Pemphigus vulgaris associated with transient acanthosis nigricans like lesion

A patient with pemphigus vulgaris was treated with predonisolone and cyclosporin. At the sites of healing erosions, hyperkeratotic, hyperpigmented plaques developed; they were clinically and histologically similar to acanthosis nigricans. These lesions regressed after a few months. This case and others described in the literature suggest that such dermatoses might be caused by immunologically as well as mechanically mediated epidermal injury.

The effect of low intensity bicycle exercise on the insulin-induced glucose uptake in obese patients with type 2 diabetes

OBJECTIVE

The present study was undertaken to reveal the effect of low intensity bicycle exercise on the insulin-induced glucose uptake in obese patients.

SUBJECTS AND METHODS

Seven obese men with Type 2 diabetes (OBDM) and seven healthy young men (HY) participated in this study. The glucose infusion rate (GIR) was determined by glucose clamp procedure at an insulin infusion rate of 40 mU m-2 min-1 (plasma insulin concentrations: 700-800 pmol l-1). Confirming stabilized GIR, a 30-min bicycle exercise was performed during the glucose clamp which was continued for 120 min after exercise.

RESULTS

Average GIR in OBDM for last 30 min prior to exercise were significantly lower than HY (28.3 +/- 1.7, 47.4 +/- 1.8 mumol kg-1 min-1 respectively, P < 0.05). GIR abruptly increased during exercise and gradually decreased after exercise to the nadir almost at the time from 30 to 60 min in recovery period in both groups. GIR in OBDM, however, gradually increased significantly over pre-exercise levels (P < 0.05), following exercise and reached the same levels compared to HY after 80 min of recovery period.

CONCLUSION

These results indicated that in obese Type 2 diabetes, 30 min of low intensity bicycle exercise significantly enhances the lower level of insulin-induced glucose uptake shortly after exercise and might be useful for the treatment of post-prandial hyperglycemia.

From behavior to development: genes for sexual behavior define the neuronal sexual switch in Drosophila

The isolation and analysis of Drosophila mutants with altered sexual orientation lead to the identification of novel branches in the sex-determination cascade which govern the sexually dimorphic development of the nervous system. One such example is the fruitless (fru) gene, the mutation of which induces male-to-male courtship and malformation of a male-specific muscle, the muscle of Lawrence (MOL). Since the MOL is formed in wild-type flies when the innervating nerve is male, regardless of the sex of the MOL itself, the primary site of Fru function is likely to be the motoneurons controlling the MOL. The fru gene produces multiple transcripts including sex-specific ones. A female-specific mRNA from the fru locus has a putative Transformer (Tra) binding site in its 5' untranslated region, suggesting that fru is a direct target of Tra. The fru transcripts encode a set of proteins similar to the BTB (Bric à brac, Tramtrack and Broad-complex)-Zn finger family of transcription factors. Mutations in the dissatisfaction (dsf) gene result in male-to-male courtship and reduced sexual receptivity of females. The dsf mutations also give rise to poor curling of the abdomen in males during copulation and failure of egg-laying by females. The latter phenotypes are ascribable to aberrant innervation of the relevant muscles. A genetic analysis reveals that expression of the dsf phenotypes depends on Tra but not on Doublesex (Dsx) or Fru, suggesting that dsf represents another target of Tra. Taken together, these findings suggest that the sex-determination protein Tra has at least three different targets, dsx, fru and dsf, each of which represents the first gene in a branch of the sex-determination hierarchy functioning in a mutually-exclusive set of neuronal cells in the Drosophila central nervous system.

[Primary Sjögren's syndrome with pulmonary hypertension]

A 50-year-old woman was admitted to our hospital because of dyspnea on exertion. A chest X-ray film showed cardiomegaly and echocardiography revealed right-heart overload. Right heart catheterization studies revealed pulmonary hypertension and no signs of pulmonary embolism or vasculitis. The patient had complained of Raynaud's phenomenon since 6 years before admission. She did not notice eye or mouth dryness, but examination of a lip-biopsy specimen showed infiltration of lymphocytes into the salivary glands. Laboratory findings showed hypergammaglobulinemia and hemolytic anemia. Primary Sjögren's syndrome with pulmonary hypertension was diagnosed. Her general condition improved with steroid pulse therapy followed by oral administration of corticosteroids and cyclophosphamide.

