Incidental Lewy body disease in a patient with REM sleep behavior disorder

We studied an 84-year-old man with a 20-year history of nocturnal violent behavior during sleep, but no other clinically evident neuropsychiatric disorders. Polysomnographic investigations confirmed that he suffered from REM sleep behavior disorder (RBD). Histopathologic examination revealed he had Lewy body disease with a marked decrease of pigmented neurons in the locus ceruleus and substantia nigra. These histologic findings represent the first documented evidence of a loss of brainstem monoaminergic neurons in clinically idiopathic RBD and suggest that Lewy body disease might provide an explanation for idiopathic RBD in the aged.

Predictive factors in the response to interferon therapy in chronic hepatitis C

Factors predicting the efficacy of interferon therapy were statistically analyzed on 111 patients with chronic hepatitis C. Of the treated patients (total doses of interferon; 96-468 MU), 35 (31.5%) had a long-term remission. On multivariate analysis, hepatitis C virus genotype (p < 0.0001), histological diagnosis (p < 0.05), fibrosis score of histological activity index (p < 0.01) and source of infection (p < 0.05) were found useful for predicting the response to interferon therapy. Our findings suggest that the outcome of interferon therapy can be predicted to some degree from pretreatment data, and that a new therapeutic strategy is necessary for the group of patients who are predicted to be nonresponders.

Membrane cofactor protein (CD46) in seminal plasma is a prostasome-bound form with complement regulatory activity and measles virus neutralizing activity

Human seminal plasma contains 0.55 microgram/ml of membrane cofactor protein (MCP; CD46) of 60,000 MW. By ultracentrifugation, gel filtration and immunoelectron microscope methods, we found that the MCP in seminal plasma was associated with prostasomes. The functional properties of the prostasome-bound MCP were assessed in comparison with a recombinant soluble form, gamma MCP1, which is composed of four short consensus repeats (SCR), type C of the serine/threonine-rich domain (STC), and unknown significance (UK). The MCP in seminal plasma, although demonstrably bound to prostasomes, behaved more like the soluble form of MCP. In the absence of detergent it, together with factor I, degraded the fluid-phase ligand, methylamine-treated C3 [C3(MA)], which is insensitive under no-detergent conditions to the membrane form of MCP and factor I. Moreover, C3dg fragment was generated as a final product instead of C3bi during the incubation, indicating that the prostasomal MCP and proteases may be responsible for the C3dg generation. The prostasomes neutralized measles virus (MV) infectivity, while gamma MCP1, for the most part, did not. These results, taken together with the CD59 concentration on the prostasomes, suggest that the prostasomes are potential immunomodulators for complement activation, providing the C3- and C9-step inhibitors. The present report also reinforces the idea that there are two different forms of MCP in semen. One is located in the inner acrosomal membrane of spermatozoa, which appears through acrosomal reaction and spermatoon-egg interaction. The other is a prostasome-bound form maintaining activities sufficient to regulate complement activation and, probably, MV infection.

Presence of vasoactive intestinal peptide receptor in the hen hypothalamus

Radioligand assays of the membrane fraction of hen hypothalamic tissues involving the preoptic (HPOA) or median eminence (HMEA) areas revealed the presence of a specific binding component to chicken vasoactive intestinal peptide (cVIP) having properties of a receptor. The equilibrium dissociation constant (Kd) was 0.70 +/- 0.07 nM (Mean +/- SEM; N = 5) in HPOA and 1.02 +/- 0.15 nM (N = 5) in HMEA as estimated by Scatchard analysis of saturation studies, and was 0.91 +/- 0.11 nM (N = 3) (HPOA) and 1.25 +/- 0.09 nM (N = 3) (HMEA) as determined by a kinetic analysis. The maximum binding capacity (Bmax) obtained by Scatchard analysis was 167 +/- 19 fmol/mg protein (N = 5) (HPOA) and 133 +/- 17 fmol/mg protein (N = 5) (HMEA). The Kd and Bmax values obtained by Scatchard analysis were similar in the two areas of the hypothalamus and in both laying and nonlaying hens. Administration of cVIP in vivo caused a decrease in specific cVIP binding. These results suggest the presence of a VIP receptor in the hen hypothalamus.

