suggest that post-TAE infarction of the gallbladder is effectively diminished by contracting it with caerulein.