Prevalence of ischemic heart disease among patients with sleep apnea syndrome

We investigated the prevalence of ischemic heart disease (IHD) in sleep apnea syndrome (SAS) and the presence of coronary risk factors involved in the onset of IHD in 386 subjects with suspected SAS due to heavy snoring. The prevalence of IHD among patients with untreated SAS was found to be 23.8%, and the percentage of patients having SAS complicated with IHD was high among those with moderate or severe SAS. Sleep apnea syndrome patients with IHD also showed high prevalences of hypertension and hyperlipidemia. It appears that sleep apnea aggravates the factors that cause coronary vascular disorders, and is involved in the onset of IHD.

Differences in refractory-period response of canine subendocardium and subepicardium to bunazosin, an alpha1-adrenoceptor antagonist, and propranolol during myocardial ischemia

Our objective was to investigate the effects of alpha1- or beta-adrenoceptor blockers on endocardial and epicardial refractory-period changes during myocardial ischemia in alpha-chloralose-anesthetized dogs. The first and second diagonal branches of the left anterior descending coronary artery were ligated. The refractory period was determined by an S1-S2 extrastimulus method. Dogs were treated with the alpha1-blocker bunazosin (0.1-0.2 mg/kg, i.v.; n = 16), the beta-blocker propranolol (0.2 mg/kg, i.v.; n = 15), or saline (n = 11). Dogs that developed ventricular tachycardia/fibrillation (VT/VF) during the experiment were excluded from the statistical assessment in refractory periods. In all groups, coronary ligation produced a significant shortening of the refractory period of ischemic epicardial tissue (p < 0.05) but only minimal shortening of ischemic endocardial refractory periods, resulting in an increased difference in repolarization time between the endo- and epicardial sites. Treatment with bunazosin ameliorated this ischemia-related shortening of refractory periods at both the endo- and epicardial sites, with a greater effect seen epicardially (p < 0.05), resulting in values similar to those in the nonischemic tissue. Treatment with propranolol prolonged refractory periods more in the epicardial (p < 0.01) than in endocardial sites, exacerbating the disparity in the refractory period between the endo- and epicardial sites (p < 0.05). Propranolol also prolonged the refractory period of nonischemic tissue (p < 0.05 and p < 0.01 in endo- and epicardial sites, respectively), resulting in a significant difference between the ischemic and normal myocardium at the endocardial site (p < 0.05). Results suggest that the alpha1-blocker bunazosin reduces the refractory-period disparity between the ischemic and normal myocardium without increasing the disparity between the endo- and epicardial surfaces, whereas propranolol produces a greater disparity.

[Study on coagulation fibrinolytic systems in predialysis patients with chronic renal failure--comparison between patients with chronic glomerulonephritis and patients with diabetic nephropathy]

To clarify the abnormalities of coagulation and fibrinolytic systems on predialysis patients with chronic renal failure, we measured indices of coagulation and fibrinolytic systems in 33 predialysis patients whose creatinine (Cr) levels were over 3.0 mg/dl. We termed twenty-four patients with chronic glomerulonephritis the "CGN group". We also termed nine patients wit diabetes mellitus the "DM group". We measured thrombin.antithrombin III complex (TAT), alpha 2-plasmin inhibitor plasmin complex (PIC), D-dimer, protein C, protein S, thrombomodulin (TM), vitronectin, tissue plasminogen activator.plasminogen activator inhibitor-1 complex (tPAI-C) in theses two groups. Furthermore, we measured the same indices after 6 months in the CGN group. As a result, the plasma levels of both TAT, PIC, TM/Cr ration in the DM group were significantly higher that those in the CGN group, changes in both protein S activities and plasma levels of tPAI-C were reduced significantly after 6 months. In conclusion, the abnormalities of coagulation and fibrinolytic systems in predialysis diabetic patients were stronger than those in predialysis patients with CGN. Furthermore, these abnormalities were worsened after 6 months in predialysis patients with chronic renal failure.