Relationship between morphological classification of the degree of maturation and the ploidy of micromegakaryocytes in myelodysplastic syndrome patients

To clarify the biological behavior of micromegakaryocytes in myelodysplastic syndrome (MDS), the relationship between the morphological classification and the ploidy of megakaryocytes was studied in bone marrow aspirates obtained from patients with MDS and from normal controls. The morphology was determined according to Feinendegen's classification, which is considered to reflect megakaryocytic maturation, and the ploidy was determined by microcytofluorometry, using 4',6-diamidino-2-phenylindole (DAPI) staining after the removal of Wright-Giemsa stain. Most micromegakaryocytes (i.e., megakaryocytes < 20 microns in diameter) in MDS were morphologically mature, as were those in the normal controls. The peak micromegakaryocytic ploidy was 4N or 8N, whereas that of the megakaryocytes in normal controls was 16N. These findings indicated that the micromegakaryocytes in MDS were morphologically mature but had impaired polyploidization.

T-614, a novel antirheumatic drug, inhibits both the activity and induction of cyclooxygenase-2 (COX-2) in cultured fibroblasts

To elucidate the mechanism for the selective inhibition of prostaglandin E2 (PGE2) production in inflammatory tissue by T-614 (3-formylamino-7-methylsulfonylamino-6-phenoxy-4H-1-benzopyran-4-o ne), its effects on both the activity and the induction of cyclooxygenase (COX)-2 were investigated in vitro. T-614 inhibited the activity of purified COX-2 enzyme (IC50: 7.7 micrograms/ml), but was inactive against both COX-1 activities of microsomal and purified enzymes (IC50: > 300 micrograms/ml). On the other hand, when the inhibition of PGE2 production by T-614 was examined in the cultured fibroblasts stimulated with bradykinin, T-614 at 1 microgram/ml or less inhibited PGE2 release more effectively than that in the above cell-free system. Therefore, we examined which of the COX enzymes was expressed in bradykinin-stimulated fibroblasts by using both the reverse transcriptase-polymerase chain reaction (RT-PCR) and Northern blot analyses. As a result, COX-1 mRNA was constitutively expressed in the cells, whereas COX-2 mRNA was not detected without stimulation with bradykinin, but was expressed within 30 min when stimulated. Furthermore, it was found that the addition of T-614 reduced the COX-2 mRNA levels in 30 min after stimulation. These studies suggest that at least some of inhibitory effects of T-614 on prostanoids production are mediated by the synergy of the inhibition of COX-2 activity and the inhibition of induction, and such an action of T-614 may explain the pharmacological properties of this drug.

[Effect of halothane on the energy metabolism of isolated perfused rat kidney as analysed by 31P-NMR]

The effects of halothane on energy metabolism of isolated perfused rat kidney were studied by 31P-NMR spectroscopy. Rat kidney was perfused by physiological medium containing halothane. Perfusion was carried out continuously in addition to ischemic period of 30 or 10 minutes. In continuous perfusion study, halothane concentration below 4% did not affect renal ATP level but halothane above 6% decreased ATP level significantly. In ischemic study, changes of renal energy metabolism were not influenced by halothane below 4% throughout the experiment, but halothane above 6% decreased ATP levels significantly after reperfusion. From the viewpoint of energy metabolism, it can be said that a low concentration of halothane does not damage renal cells but a high concentration of halothane has possibility to damage them. During and after ischemic insult, halothane does not diminish renal damage, but on the contrary a high concentration of halothane reversely worsens it.

