Fulminant hepatitis following exposure to dichlorohydrin--report of two cases

A 34-year-old man suffered from fulminant hepatitis after cleaning a tank in which there were traces of dichlorohydrin. In spite of daily plasma exchanges, he died 10 days after exposure. A 27-year-old man with much lighter exposure showed only slight liver dysfunction. This is the first report of lethal injury following exposure to dichlorohydrin.

The role of calcium in prolonged modification of a GABAergic synapse

Caudal hair cell impulses cause postsynaptic inhibition of ipsilateral type B photoreceptors in the snail Hermissenda. This inhibition is shown to be GABAergic according to a number of criteria. HPLC, mass spectrophotometric, and immunocytochemical techniques demonstrated the presence of GABA in the hair cells and their axons. GABA agonists and antagonists mimic and block the synaptic effect in a manner consistent with endogenous GABAergic transmission. Other properties, including I-V relations, conductance changes and reversal potentials, are comparable for exogenous GABA responses and endogenous effects of the hair cell impulses. This inhibitory synapse has been found to undergo a long-lasting transformation into an excitatory synapse if GABA release is paired with post-synaptic depolarization. GABA, via GABAA and GABAB receptors in the B cell, causes the opening of calcium sensitive chloride and potassium channels that leads to the post-synaptic hyperpolarization. GABA also induces a long-lasting intracellular calcium elevation at the terminal branches of the B cell that greatly outlasts the voltage responses. Synaptic transformation induced by pairings is caused by a decrease in both GABA induced chloride and potassium conductances in the post-synaptic B cell, as well as a significant prolongation of the intracellular calcium accumulation in the B cell's terminal axonal branches.

Differences in ultrastructural and metabolic profiles within the same type of fibres in various muscles of young and adult rats

Single fibres from tibialis anterior, extensor digitorum longus, gastrocnemius and soleus muscles in young (4-week-old) and adult (35-week-old) Wistar male rats were classified into three types on the basis of their enzyme-histochemical features: slow-twitch oxidative (SO), fast-twitch oxidative and glycolytic (FOG) and fast-twitch glycolytic (FG) fibres. Ultrastructural (volume density of mitochondria: Vmt and Z line width) and metabolic (phosphofructokinase: PFK and succinate dehydrogenase: SDH activities) profiles were measured. PFK activity in all types of fibres was higher in adult rats, and the difference between the two age-groups (adult/young) was largest between FG, FOG and SO fibres respectively. SDH activity and Vmt were lower in adult rats in a similar way in all fibres. A significant positive correlation was observed between the Vmt and SDH activity in both age-groups. This positive correlation was very specific in fast-twitch and slow-twitch fibres. Changes in the Vmt did not relate directly to the changes in fibre cross-sectional area. The overall pattern indicates that glycolytic capacity of fast-twitch fibres in flexor muscles (TA and EDL) is higher than in extensor muscles (GC and SOL), and that oxidative capacity of all types of fibre in extensor muscles is higher than in flexor muscles. These profiles were changed by growth, and may be related to the specific differences in pattern of activity of each skeletal muscle, and may reflect differences in the recruitment order of different muscles.

Interactions between respiratory, cardiac and stepping rhythms in decerebrated cats: functional hierarchical structures of biological oscillators

Interactions are described of central origin between respiratory, cardiac and stepping rhythms during fictive locomotion in paralyzed, vagotomized, and decerebrated cats. Fictive locomotion was induced by tonic electrical stimulation of the mesencephalic locomotor region (MLR). The coherence between heart beat fluctuation, the efferent discharges of the phrenic, and the lateral gastrocnemius nerves was used to evaluate the strength of the coupling between those three rhythms. The heart beat rhythm was modulated by the centrally generated respiratory and stepping rhythms. The central respiratory rhythm was modulated by the centrally generated stepping rhythm. Based on the present findings, we have proposed a new model concerning the functional hierarchical structures of the three biological oscillators.