Sexual orientation in Drosophila is altered by the satori mutation in the sex-determination gene fruitless that encodes a zinc finger protein with a BTB domain

We have isolated a new Drosophila mutant, satori (sat), the males of which do not court or copulate with female flies. The sat mutation comaps with fruitless (fru) at 91B and does not rescue the bisexual phenotype of fru, indicating that sat is allelic to fru (fru(sat)). The fru(sat) adult males lack a male-specific muscle, the muscle of Lawrence, as do adult males with other fru alleles. Molecular cloning and analyses of the genomic and complementary DNAs indicated that transcription of the fru locus yields several different transcripts. The sequence of fru cDNA clones revealed a long open reading frame that potentially encodes a putative transcription regulator with a BTB domain and two zinc finger motifs. In the 5' noncoding region, three putative transformer binding sites were identified in the female transcript but not in male transcripts. The fru gene is expressed in a population of brain cells, including those in the antennal lobe, that have been suggested to be involved in determination of male sexual orientation. We suggest that fru functions downstream of tra in the sex-determination cascade in some neural cells and that inappropriate sexual development of these cells in the fru mutants results in altered sexual orientation of the fly.

Hepatocyte growth factor in nephronophthisis-medullary cystic disease complex

A 13-year-old Japanese girl presented with severe anemia and renal dysfunction. The nephronophthisis-medullary cystic disease complex was diagnosed from the results of renal biopsy and a family study. Immunohistochemical detection of hepatocyte growth factor in the epithelial cells of dilated renal tubules suggested that it may have a role in the development of the tubular cystic changes which are characteristic of this disease.

Histopathological findings on ulcerative lesions of carpal and tarsal joints in Japanese black cattle

In order to determine the pathogenesis of ulcerative lesions of the articular cartilages in Japanese Black cattle, tissue samples of the ulcerative lesion, marginal portion of the ulcer, macroscopically normal portions and synovial membranes were histopathologically examined by light microscopy, scanning electron microscopy and contact microradiography. The results are summarized as follows: (1) In the ulcerative lesions, degeneration and complete destruction of articular cartilage and its replacement with a proliferation of myelogenic connective tissue were observed. (2) In macroscopically normal portions, fissures of the articular surface and changes of the trabecular pattern in subchondral bone were present. (3) In the marginal portions of the ulcerative lesions, evidences of the repair process such as connective tissue growth from subchondral bones and articular cartilages were seen. (4) In synovial membranes, no pathological findings were observed. And (5) among the above mentioned changes, no inflammatory findings were seen. In conclusion, the ulcerative lesions of bovine articular cartilage may be regarded as the early stage of osteochondrosis to osteoarthrosis since the findings such as noninflammatory destruction or degeneration and remodeling of the joints are characteristics of the latter.

Acute generalized exanthematous pustulosis induced by dexamethasone injection

A 52-year-old woman, without a history of psoriasis, developed a widespread, sterile pustular eruption on the trunk and extremities 2 days after subcutaneous injection of dexamethasone solution. Skin biopsy revealed subcorneal pustules filled with neutrophils and moderate lymphohistiocytic infiltrate with a few eosinophils in the dermis. There was no evidence of vasculitis. Patch testing showed positive pustular reactions to dexamethasone solution. Histology of this pustule also resembled that of the original eruption. To our knowledge, acute generalized exanthematous pustulosis due to corticosteroid has not been previously reported.

Plasma thrombomodulin: usefulness as a blood access failure marker in hemodialysis patients

In 144 patients on hemodialysis (76 males and 68 females, median age 55.7 +/- 14.1 years, mean period on dialysis 44.1 +/- 33.3 months), thrombomodulin was determined by enzyme immunoassay prior to initiation of hemodialysis. The results showed that the mean thrombomodulin value of hemodialysis patients was 13.59 +/- 3.63 ng/ml which was significantly higher than the control value (3.20 +/- 0.90 ng/ml). The thrombomodulin values were significantly higher in patients with blood access failure (15.27 +/- 4.45 ng/ml) than in those without (13.11 +/- 3.31 ng/ml), and the rate of blood access failures was also significantly higher in those with thrombomodulin values of 15.0 ng/ml or higher than in those with values < 15.0 ng/ml. It was evident that there is a higher risk of blood access failure in patients with severe systemic vascular endothelial injury, and thrombomodulin is a useful marker of such an injury.