The slow progression of hepatic fibrosis in intrahepatic cholestasis as compared with extrahepatic biliary atresia

It has been shown that the progression of hepatic fibrosis in intrahepatic cholestasis (IHC) is not so prominent as in extrahepatic biliary atresia (EHBA), and that the biosynthetic activity of collagen increases along with the fibrotic disease process. We conducted immunohistochemical and ultrastructural studies on the distribution of collagen types III and IV and of alpha-actinin in the smooth musculature in liver specimens obtained from 4 patients with IHC and 14 patients with EHBA in liver transplantation from living related donors (LRLT). A recently developed sandwich enzyme immunoassay (EIA) was used to determine serum concentrations of type IV collagen, laminin and prolyl 4-hydroxylase (PH) in the patients before and after LRLT. Pathological study showed that the excessive deposition of type IV collagen in the perisinusoidal walls resulted in a clearly developed basal membrane beneath the sinusoidal endothelial cells, so-called sinusoidal capillarization. In the fibrous septa of IHC, fibrogenesis was apparently lower than in EHBA, since collagen deposition and myofibroblast proliferation were not so prominent compared to EHBA. Serum type IV collagen, laminin and PH increased in IHC, although not so markedly as in EHBA, and returned to normal within 5 weeks after successful LRLT. In conclusion, it is suggested that an increased level of serum type IV collagen reflects the de novo synthesis of basal membrane components, and that the determination of their serum levels by EIA can be utilized for the differentiation of the specific fibrogenic activity in each disease, and for monitoring patients before and after liver transplantation.

A DNA region that complements on Escherichia coli cysG mutation in Thiobacillus ferrooxidans

Thiobacillus ferrooxidans AP19-3 has a novel NADH-dependent sulfite reductase in the periplasmic space. The gene responsible for the appearance of NADH-dependent sulfite reductase activity was cloned into a vector plasmid pBR322 to give a 5.7-kb hybrid plasmid, pTHS1, which contains a 1.3-kb DNA fragment of T. ferrooxidans AP19-3. When pTHS1 was used to transform sulfite reductase deficient E. coli mutants, strain AT2455 (cysG), JM246 (cysI), and AT2427 (cysJ), it complemented only the E. coli cysG mutation. Since cysG codes for S-adenosyl-L-methionine: uroporphyrinogen III methyltransferase, the enzyme involved in siroheme synthesis, the results indicate that the DNA region that codes for S-adenosyl-L-methionine: uroporphyrinogen III methyltransferase is present in a T. ferrooxidans 1.3 kb DNA fragment on pTHS1.

Senile dementia-Alzheimer's type and estrogen

Some reports have suggested the ameliorative effects of estrogens on clinical symptoms, such as short memory, in women suffering from senile dementia-Alzheimer's type, in vivo. The action mechanism of estrogen remains to be clarified, but 1) an anti-depressive effect, 2) improvement of cerebral blood flow, 3) direct stimulation of neuron, 4) development of gliacyte and 5) suppression of apolipoprotein E have been suggested. Some mechanisms may be combined, contributing to the beneficial effects on clinical symptoms.

An opiate receptor in the neurohypophysis of laying hens

An opiate binding component in the membrane fraction of the neurohypophysis of the laying hen showed a high affinity, limited capacity, reversible binding, and binding specificity to [3H]diprenorphine. The binding sites were of a single class. The equilibrium dissociation constant was .30 +/- .03 nM (mean +/- SEM; n = 5) in Scatchard analysis and .31 +/- .02 nM (n = 5) in kinetic analysis. The maximum binding capacity determined by Scatchard analysis was 619 +/- 34 fmol/mg protein (n = 5). The association and dissociation rate constants determined by kinetic analysis were .088 +/- .002 nM-1 min-1 (n = 5) and .027 +/- .001 min-1 (n = 5), respectively. The results suggest that the binding component is regarded as being an opiate receptor.