Analysis of the population of human T cell receptor gamma and delta chain variable region subfamilies by reverse dot blot hybridization

We have developed a simple method to analyze the population of T cell receptor (TCR) gamma and delta chain variable (V) region subfamilies by the application of reverse dot blot hybridization, which was originally developed for the analysis of human HLA-DR polymorphism. The four oligonucleotides corresponding to each TCR-gamma V region subfamily and the six oligonucleotides to each TCR-delta V region gene were synthesized, and tailed with dTTP. The cDNA was amplified by ligation-mediated PCR in the presence of biotinylated deoxynucleotides. Hybridization between immobilized specific oligoprobes and biotinylated target DNA was nonradioactively detected by a reaction using alkaline phosphatase. The population of the V region subfamilies of TCR-gamma and -delta in PBL analyzed by reverse dot blot hybridization described here showed good correlations with the result of colony hybridization.

Inhibition of the Ca(2+)-activated K(+)-channel by sapecin B, an insect antibacterial protein

Sapecin is an antibacterial protein of the flesh fly and sapecin B is its homologue structurally similar to charybdotoxin of scorpion venom, which is known to be a K+ channel inhibitor. We found that, like charybdotoxin, sapecin B inhibits part of the voltage pulse-induced K+ currents of rat cerebellar Purkinje cells. We suggest that this effect is due to inhibition of the Ca(+)-activated K+ channel. Probably, sapecin B is a naturally occurring K+ channel inhibitor as well as an antibacterial protein.

Angiotensin converting enzyme inhibitor modulates glomerular function and structure by distinct mechanisms

Rats with puromycin aminonucleoside (PAN) nephrosis were given either angiotensin I converting enzyme inhibitor (ACEI), angiotensin II type 1 receptor antagonist (Ang IIRA), or no treatment for four weeks and were then monitored for an additional 12 weeks. In untreated PAN rats, proteinuria reached a maximum at two weeks (271 +/- 38 mg/day). Proteinuria in this early phase was markedly attenuated by ACEI (96 +/- 35 mg/day, P < 0.01), but unaffected by Ang IIRA (306 +/- 34 mg/day). Acute administration of a bradykinin antagonist substantially dampened the antiproteinuric effect of ACEI in PAN rats, resulting in an average increase in proteinuria of 41 +/- 14% in ACEI-treated rats (P < 0.05, ACEI vs. ACEI+bradykinin antagonist). Acute phase therapy for four weeks with ACEI or Ang IIRA did not attenuate subsequent glomerulosclerosis. Separate groups of PAN rats with similar degree of glomerulosclerosis, assessed at 16 weeks after PAN by renal biopsy, were then treated as follows: ACEI [50 mg/liter drinking water (DW), or 200 mg/liter DW], Ang IIRA (20 mg/liter DW, or 80 mg/liter DW) or no treatment, starting after renal biopsy. Whereas glomerulosclerosis increased from biopsy to autopsy at 28 weeks with emergence of low grade proteinuria in untreated PAN rats, proteinuria was absent and glomerulosclerosis was ameliorated or reversed in ACEI and Ang IIRA groups. The results indicate that the early phase proteinuria of PAN nephropathy is independent of Ang II, and that the antiproteinuric effect of ACEI is, at least in part, channeled through activation of bradykinin, whereas the subsequent progression of glomerulosclerosis is caused by a mechanism involving endogenous Ang II actions.(ABSTRACT TRUNCATED AT 250 WORDS)

[Experimental study on the effectiveness of PET tumor images for cancer diagnosis]

Positron emission tomography (PET) with 2-deoxy-2 [18F] fluoro-D-glucose (18FDG), a structural analog of glucose, allows tumor images to be obtained, based on increased glycolysis in cancer cells. In the present study, in order to confirm the effectiveness of 18FDG-PET tumor images for cancer diagnosis, 18FDG tumor uptake values were measured in human gastric cancer xenografts in nude mice. Firstly, comparison of 18FDG uptake and histological grade in four gastric cancers showed that 18FDG uptake increased with loss of differentiation. Secondly, reduction of 18FDG uptake values after administration of anticancer drug was found to correlate with chemosensitivity to anticancer agent, and the values were reduced prior to suppression of tumor growth. These data suggest that 18FDG-PET tumor images may provide reliable indications for assessment of the histological grade of the tumor and the efficacy of cancer chemotherapy.