Leiomyoma of the lesser omentum: report of a case

The case of a 67-year-old Japanese woman with leiomyoma arising from the lesser omentum is reported herein. Although the patient had no abdominal symptoms, findings of a routine abdominal ultrasound examination suggested a mass between the stomach and the lateral segment of the liver. Subsequent magnetic resonance imaging (MRI) demonstrated a 6-cm well-encapsulated tumor in the lesser omentum, and this was confirmed intraoperatively. Resection of the tumor was performed without any other procedure and the histological diagnosis was confirmed as leiomyoma. The patient has been well for the 6 months since her operation. To our knowledge, this is the first report in the English literature of leiomyoma arising from the lesser omentum.

Usefulness of immunoadsorption therapy for systemic lupus erythematosus associated with transverse myelitis. A case report

Transverse myelitis (TM) is a very rare complication of systemic lupus erythematosus (SLE) and its prognosis is poor. It therefore needs to be treated aggressively. We describe a patient suffering from SLE associated with TM, who responded well to a combination of immunoadsorption therapy and steroid mini-pulse therapy. His serum interleukin 6 levels as well as clinical indicators fell to normal after this treatment.

An adult case of cardiac fibroma

The patient, a 48-year-old woman with cardiac fibroma, is the second oldest patient with this disease in Japan. Her electrocardiogram showed findings compatible with old high lateral, posterior and possibly lateral myocardial infarction, regions which corresponded to the tumor site. In patients whose electrocardiogram suggests a previous myocardial infarction (pseudo myocardial infarction), the possibility of intramyocardial tumor should be taken into consideration.

Simple purification method for a Vibrio vulnificus hemolysin by a hydrophobic column chromatography in the presence of a detergent

A Vibrio vulnificus hemolysin (VVH) was purified by two steps of hydrophobic column chromatography on Phenyl-Sepharose HP. The first chromatography was carried out at pH 6.0. In this pH condition, VVH efficiently bound to the column, but the hemolysin fraction eluted was accompanied with colored substance(s). To eliminate this colored substance, the second chromatography was carried out at pH 9.8 in the presence of 1% 3-[(3-cholamidopropyl) dimethylammonio]-1-propanesulfonate (CHAPS), a zwitterionic detergent. Homogeneity of the hemolysin thus obtained was shown by polyacrylamide gel electrophoresis. The specific activity increased 33,600 times and the yield was 35%. The method is simple and useful to supply enough VVH for study of the role of the hemolysin in the infection by V. vulnificus or on the mechanism of action of the hemolysin.

[A case report of one-staged surgery for annuloaortic ectasia associated with atypical coarctation of the aorta]

A 33-year-old man admitted to our hospital with an episode of chest discomfort and dyspnea. UCG, CT, MRI and DSA disclosed an annuloaortic ectasia with grade 3 aortic regurgitation and atypical coarctation of the aorta. Cabrol operation was performed with simultaneous graft bypass using a woven Dacron prosthesis between the ascending aorta and the abdominal aorta. The course of the bypass graft was arranged to pass behind the rectal muscle without laparotomy and major collateral vessels of the thorax could been kept without thoracotomy. There are only 10 reported cases of annuloaortic ectasia associated with atypical coarctation of the aorta in Japan. This is the second successful case report of one-stage surgery to the complicated cardiovascular disease.