Hyaluronic-acid-deficient extracellular matrix induced by addition of 4-methylumbelliferone to the medium of cultured human skin fibroblasts

The effects of xylosyl-beta-D-(4-methylumbelliferone) and its aglycone, 4-methylumbelliferone, on hyaluronic acid synthesis were investigated in cultured human skin fibroblasts. Xylosyl-beta-D-(4-methylumbelliferone) added to the medium of cultured cell reduced the synthesis of hyaluronic acid. Furthermore, 4-methylumbelliferone reduced the production of hyaluronic acid markedly. In addition, 4-methylumbelliferone had hardly any effect on proteoglycan synthesis, whereas xylosyl-beta-D-(4-methylumbelliferone) produced a large amount of glycosaminoglycan chains. The present results indicate that cells cultured with 4-methylumbelliferone produce a hyaluronic-acid-deficient extracellular matrix, which will be useful for functional studies of hyaluronic acid.

Promoter determinants for Escherichia coli RNA polymerase holoenzyme containing sigma 38 (the rpoS gene product)

Sequence determinants responsible for promoter recognition by RNA polymerase holoenzyme containing sigma 38, the rpoS gene product, were analyzed. In a previous study [Tanaka et al. (1993) Proc. Natl. Acad. Sci. USA, 90, 3511-3515], Escherichia coli promoters were classified into three groups: promoters recognized only by RNA polymerase holoenzyme containing sigma 70 (E sigma 70); promoters recognized preferentially by that containing sigma 38 (E sigma 38); promoters recognized by both E sigma 70 and E sigma 38. As representatives of each group of promoter, we chose the alaS, fic and lacUV5 promoters. Making use of a restriction enzyme site inserted between the -10 and -35 hexamer sequences, promoters were divided into the upstream (UE) and downstream (DE) elements. These UEs and DEs were combined in all possible combinations and used for in vitro transcription reactions. Promoters containing DE from the fic or lacUV5 promoter were found to be recognized by E sigma 38, while those containing DE from the alaS promoter were not. Moreover, fic DE alone functioned as an efficient promoter for E sigma 38. Thus we conclude that the discrimination signal resides within the DE sequence. To test the activator response of E sigma 38, in vitro transcription reactions were also performed with the gal and lac promoters. For both CRP-responsive P1 promoters, E sigma 38 was found to be activated by the CRP-cAMP complex.

Nitric oxide synthase containing nerves in the atrioventricular node of the guinea pig heart

Immunoelectron microscopy was performed to localize immunoreactivity for nitric oxide synthase (NOS) in the guinea-pig atrioventricular node. Many small ganglia were found in the interatrial septum near the atrioventricular node. A small number of neurons in these ganglia were immunoreactive. NOS immunoreactive axons were observed in nerve bundles near or within the node. Very thick immunoreactive axons, 8-10 microns in diameter, were found between the conductive tissue and the ordinary cardiac muscles. Electron-microscopic examination confirmed that these axons were unmyelinated. Nerve bundles in this region contained both myelinated and unmyelinated axons; however, immunoreactivity was detected exclusively in unmyelinated axons. Fine NOS-immunoreactive nerve fibers with terminal varicosities were often seen in the atrioventricular node. Close contact between NOS-immunoreactive axon varicosity and specialized cardiac muscle cell was observed. Intranodal ganglia were observed among the specialized cardiac muscles. They were surrounded by numerous axons, some of them were immunoreactive. Direct axo-somatic synapses from NOS-immunoreactive terminals to the intranodal ganglion cells were observed. The present results indicate a possibility that nitric oxide plays a role in the neural control of the conductive tissue in the heart through direct neuromuscular contact.