Segmental transarterial chemoembolization with Lipiodol mixed with anticancer drugs for nonresectable hepatocellular carcinoma: follow-up CT and therapeutic results

We developed segmental Lp-TAE, which is transcatheter hepatic sub-subsegmental, subsegmental, or segmental chemoembolization using Lipiodol introduced into the tumor-bearing hepatic sub-subsegment, subsegment, or segment as the target area. A total of 98 patients with nonresectable hepatocellular carcinoma (HCC) undergoing segmental Lp-TAE (Seg-Lp-TAE) were studied, and the relationship between the CT pattern observed after Seg-Lp-TAE (Seg-Lp-CT) and the therapeutic results obtained in those patients was evaluated. Seg-Lp-CT was classified into four types (type I, homogeneous; type II, defective; type III, inhomogeneous; and type IV, only slight accumulation, if any) according to the Lipiodol accumulation pattern observed after Seg-Lp-TAE. The cumulative nonrecurrence rates of type I were higher than those of types II-IV. The cumulative survival rates of type Ia, in which Lp accumulation is also seen around the main tumor, were the highest (93.8% at 1 year, 85.9% at 2 years, 85.9% at 3 years, and 57.3% at 4 years). The cumulative survival rates achieved with Seg-Lp-TAE were 89.2% at 1 year, 69.4% at 2 years, 58.9% at 3 years, 44.0% at 4 years, and 30.2% at 5 years, which were higher than those achieved with conventional Lp-TAE. Seg-Lp-TAE is very useful in the treatment of HCC limited to one sub-subsegment, subsegment, or segment, and it is important to choose sub-subsegmental, subsegmental, or segmental Lp-TAE on the basis of the size and site of the tumor as well as the type and the number of feeding arteries.

Induction of manganese superoxide dismutase by glucocorticoids in glomerular cells

Our previous in vivo study demonstrated that methylprednisolone (MP) activates glomerular antioxidant enzymes and attenuates glomerular oxidant injuries, including those in experimental nephrosis. The present study investigates the cellular mechanism of the MP-induced activation of antioxidant enzymes and their contribution to the attenuation of cellular oxidant toxicity. When bovine glomerular endothelial cells (GECs) were treated with 10 microM MP, cellular manganese superoxide dismutase (Mn-SOD, 3.95 +/- 0.33 mu/mg protein, M +/- SE) and catalase (1.64 +/- 0.06 k/mg protein) activities were significantly (P < 0.05) elevated above control GECs (2.23 +/- 0.43 mu/mg protein and 1.06 +/- 0.09 k/mg protein, respectively). When GECs pretreated with MP (10 microM 24 hrs) were exposed to xanthine (0.1 mM)+xanthine oxidase (5 mU/ml) for four hours, levels of specific membrane lipid peroxidation products, that is, phosphatidylcholine- and phosphatidylethanolamine-hydroperoxides, remained at levels 10 to 25% of those measured in non-MP-treated (xanthine/xanthine oxidase-exposed) control cells. Moreover, the degree of cell damage following exposure to the superoxide generating system, assessed by 51Cr release, was significantly attenuated in MP-treated cells (approximately 50% of MP-non-treated controls, N = 6). Thus, MP-treated GECs with elevated antioxidant enzyme activities by MP were more resistant to the toxic effect of reactive oxygen metabolites. The mechanism of antioxidant enzyme induction by MP was studied for Mn-SOD. MP was shown to enhance Mn-SOD mRNA in bovine GECs and rat glomerular mesangial cells (GMCs) in dose-dependent manners.(ABSTRACT TRUNCATED AT 250 WORDS)

Accumulation of 2-deoxy-2[18F]fluoro-D-glucose in human cancers heterotransplanted in nude mice: comparison between histology and glycolytic status

The success of tumor imaging with PET and 2-deoxy-2-fluoro[18F]-D-glucose (18FDG) is based on preferential accumulation of 18FDG in tumors.