Effects of bunazosin, a selective alpha 1-blocking agent, and propranolol used alone and in combination on canine ventricular refractoriness and its dispersion during myocardial ischemia

The individual and combined effects of bunazosin, a selective alpha 1-adrenergic blocking agent, and propranolol on ventricular refractoriness and its dispersion were assessed in 33 chloralose-anesthetized, sympathectomized, and vagotomized dogs 2-3 h after occlusion of the obtuse marginal branches of the circumflex artery. The refractory period was measured in eight sites of the ischemic zone, two sites of the border zone, and two sites of the normal zone with S1-S2 extrastimulus methods. In group 1 dogs (n = 9), coronary artery ligation significantly shortened refractoriness in the ischemic zone (p = 0.023-0.001 in each site). Intravenous (i.v.) administration of a low dose of bunazosin at 0.1 mg/kg significantly blunted the shortening of refractoriness in the ischemic zone (p = 0.026-0.002 in each site), although the values did not reach those observed in the nonischemic zones (both the border and normal zones), where refractoriness remained unchanged. In group 2 dogs (n = 11), a higher dose of i.v. bunazosin, 0.5 mg/kg, significantly blunted the shortening of the refractory period within the ischemic zone (from 149 +/- 14 to 175 +/- 8 ms; mean +/- SD, p < 0.001) and reached the levels of the nonischemic zones (border zone 175 +/- 15 ms, normal zone 170 +/- 14 ms), resulting in a dispersion reduction in refractoriness between the ischemic and nonischemic zones. This dispersion tended to increase again with i.v. administration of 0.2 mg/kg propranolol (ischemic vs. border zone p = 0.034; ischemic vs. normal zone p = 0.089).(ABSTRACT TRUNCATED AT 250 WORDS)

Pustular vasculitis with clinical feature of pustular psoriasis and sternoclavicular hyperostosis

We report the case of a 51-year-old Japanese man with a unique pustulosis. He had multiple erythematous plaques and numerous pinpoint pustules on the trunk and extremities resembling pustular psoriasis. Histologic features revealed a fully developed intraepidermal abscess filled with neutrophils and disrupted epidermal keratinocytes. Mild leukocytosclastic vasculitis was seen in the underlying dermis. A direct immunofluorescence study revealed IgM, Clq, C3 and fibrinogen deposits in the dermal vessels. The patient had also sternoclavicular hyperostosis. We think that this represents a unique type of pustular vasculitis distinct from pustular psoriasis.

Sensory mother cells are selected from among mitotically quiescent cluster of cells in the wing disc of Drosophila

The large sensory bristles on the head and thorax of Drosophila are arranged in a precise pattern. Each bristle is formed by the progeny of a sensory mother cell (SMC) which is generated in the imaginal wing disc. The proneural genes ac and sc play an important role in the correct positioning of these SMCs by conferring to reproducibly located clusters of cells the competence to become SMCs. Indirect evidence suggested that the mitotic state of a cell could also play an important role in SMC positioning. In order to analyze the relation between the formation of SMC and the mitotic activity in the developing wing disc, we used BrdU immunolabeling to monitor the mitotic activity in an enhancer-trap transformant line, A101, where the SMCs can be visualized. Our results indicate that SMCs arise from clusters of mitotically quiescent cells (MQC), and that the cell that becomes a SMC was itself arrested at the G2 stage of the cell cycle. The emergence of MQCs follows a precise temporal and spatial pattern which is not affected by the absence of the ac and/or sc genes. We propose that the reproducible emergence of MQCs could be an important factor in the formation of SMCs.

A corrected transposition of the great arteries with situs inversus visceralis and cleft palate, but without other cardiac defects

A 17-year-old female admitted for cleft palate surgery was referred for further evaluation of her cardiac condition. The patient had been diagnosed as dextrocardia at birth, without any cardiac murmurs. She has led a normal life. The apical impulse was felt at the fifth intercostal space at the right mid-clavicular line. The ECG and chest x-rays were strongly suggestive of corrected transposition of the great arteries (CTGA) with situs inversus visceralis. Findings of the two-dimensional and Dopplar echocardiograms showed CTGA with a mild morphologic tricuspid regurgitation without any other complicated cardiac anomalies. In the Japanese literature, 36 CTGA patients without associated cardiac defects have been reported. Of these, four patients revealed dextrocardia. To our knowledge, our patient is the first reported adult case without any cardiac defects, only minimal tricuspid regurgitation, situs inversus totalis and cleft palate.