Safety of the donor in living-related liver transplantation--an analysis of 100 parental donors

The safety and lack of undue operative stress on the donor are documented from an analysis of 100 parental donors, whose children (3 months to 17 years old), received LRLTx at our institution between June 1992 and May 1994. Survival rate of recipients was 86%. No primary nonfunctioning liver was observed. The donors were 56 mothers and 44 fathers. Their ages ranged from 19 to 51 years and their weight ranged from 44 to 80 kg. They received partial liver resections to harvest the grafts. With regard to the liver graft, the left lobe was used in 24 cases (group L) and the left lateral segment was used in 75 cases (group S). The right lobe was used in one case. In the two groups, blood losses were 242 +/- 5 (S) and 312 +/- 14 ml (L); operation times were 6.22 +/- 0.11 (S) and 7.15 +/- 0.21 hr (L), respectively; in both groups, the postoperative hospital stay was 11 days (S, L). No significant differences between the two groups were observed in peripheral RBC and WBC count or serum AST. An increase in total bilirubin was not observed. In the exceptional case using the right lobe, blood loss of 2300 ml necessitated a blood transfusion of 1000 ml, and the total bilirubin increased up to 4.0 mg/dl on the third postoperative day, which prolonged the postoperative hospital stay to 17 days. These results conclusively suggest that safety is guaranteed when the left lobe or the left lateral segment is used as the liver graft for LRLTx.

Early skip-a-day feeding of female broiler chicks fed high-protein realimentation diets. Performance and body composition

The effect of an early skip-a-day feeding program on performance and body composition of broiler chicks fed high-protein realimentation diets was studied. One-day-old female broiler chicks were withheld from feed for 2d (0 to 2 d of age), and at 7 d of age three pens of 15 chicks each were randomly assigned to one of five treatments. One treatment (as the control) involved ad libitum access to feed, and other four treatments were subjected to a skip-a-day regimen from 7 to 13 d of age. From 14 to 20 d of age, chicks of the five treatment groups were fed diets containing 21, 21, 25, 30, or 35% protein. Thereafter, chicks were fed a commercial finisher mash diet (18% CP and 3,160 kcal/kg ME) until 56 d of age. Restricted chicks exhibited compensatory growth during the refeeding period, but the 35% CP realimentation diet impaired this phenomenon as indicated by lower recovery index. Chicks of the skip-a-day program, regardless of dietary protein level, had less abdominal fat, as compared with chicks that ate ad libitum. In comparison with the control, less body fat and ash and greater protein contents were observed in chicks fed the 35% CP realimentation diet. Greater or less liver triglyceride content was observed in chicks fed 21% CP, or the 30 and 35% CP realimentation diet, respectively, whereas, less carcass triglyceride content was found in chicks fed 21 or 35% CP realimentation diet, as compared with the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Ordered structure of the crystallized bovine 20S proteasome

Eukaryotic proteasomes are multicatalytic proteinase complexes with a molecular weight of 750 kDa, containing, respectively, two copies of a hetero-heptamer of alpha-type subunits and one of beta-type subunits, (alpha 1-7 beta 1-7)2. Proteasome was purified from bovine liver and crystallized into a hexagonal system with cell dimensions of a = b = 121.83(2) A, c = 930.68(6) A. A cylindrical particle size of 122 A diameter and 155 A height was determined from the molecular packing in a unit cell. The crystal gave diffraction spots up to at least 4.4 A resolution, which was the minimum spacing of the camera used. The overall temperature factor of the enzyme was estimated to be in the range of 36.2 to 25.8 A2. These results imply that the enzyme complex has a unique ordered structure comprising multisubunits with two types of hetero-heptamer. This ordered structure may facilitate highly organized cooperation of individual functions of subunits within the enzyme complex.