METHODS

Fluorine-18-FDG uptake was measured in nine human cancers heterotransplanted in nude mice and compared with histologic subclassification.

RESULTS

Mean 18FDG uptake by the human cancers was considerably less than that by the host's heart, but values at 60 min after injection were about 2.5 times as high as the liver and kidney, about two times as that for the muscle and about six times that for the blood. Comparison of 18FDG uptake and histological grade in four gastric, two pancreatic and three colonic cancers showed that 18FDG uptake increased with loss of differentiation.

CONCLUSION

This nude mice model system is useful for studying correlations between physiological and morphological parameters of heterotransplanted human cancers.

Light microscopical immunohistochemical study on parathyroid adenoma in primary hyperparathyroidism

Fifteen adenomatous parathyroid glands obtained from 15 patients with primary hyperparathyroidism were examined both pathologically and immunohistochemically and connected with the clinical data for each patient. Four consecutive sections of the largest section surface of each resected adenomatous parathyroid gland were utilized for 4 kinds of stains, that is, hematoxylin-eosin, Grimelius and the immunohistochemical stains for parathyroid hormone (PTH) and chromogranin A. The results were as follows: (1) The large adenomatous parathyroid glands showed strong reactions to PTH as well as chromogranin A and Grimelius. On the other hand, the parathyroid adenoma obtained from a 9-year-old boy with hypercalcemic crisis showed almost no stain-positive cells for both PTH and chromogranin A. It is assumed that the former phenomenon reflects a substantial storage of secretory granules, while the latter reflects exhaustion of these granules. (2) The normal parathyroid cells in the neoplastic parathyroid glands generally showed stronger reactions to PTH and chromogranin A than neoplastic parathyroid cells. This suggests that normal cells in the neoplastic parathyroid glands may have their release of PTH rather than its synthesis suppressed, and also might support the hypothesis of some authors that chromogranin A or SP-I might contribute to stabilization of PTH or the secretory vesicle.

Cardiac tamponade secondary to hemorrhagic pericarditis during continuous hemofiltration for renal failure. The role of the anticoagulant

Cardiac tamponade secondary to hemorrhagic pericarditis during continuous hemofiltration (CHF) for renal failure is reported. Cardiac tamponade developed while heparin was being used as an anticoagulant and did not recur when nafamostat mesilate was substituted. The role of the anticoagulant in the etiology of hemorrhagic pericarditis in dialysis patients is discussed.

Antinuclear antibodies in patients with atopic dermatitis and severe facial lesions

BACKGROUND

In adult patients with atopic dermatitis (AD), the presence of autoantibodies such as anti-IgE and antinuclear antibodies (ANA) has been demonstrated. The patients may have altered immune regulation.

OBJECTIVE

The purpose of this study is to examine the prevalence of ANA in AD patients with severe facial eruptions and to evaluate the differences between ANA-positive and ANA-negative AD patients.

METHODS

ANA, blood eosinophil count, total serum IgE levels, specific IgE antibody to Dermatophagoides pteronyssinus, disease duration, photosensitivity and association with respiratory allergic diseases were checked in 89 AD patients.

RESULTS

Twenty-three (25.8%) AD patients showed positive ANA at titers ranging from 1:40 to 1:640, and the incidence of positive ANA was 12.1% in controls. Twenty-five (71.4%) of 35 AD patients with positive ANA at titers ranging from 1:20 to 1:640 were females.

CONCLUSION

Adult AD patients with severe facial lesions should be examined for serum ANA. Particularly in female and photosensitive AD patients with severe facial lesions, serum autoantibodies have to be carefully investigated to differentiate from autoimmune diseases.