An entirely suprasellar symptomatic Rathke's cleft cyst: case report

An entirely suprasellar symptomatic Rathke's cleft cyst in a 21-year-old woman is reported. An unusual feature of this cyst was the fact that the subepithelial tissues were composed of pituitary gland cells. High resolution magnetic resonance imaging is sensitive in the detection of subtle suprasellar abnormalities. We review the literature regarding the embryological pathogenesis of Rathke's cleft cyst, with special reference to the entirely suprasellar type.

Correlation of coronary artery stenosis site with anterior or inferior projection of ST changes induced by treadmill exercise using a newly devised 9-lead Holter method

A 9-lead Holter monitor using the lead-switching technique (9-lead DCG) and conventional 12-lead electrocardiograph (12-lead ECG) were simultaneously used for recording during treadmill exercise testing (Td-test) in 140 patients with coronary artery disease. Coronary arteriography was performed in 118 of the 140 patients, and the correlation between coronary stenosis and anterior or inferior projection of ST depressions occurring during the Td-test was investigated. Additionally, 10 patients with acute myocardial infarction (AMI) were studied to test ST elevation detection by the 9-lead DCG. The CM5 lead demonstrated ST depressions in 92 of the 109 patients showing ST depressions in one or more leads. High lateral (HL) and/or low lateral leads detected all ST depressions occurring in the I and aVL leads of the 12-lead ECG. Leads CM1, CM2 and CM3 exhibited low sensitivity (0-32%) and high specificity (56-100%), while leads CM4, CM5, and CM6 provided greater sensitivity (66-95%), but less specificity (3-32%) in detecting diseases of the left anterior descending artery, left circumflex artery and/or right coronary artery (RCA). In contrast, the low back (LB) lead demonstrated high sensitivity (88%) and high specificity (86%) in detecting RCA disease. Lead CM3 detected ST elevations in all 6 patients with anterior AMI, while the LB lead did so in all 4 patients with inferior AMI. With a Holter monitor, 4 leads are needed: CM5 like, CM3 like, lateral (such as HL) and inferior (such as LB). The LB lead is useful in detecting inferior ischemia.

Molecular and histological characterizations of the Om(2D) mutants in Drosophila ananassae

A series of transposon-induced optic morphology (Om) mutants found in a hypermutable marker stock of Drosophila ananassae provides a useful system for analyzing the molecular mechanism of eye morphogenesis. In the present study, one of the 25 Om loci so far reported, Om(2D), has been subjected to histological and molecular analyses as a first step toward understanding the role of Om genes in eye morphogenesis. Histological abnormalities observed during eye morphogenesis of the mutant, i.e. cell death within the eye-antennal discs of third instar larvae, and loss of the lamina, disorganized ommatidia and atrophied optic lobes in adults, were all comparable to those reported with various eye morphology mutants of D. melanogaster. Approximately 25 kb of genomic DNA including the Om (2D) locus was cloned by tom tagging. Southern blot and cloning analyses of two alleles of the Om (2D) locus revealed that insertions of the tom element occurred at three sites within 359 bp; two tandemly arrayed toms sharing one long terminal repeat at the junction and an internally deleted tom were present 359 bp apart from each other in Om (2D) 63, while a single tom in reverse orientation was present within the 359 bp in Om (2D) 10a. Host DNA sequences at the three insertion sites were TATAT or AATAT, and ATAT was duplicated upon the tom insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

Asymmetry of membrane fluidity in the lipid bilayer of blood platelets: fluorescence study with diphenylhexatriene and analogs

