Multimodality evoked potentials in children with moyamoya disease

Twenty Japanese children with Moyamoya disease were investigated by examining the multimodality evoked potentials (BAEPs, FVEPs and SSEPs). BAEPs were abnormally prolonged wave I-III and wave III-V in each one (10%). FVEPs were abnormal in 6 (30%), included prolonged latencies, reduced amplitudes and poor waveform in one each, and delayed latencies as well as reduced amplitudes in three. FVEPs significantly correlated with intellectual deterioration (p less than 0.01). SSEPs were abnormal in 13 (65%) significantly more frequent than BAEPs and FVEPs (p less than 0.01); reduction of N20 in 7, delayed latencies of N13-N20 in 4, and both delayed latencies and reduced amplitudes of N20 in two. These findings correlated well with the neurologic deficits, CT findings and EEG findings in this progressive cerebrovascular disease (Moyamoya disease) in children.

[Hypothermic effect of intracerebroventricular injections of taurine on endotoxin-induced fever in rabbits]

Taurine (Tau) was infused by intracerebroventricular (icv) injection 20 min after iv endotoxin (ET). Cerebrospinal fluid was taken from the posterior cisterns at 0, 60, 210 and 390 min after Tau infusion. The concentrations of cAMP and PGE2 in the samples were determined by radioimmunoassay. In the control groups, an equivalent isotonic saline (NS) (non-pyrogenic) instead of Tau or ET was used respectively. The rectal and ear skin temperatures of the rabbits in a non-fasting state were recorded automatically. Tau icv 1.0 mg/50 microliters, followed by the slow infusion of Tau 0.06-0.22 mg/(kg.min) for about 20 min into rabbits, caused sedation and peripheral vasodilation (rise in ear skin temperature), and initially blocked the rise in rectal temperature induced by ET (iv, 1 micrograms/kg). The results for the control groups were significantly different from those of the ET + Tau group. In the ET + NS group, the fluctuations in concentrations of PGE2 and cAMP paralleled the change in rectal temperature, but in the ET + Tau group, the changes in PGE2 and cAMP concentrations were similar to those of the ET + NS group, even though the fever was initially inhibited. There were no changes in the concentrations of these mediators in the NS + Tau group.

Human stomach alcohol and aldehyde dehydrogenases (ALDH): a genetic model proposed for ALDH III isozymes

Isozyme phenotypes of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) from human gastroendoscopic as well as surgical gastric biopsies were determined by starch gel electrophoresis and agarose isoelectric focusing. gamma gamma ADH isozymes were expressed predominantly in the mucosal layer of the stomach, whereas beta beta isozymes were in the muscular layer. In the 56 gastroendoscopic mucosal biopsies examined, the homozygous ADH3 1-1 phenotype was found in 75% of the samples, and the heterozygous ADH3 2-1 phenotype in 25%. Accordingly, the gene frequencies of the alleles ADH1/3 and ADH2/3 were calculated to be 0.88 and 0.12, respectively. Using a modified agarose isoelectric focusing procedure, gastric ALDH I, ALDH II, and up to five ALDH III forms could be clearly resolved. The ALDH III isozymes accounted for more than 80% of the total ALDH activities in gastric mucosa and exhibited Km values in the millimolar range for propionaldehyde at pH 9.0. Forty-five percent of the 55 gastroendoscopic biopsies studied lacked ALDH I isozyme. The complex gastric ALDH III isozyme phenotypes seen in these biopsies fall into three patterns. They can be interpreted by a genetic hypothesis, based on a dimeric molecule, in which there are two separate genes, ALDH3a and ALDH3b, with the ALDH3b locus exhibiting polymorphism. The homozygous phenotypes ALDH3b 1-1 and ALDH3b 2-2 were found to be 4 and 76%, respectively, and the heterozygous ALDH3b 2-1 phenotype 20%, of the total. Therefore, the allele frequencies for ALDH1/3b and ALDH2/3b were calculated to be 0.14 and 0.86, respectively. Several lines of biochemical evidence consistent with this genetic model are discussed.

Late infantile Krabbe leukodystrophy: MRI and evoked potentials in a Japanese girl

A Japanese girl showed deterioration in development from the age of 13 months. At the age of 16 months, there were mild spastic diplegia, increase in cerebrospinal fluid protein to 61.5 mg/dl and deficient galactosylceramidase I. Magnetic resonance imaging (MRI) demonstrated a high signal intensity with increased T2 in the centrum semiovale. Short latency somatosensory evoked potentials (SSEPs) showed a prolonged N13-N20 interpeak latency followed by abolition of N20. Brainstem auditory evoked potentials (BAEPs) were normally followed by prolonged interpeak latencies of wave I-V. This may be the first report of what we consider to be the late infantile form of Krabbe disease with MRI and evoked potential examinations.

