Video thoracoscopic resection of neurogenic tumor in a superior-posterior mediastinum: three case reports

Neurogenic tumors of the thorax can originate in any neurogenic structure within the chest. Surgical resection is considered the primary treatment of such tumors and usually is performed through a thoracotomy. Recently, using a new approach, we applied the technique of video thoracoscopic surgery to resection a posterior mediastinal tumor. In this paper, we report three patients with superior-posterior mediastinal neurogenic tumors in which the approach to the tumor is technically difficult. Cases 1 and 2 were a 26-year-old man and a 50-year-old asymptomatic man, respectively, and case 3 was a 45-year-old asymptomatic woman. The sizes of the three tumors were 3.0 x 2.5 x 1.8 cm (case 1), 6.0 x 4.0 x 2.0 cm (case 2), and 3.0 x 2.0 x 2.0 cm (case 3). In one case (case 2), minithoracotomy was added to video thoracoscopic surgery for adhesion to the spinal artery and intraspinal extension. A standard thoracotomy was avoided in all three cases. All patients had uncomplicated postoperative courses. Video thoracoscopic resection of a neurogenic tumor in the superior-posterior mediastinum may be a safe and useful approach with improved cosmetic results.

Blood supply to the latissimus dorsi muscle and muscle performance during co- or counterpulsatile stimulation for circulatory assist

For the application of the latissimus dorsi muscle (LDM) to circulatory assist, the muscle is stimulated with co- or counterpulsation during the cardiac cycle. The purpose of this study was to evaluate the blood supply to the LDM and its muscular performance during each respective stimulation. The origin of the LDM was connected to a tension gauge, a potentiometer, and 1 kg of weight in series. The LDM was stimulated at a ratio of 1:1 of heart to muscle contraction for 10 min. Copulsatile stimulation made thoracodorsal arterial flow (TDF) predominant during cardiac diastole. In counterpulsatile stimulation, TDF occurred predominantly during cardiac systole. Between the 2 patterns of stimulation, no significant differences were observed in the mean TDF rate during 1 cardiac cycle. The maximal force, maximal contraction length, and power of the LDM also did not differ significantly. These results suggest that despite the difference of the TDF profile, LDM performance may be comparable between co- and counterpulsatile stimulation for the application of the LDM to circulatory assist.

Monitoring and regulating latissimus dorsi muscle performance for circulatory assist

The purposes of this study were monitoring and regulating latissimus dorsi muscle (LDM) performance with muscle internal pressure and thickness, and with burst stimulation parameters, respectively. The unconditioned LDM flap of a pig was connected to a measurement system to examine force and contraction length. Internal pressure was measured using a catheter pressure transducer with a fluid-filled balloon inserted into the muscle, and correlated linearly with force during both contraction and relaxation. During contraction, thickness change correlated linearly with contraction length and the area enclosed within an internal pressure-thickness curve, and the X-axis was correlated linearly with muscle work. Stroke work increased incrementally according to the pulse width up to 6.72 msec or burst rate up to 120 Hz, and then plateaued at 240 Hz. The authors conclude that muscle work during contraction could be monitored with internal pressure and thickness, and that stroke work could be regulated with pulse width or burst rate.

Decrease in Thy-1 expression on peripheral CD34 positive cells induced by G-CSF mobilization. The Tohoku Children Leukemia Study Group

In order to ascertain the cytological features of peripheral hematopoietic progenitor cells (PHPC) mobilized after administration of chemotherapeutic agents and G-CSF, lineage- and progenitor cell-specific surface markers on CD34 positive (+) cells were sequentially examined. Nineteen evaluable samples were obtained from a malignant lymphoma, an acute lymphoblastic leukemia and 5 neuroblastoma patients. CD38 and HLA-DR were respectively expressed on more than 95% and approximately 85% of CD34+ PHPC cells. CD19 was also expressed on the majority and CD117 on 10 to 20% of the CD34+ cells. The most striking finding was that the Thy-1(CDw90)+/CD34+ population was decreased at the peak of mobilization of CD34+ cells as compared to the early phase after G-CSF administration (approximately 20% vs. 60%). These results suggest that decrease in Thy-1 expression on CD34+ cells is related to mechanisms easing CD34+ cell mobilization to the peripheral blood.

Role of tyrosine specific phosphorylation of cellular proteins, especially EGF receptor and p125FAK in human lung cancer cells

To clarify the role of tyrosine phosphorylation of cellular proteins in human lung cancer cells, phosphotyrosine (PTYR)-containing proteins in lung cancer cell lines and in paired tissues resected from cancerous and normal lungs were studied by immunoblotting with an anti-PTYR antibody. We found that the profiles of protein phosphorylation were very similar among those cell lines which had different histological features. The major PTYR-containing proteins (180-190 KDa, 120-130 KD, and 95-100 KDa) were detected in lung cancer cell lines. The expression of EGF receptor (EGF-r) (p185) and o-erb B2 protein, and tyrosine phosphorylation of p125FAK were examined in cancerous lung tissues and normal lung tissues. In surgical specimens, approximately half of the samples of lung cancer tissues showed clear elevation of tyrosine phosphorylation. In these cancerous tissues, no clear amplification of EGF-r and c-erb B2 protein expression was observed. However, elevation of tyrosine phosphorylation of p125FAK was observed in cancerous lung tissues but not in normal lung tissues, and its phosphorylation was closely correlated with the nodal involvement of cancer and disease-free survival time. These results suggested that the intracellular signaling pathway via tyrosine phosphorylation plays a role in the generation and immortalization of lung cancer, and assessment of tyrosine phosphorylation of cellular proteins. especially p125FAK, may be available clinically as a prognostic factor.