Membrane fluidity of bovine platelets was examined with diphenylhexatriene (DPH), its cationic trimethylammonium derivative (TMA-DPH) and anionic propionic acid derivative (DPH-PA). After addition of these probes to platelet suspensions at 37 degrees C, the fluorescence intensity of DPH-PA reached equilibrium within 2 min, whereas those of DPH and TMA-DPH increased gradually. With increase in the fluorescence intensity of TMA-DPH, its fluorescence anisotropy decreased significantly, but the fluorescence anisotropies of DPH-PA and DPH did not change during incubation. The gradual increase of fluorescence intensity of TMA-DPH was due to its penetration into the cytoplasmic side of the platelet membrane, as shown quantitatively by monitoring decrease in its extractability with albumin. Transbilayer movement of TMA-DPH was markedly temperature-dependent, and was scarcely observed at 15 degrees C. The fluorescence intensity of TMA-DPH was much higher in platelet membranes and vesicles of extracted membrane lipids than the initial intensity in intact platelets. Moreover, the fluorescence anisotropy of TMA-DPH was much lower in the former preparations than the initial value in intact platelets. These results suggest that binding sites for TMA-DPH in the cytoplasmic side of the platelet membrane are more fluid than those in the outer leaflet of the plasma membrane. Platelet activation by ionomycin induced specific change in the fluorescence properties of TMA-DPH without causing transbilayer incorporation of the probe.

Cavernous angioma in the fourth ventricular floor--case report

A rare case of cavernous angioma located in the fourth ventricular floor occurred in a 44-year-old female complaining of occipital headache, vomiting, diplopia, and dysarthria. Computed tomographic scans demonstrated a high-density area in the fourth ventricle and slight hydrocephalus. Magnetic resonance (MR) imaging showed a mixed intensity mass on T2-weighted images and high- or isointensity regions on T1-weighted images. The tumor was totally removed and histologically diagnosed as cavernous angioma. Postoperatively, ataxic gait, nausea, and vomiting disappeared gradually. MR imaging was useful to accurately evaluate the anatomic relationship between the lesion and the brainstem.

Growth of the Cellular Slime Mold, Dictyostelium discoideum, Is Gravity Dependent

The effect of artificial gravity on the growth of a microorganism, Dictyostelium discoideum, was studied and the following results were obtained: (a) Germination efficiency increased as gravity increased up to 3 gravities. (b) Cell differentiation was influenced by gravity. Retardation of spore formation or reduction in the spore fraction was observed at hypergravity. (c) Fruiting bodies were taller at hypergravity and smaller at simulated microgravity when compared at 1 gravity. It is suggested that modulation of gravity provides useful information on the mechanisms of life.

Extracranial metastases of malignant ependymoma--case report

A case of malignant ependymoma with extracranial metastases is reported. A 59-year-old male was admitted to our hospital with vomiting and ataxia. Following computed tomographic (CT) scanning indicating a ring-like enhanced mass in the cerebellum, the tumor was subtotally removed in December, 1985. Histological diagnosis was malignant ependymoma. A second operation was performed in February, 1987, due to recurrence of the tumor in the fourth ventricle. Postoperative radiation therapy at a total dose of 7780 rads was given over 2 years. Eleven months after radiation therapy was completed, he reported cough and multiple skin metastases. Chest x-rays showed metastases at the right hilus. Repeated CT scans revealed separate frontal cerebral metastatic tumors. He died of respiratory insufficiency. Extracranial metastases of infratentorial ependymoma to the skin and lung are rare pathological entities.

[Epidural morphine as a sedative after open heart surgery: in cases of coronary artery bypass graft]

20 cases of coronary artery bypass graft (CABG) were divided randomly into 2 groups. 10 cases (Group I) received epidural catheterization between Th 6/7 at least 24 hours prior to the operation. After operation, these 10 cases were sedated with 3 mg of Morphine hydrochloride given through the epidural catheter. Other 10 cases (Group II) were sedated with 10 mg of Morphine given intravenously. Parameters of cardiorespiratory dynamics such as arterial blood pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, central venous pressure, oxygen saturation of mixed venous blood, cardiac index, doses of intravenous Nitroglycerin, Dopamine and Dobutamine, arterial blood gas analysis were measured and compared in two groups. No side effect caused by the epidural catheter was found in Group I. Parameters with significant difference in two groups were only doses of Dopamine and base excess from blood gas analysis, but these were not due to the method of sedation. Frequency of the sedation needed within 24 hours after operation was fewer, and the condition of the sedation was better in Group I. The course of postoperative management had no difference between both groups. Epidural Morphine was concluded to be an employable method of sedation after CABG.