Etiological types and clinical and epidemiological features of acute viral hepatitis in Xi'an in China

The etiological types and some features of 163 in-patients with acute viral hepatitis in Xi'an in China are reported. Hepatitis A (HA) accounted for 89.2% in the age group 0-15 years, whereas hepatitis B (HB) mainly occurred at the age of 16 to 30 and non-A, non-B hepatitis 31 to 50. This is different from the age distribution in western countries. The cause of the difference is discussed. The transmission factors of NANB hepatitis might be different from those of HA and HB. Fever was more often seen in HA than in HB and NANB, while the maximal bilirubin was higher in HB than in NANB. Hepatic dysfunction of all three types of hepatitis seemed to be closely associated with the age of the patients. Of ten cases with fulminant hepatitis, none was due to hepatitis A; nine were adults.

Leukaemia in benzene workers: a retrospective cohort study

A retrospective cohort study was conducted in 233 benzene factories and 83 control factories in 12 cities in China. The benzene cohort and the control cohort consisted of 28,460 benzene exposed workers (178,556 person-years in 1972-81) and 28,257 control workers (199,201 person-years). Thirty cases of leukaemia (25 dead and 5 alive) were detected in the former and four cases (all dead) in the latter. The leukaemia mortality rate was 14/100,000 person-years in the benzene cohort and 2/100,000 person-years in the control cohort; the standardized mortality ratio was 5.74 (p less than 0.01 by U test). The average latency of benzene leukaemia was 11.4 years. Most (76.6%) cases of benzene leukaemia were of the acute type. The mortality due to benzene leukaemia was high in organic synthesis plants followed by painting and rubber synthesis industries. The concentration of benzene to which patients with a leukaemia were exposed ranged from 10 to 1000 mg/m3 (mostly from 50 to 500 mg/m3). Of the 25 cases of leukaemia, seven had a history of chronic benzene poisoning before the leukaemia developed.

Brainstem auditory evoked potentials in children with neurodegenerative diseases

We assessed the usefulness of brainstem auditory evoked potentials (BAEPs) for differentiating types of degenerative diseases in children. The findings of BAEPs were abnormal in one out of two with polioencephalopathies and in seven of the eight with leukoencephalopathies, showing prolonged interpeak latencies of waves I-III, I-V or disappearance of wave components. On the other hand, normal responses were observed in four with corencephalopathies and one with spinocerebellopathy. The serial BAEPs in eight patients had deteriorated with progression of the clinical symptoms. These data on 16 children suggest that BAEPs are indeed a useful tool for monitoring pathophysiologic processes of neurodegenerative diseases.

Cerebrovascular occlusive disease with and without the moyamoya vascular network in children

Clinical features of cerebrovascular occlusive disease with the moyamoya network (group 1: twenty-nine children) and those without this network (group 2: nine children) are reported herein. Group 1 was characterized by female preponderance, recurrent and transient ischemic attacks, progression of mental deterioration, rebuild-up after hyperventilation on EEG and wide-spread lesions on CT scan. Group 2 had one or two attacks which led to a rather long-lasting hemiplegia but not to mental deterioration, rare rebuild-up findings on EEG and unilateral focal lesion on CT scan. Precipitating factors for ischemic attacks included deep breathing, changes in body temperature or sleep-waking transition were present in both groups. Etiology in some children was considered to be congenital.

Cerebral arteriovenous malformations in children

Differences in clinical features of arteriovenous malformations (AVM) in six children with ruptured AVM (RAM) and three with unruptured AVM (URAM) are herein reported. The age at onset ranged from the neonatal period to 8 yrs in cases of URAM and 10 to 12 yrs in those with RAM. The children with RAM had a sudden onset of intracranial hemorrhage, except for one with prodromal symptoms such as vertigo or headache. The clinical features of URAM were chronic mild symptoms such as a certain degree of delayed development, focal neurologic signs or increased intracranial pressure in addition to macrocephalus and cranial bruit. CT scan revealed an evenly enhanced AVM and dilatation of ventricles in cases of URAM. The RAMs were angiographically relatively small while the URAMs were large.

Colorectal cancer and schistosomiasis

The risk of colorectal cancer is known to be increased in patients with long-standing schistosomal colitis. A retrospective review of clinical data and surgical specimens from 60 patients with schistosomal granulomatous disease of the large intestine but without carcinoma demonstrated that 36 of them had mild to severe grades of colonic epithelial dysplasia. This was either focal or diffuse in distribution and occurred in flat mucosa, in pseudopolyps, or in regenerating epithelium at the edges of ulcers. These dysplastic changes are regarded as the pathological basis for the malignant potential of schistosomal colitis, and they resemble the changes found in long-standing chronic ulcerative colitis.