Distribution of gentamicin to the cochlea of the chicken embryo

Aminoglycoside antibiotics are ototoxic in mammals and birds, including recently hatched chicks, but chicken embryos are insensitive to the ototoxicity of gentamicin, kanamycin, and streptomycin. To determine whether or not the insensitivity is due to a lack of antibiotic distribution to the avian cochlea, the distribution of gentamicin to the cochlea of the White Leghorn chicken embryo was compared to the distribution to the cochlea of the recently hatched White Leghorn chick. Fertile eggs were injected with a maximally tolerated dose of gentamicin sulfate (0.1 mg/egg/day) on incubation days 10-18, and the chicks were injected subcutaneously with either 5 mg (non-ototoxic) or 100 mg (ototoxic) gentamicin sulfate/kg body weight on days 1-9 after hatching. Gentamicin sulfate was histochemically detected within the basilar papilla (the avian equivalent of the organ of Corti) in all treated chicken embryos and chicks by 1 day after the first injection, and the staining was intense after 3 days of treatment. By ultrastructural immunocytochemistry, mild, diffuse labeling for gentamicin sulfate was detected within the endoplasmic reticulum of short and tall hair cells of chicken embryos by incubation day 17. Moderate labeling of gentamicin sulfate was detected in the infracuticular region of lysosomes of hair cells in chicks receiving 5 treatments of gentamicin sulfate at 5.0 mg/kg body weight and after 1 treatment of gentamicin sulfate at 100 mg/kg body weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Topography of pyramidal neuron intrinsic connections in macaque monkey prefrontal cortex (areas 9 and 46)

An understanding of the normal organization of prefrontal cortex is essential to the recognition of pathology underlying human behavioral disorders believed to depend on this region. We have therefore studied the pattern of intrinsic intra- and interlaminar pyramidal neuron connectivity in prefrontal areas 9 and 46 (of Walker) in macaque monkey cerebral cortex (anterior to the arcuate sulcus between the principal sulcus and midline). We made focal (200-400 microns) injections of biocytin and mapped the pattern of orthogradely transported label. Injections made into the superficial layers label wide-ranging lateral projections within the same areas of prefrontal cortex. Projections local to such small injections form a narrow band of terminals in layers 1-3 (200-400 microns wide, 2-4 mm long) centered on the injection site. Collateral fibers spread orthogonal to this terminal band, making frequent bifurcations, to establish a series of parallel bands of terminals with uninnervated bands between, spaced regularly across the cortex (center to center 500-600 microns). The entire pattern of terminal label is stripe-like, with occasional narrower interbands and crosslinks between the bands, and can extend over 7-8 mm across the cortex. These projections arise from pyramidal neurons in layers 2, 3, and 5 and terminate in layers 1-3. The stripe-like pattern contrasts with patch-like patterns in other cortical regions (V1, V2, V4, motor, somatosensory) and is smaller in scale than stripe-like zones of corticocortical afferent terminals to this region, reported to be 300-750 microns wide and spaced 1.0-1.5 mm center to center.

Ano-urethral fistula, a special type of anomaly: report of two cases

Two cases of an ano-urethral fistula, being a low malformation, are reported herein. Both patients underwent a colostomy under the diagnosis of a recto-urethral fistula during the neonatal period. As a urethro-rectogram later revealed the fistula to be located between the anus and anterior urethra, revision of the urethral fistula and an anoplasty were performed through the perineal approach. It is very difficult to establish a correct diagnosis of an ano-urethral fistula at the initial stage of treatment, but we found the urethro-rectogram invaluable in this regard. This type of malformation can be treated through the perineal approach, while the additional anterior perineal incision is very helpful for revising the urethral fistula.

The size of regional lymph nodes does not correlate with the presence or absence of metastasis in lymph nodes in rectal cancer

We evaluated the relationship between the size of regional lymph nodes and the presence of metastasis in them in rectal cancer. Of 1,064 lymph nodes in 46 specimens, 133 (13%) were found to have metastases. A half of the positive nodes and most of the negative ones were less than 5 mm in diameter. Therefore, we must find lymph nodes smaller than 5 mm in diameter for assessment of lymph node metastasis. Although positive nodes were larger than negative ones, there was no significant difference. However, when comparing the size of lymph nodes in relation to their location, the epi- and pararectal lymph nodes larger than 10 mm in diameter were highly suggestive of metastases, but the size of the lymph node was not a reliable indicator of lymph node metastases in other situations.