Isolation of tryptic fragment of antigen from mitochondrial inner membrane proteins reacting with antimitochondrial antibody in sera of patients with primary biliary cirrhosis

Most of the sera from patients with primary biliary cirrhosis contains antimitochondrial antibodies, which react with four proteins of the mitochondrial inner membrane. We reported in a previous paper that when beef heart mitochondrial inner membrane proteins were digested by trypsin, a new reactive 36 kDa fragment with antimitochondrial antibody was obtained. This 36 kDa fragment derives from original 70 kDa protein because the monoclonal antibody specific to 70 kDa protein reacts with the 36 kDa band equivalent to 70 kDa band. The 36 kDa fragment was purified using an affinity column conjugated with an immunoglobulin-rich fraction of primary biliary cirrhosis serum containing antimitochondrial antibody, preparative electrophoresis and high-performance liquid chromatography using a reverse phase column. The final preparation showed a single band in sodium dodecyl sulfate polyacrylamide gel electrophoresis. Its amino acid composition is in good agreement with that of the subunit binding domain of the pyruvate dehydrogenase complex E2 from bovine heart.

Effect of intracellular Na+ on platelet aggregation and Ca2+ mobilization

The effects of ionophores, which can carry alkali metal cations, on platelet aggregation were examined. At an alkaline extracellular pH, alkali metal cation/H+ exchanger nigericin accelerated aggregation in K+-enriched medium, whereas it rather inhibited aggregation in Na+-enriched medium, even though the intracellular pH was only slightly alkaline. The inhibitory effect of Na+ on platelet aggregation was more clearly shown with the alkali metal cation exchanger gramicidin D. The ionophore had no effect or a slightly accelerative effect on aggregation in K+-enriched medium, whereas it significantly inhibited aggregation induced by thrombin, ADP and platelet activating factor in Na+-enriched medium. Fluorescence studies on fura-2-labeled platelets revealed that in Na+-enriched medium gramicidin D inhibited agonist-induced Ca2+ mobilization both in the presence and absence of extracellular Ca2+. These results suggest that the intracellular Na+ inhibits platelet aggregation by inhibiting Ca2+ mobilization.

[Clinical and histopathological studies of the suture made of DCFF-treated natural collagen fiber]

Natural and synthetic fiber sutures used clinically, especially twist or braid type ones, will remain to the region after healing by the first intention and often cause inflammation by capillarity. It is necessary to remove those sutures from healing wounds. To obviate this necessity, we separated collagen fibers from a tendon of a rat's tail, gave them DCFF treatment for immunological tolerance, and made collagen sutures on an experimental basis. The discussion on the clinical, histopathological and physical properties of the collagen sutures proved their superiority over any other type of suture currently used. (DCFF treatment: decalcifying, defatting and freeze-drying a material previously fixed in formalin.) 1. Results of Clinical Application: Collagen sutures immersed in 70% ethanol, contacting saliva, were easily handled and fell off spontaneously in about 7 days after operation. Thus removing sutures aren't necessary. 2. Histopathological Characteristics: (1) Biopsy observations show that the collagen sutures disclosed outside of the tissues were gradually decomposed by the activity of microbes in the oral cavity, falling off spontaneously in 7-10 days by the time of healing by the first intention, whereas those inside the tissues were more slowly absorbed. (2) The major portion of the collagen sutures, implanted in the dermis of a rat's back, was decomposed and absorbed in one week or 3 months at latest, with some portion encapsulated. All nylon sutures remained without being decomposed; most silk sutures, neither easily decomposed nor encapsulated, remained and occasionally caused distinct inflammatory rejection. 3. Physical Characteristics (load and elongation test): A tensility comparison between silk sutures (4-0 U.S.P. standard) with the collagen sutures of the same thickness showed the collagen sutures were stronger than the silk ones when they are wet.

Interhemispheric subdural haematoma complicated by intracerebral haematoma: case report

The authors describe a case of interhemispheric subdural haematoma which was followed by an ipsilateral intracerebral haematoma after an interval of about a half day. The intracerebral haematoma is considered to be the consequence of a haematoma induced thrombosis of cortical veins in connection with a bleeding diathesis due to previous anticoagulant therapy.