Recovery of graft circulation following percutaneous transluminal angioplasty for stenotic venous complications in pediatric liver transplantation: assessment with Doppler ultrasound

Percutaneous transluminal angioplasty was performed for venous stenosis after living related liver transplantation in three children. Two of them had hepatic vein stenosis and one had stenosis of both the hepatic and portal veins. Progressive development of ascites and deterioration of liver function were found in all cases. Serial Doppler ultrasound studies showed that the flow velocity in the hepatic vein gradually decreased with a flattened velocity waveform, followed by a decrease in portal blood flow. After a successful hepatic vein angioplasty, the velocity in the hepatic and portal veins increased and the Doppler waveform in the hepatic vein became pulsatile in two cases. In the remaining case, a remarkable recovery of both graft perfusion and clinical findings was achieved via combined hepatic vein and portal vein angioplasty. We conclude that balloon angioplasty is an effective alternative to surgery for post-transplant vascular stenosis and that Doppler ultrasound is useful in monitoring graft circulation.

Index of assessing functional status in elderly Japanese men

We attempted to propose the equation of assessing the functional status of elderly adult Japanese men. A number of physical and motor performance measurements were collected from a group of 104 male volunteer subjects (mean age 76.4 +/- 5.8 years). Factor analysis with varimax criterion was applied to all the data. Five factors extracted were interpreted as follows: (1) coordination of the body, (2) flexibility of the trunk, (3) static balance, (4) muscular strength and endurance, and (5) cardiorespiratory fitness. Furthermore, the factor score was computed for each individual by each factor. Each of the five factors were weighted in accordance with its relative contribution to the total variance (or the size of eigenvalue). The weighted combination of factor scores was summed to generate an index of functional status (IFS). Next, IFS scores were computed for each individual and normalized to T scores. Then, a multiple linear regression analysis was performed with the factor analytically derived IFS scores as the dependent variable: IFS = -0.625X1 + 0.604X2 + 0.346X3 + 0.223X4 + 0.465X5 + 0.082X6 + 0.114X7 + 0.199X8 + 0.019X9 + 0.071X10 + 19.76; where X1 = walking around two chairs in a figure 8 (sec), X2 = manipulating pegs in a pegboard (num), X3 = vertical jump (cm), X4 = sit and reach (cm), X5 = estimated maximal oxygen uptake (ml/kg/min), X6 = balancing on one leg with eyes open (sec), X7 = grip strength (kg), X8 = trunk flexion from a standing position (cm), X9 = leg muscle endurance in a semi-squat position against a wall (sec), and X10 = balancing on one leg with eyes closed (sec) Thus, information on the 10 variables from five domains was statistically combined to a single score. The above equation was cross-validated in the other group of elderly men (n = 54). The mean IFS obtained for this group (50.0 +/- 8.3) was not significantly different from the validation group (50.0 +/- 10.0). It is apparent that the IFS has the potential to serve as another useful measure of high order, daily living activities.(ABSTRACT TRUNCATED AT 250 WORDS)

[The significance of bone mineral density measurement of premenopausal women]

We examined the starting age for measuring bone mineral density (BMD) in premenopausal women to detect osteopenia as soon as possible. BMD of the second to fourth lumbar spine vertebrae was measured by dual-energy X-ray absorptiometry to determine normal values for 500 healthy premenopausal women (aged from 17 to 55). We found the rate for low BMD premenopausal women, whose BMD was under the peak bone mass-2SD. And we compared normal BMD women with low BMD women with reference to menstrual history, obstetrical history, and life style, by means of a questionnaire. The peak bone mass of premenopausal women was reached between 35 and 39 years of age (1.059 +/- 0.097g/cm2). The low BMD rate was 7% in all premenopausal women, and increased to 13.5% at from 45 to 49 years. On the other hand, it was only from 5.7 to 7.4% even at from 20 to 29 years. There was the positive correlation between BMD and the body mass index (BMI). There was no statistically significant difference between the low BMD women and the normal BMD women in menstrual history, obstetrical history or life style (parity was 1.7 +/- 1.6 and 1.1 +/- 1.2, respectively, p < 0.05). We concluded that premenopausal women should have their BMD measured after aged 45, and be measured once from 20 to 40 years of age if possible.