Effects of low-dose simvastatin therapy on serum lipid levels in patients with moderate hypercholesterolemia: a 12-month study. The Simvastatin Study Group

The aim of this study was to investigate the safety and long-term effects on serum lipid levels of low-dose simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, in Japanese patients with moderate primary hypercholesterolemia. We assigned 201 patients (68 men and 133 women; mean +/- SD age, 61.3 +/- 10.2 years) with serum total cholesterol levels > or = 220 mg/dL to receive simvastatin 5 mg each evening; the treatment period was 1 year. Serum total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol levels decreased significantly in response to simvastatin therapy, and the changes were maintained throughout the treatment period. Mean total cholesterol decreased from 269.9 +/- 35.4 mg/dL to 215.2 +/- 34.5 mg/dL (20.3%), triglycerides decreased from 183.0 +/- 110.2 mg/dL to 155.5 +/- 88.5 mg/dL (15.0%), and LDL cholesterol decreased from 180.0 +/- 33.1 mg/dL to 130.1 +/- 35.1 mg/dL (27.7%). Total cholesterol, triglycerides, and LDL cholesterol tended to decline when the pretreatment values were higher; the critical values and the bidirectional changes of the serum lipid levels were 188.1, 109.5, and 91.6 mg/dL, respectively. Although the serum level of high-density lipoprotein cholesterol did not change significantly, it tended to increase more when the pretreatment values were lower; the "critical value" was 70 mg/dL. Nine patients experienced mild adverse events, but none discontinued simvastatin during the 12-month treatment period. We found that low-dose simvastatin therapy is effective in achieving long-term decreases in serum lipid levels and is well tolerated by patients with moderate hypercholesterolemia. Simvastatin therapy may result in normalization of serum lipid levels.

[Three cases of mediastinal neurogenic tumors originating from the intrathoracic vagal nerve]

Three cases of mediastinal neurogenic tumors originating from the intrathoracic vagal nerve is reported. Two of those is neurilemmomas. One tumor was located in the site to the branching point of the recurrence nerve. The tumor was enucleated. Postoperative hoarseness arose. Another tumor was located in the vagal nerve. The tumor was resected. One of those is neurofibromatosis in the vagus nerve with the axillary tumor. The tumors arose from the vagus nerve was resected. Careful follow-up are required in two patients.

Acute myelogenous leukaemia with t(8;21) translocation of normal cell origin in mosaic Down's syndrome with isochromosome 21q

We report a 13-year-old girl with Down's syndrome (DS) having a mosaic karyotype of 46,XX/46,XX, -21,+i(21q), who developed acute myelogenous leukaemia (AML) (FAB M1). The t(8;21) translocation generating a AML1/MTG8 chimaeric gene of her blasts was demonstrated by cytogenetic analysis and reverse transcription-polymerase chain reaction. Interestingly, the leukaemic clone with t(8;21) did not have isochromosome 21q, indicating that the blasts were of normal cell origin. These findings suggest that, in older patients with DS, 21 trisomy cells have no greater predisposition to develop AML than normal karyotypic cells.

Treatment of empyema by transposition of contralateral lower trapezius flap

We report the successful treatment of bronchopleural fistula and empyema using transposition of a contralateral lower trapezius musclocutaneous flap, which provided immediate obliteration of the middle-back empyema cavity. This technique is easy to perform without any intraoperative change of position and with little postoperative impairment of the back and shoulder movement.

High signal intensity on T2-weighted magnetic resonance imaging and cerebral hemodynamic reserve in carotid occlusive disease

BACKGROUND AND PURPOSE

The importance of MR imaging in carotid artery disease is unclear. We evaluated the sensitivity and specificity of the high signal intensity changes on MR images for diagnosis of hemodynamically compromised unilateral internal carotid artery disease.

METHODS

We evaluated the association of high signal intensities on T2-weighted MR images with changes in cerebral perfusion reserve measured using 99mTc-hexamethylpropyleneamine oxime single-photon emission CT and acetazolamide in 23 patients.

RESULTS

Eleven patients had a type I response (normal flow and normal perfusion reserve), 8 patients had a type II response (normal flow and decreased perfusion reserve), and 4 patients had a type III response (decreased flow and decreased perfusion reserve). High signal intensities in the centrum semiovale (11/12) and/or posterior periventricular white matter (6/12) were frequently seen in the hemodynamically compromised groups. Extensive high signal intensities were associated with severely impaired cerebral circulation. MR imaging had high sensitivity (0.92) and specificity (1.0) in predicting hemodynamically compromised patients when we used the presence of T2 high intensity in the centrum semiovale as a criterion.

CONCLUSIONS

The centrum semiovale T2 hyperintensities lateralized to the side of carotid occlusion are specific and sensitive for the presence and severity of hemodynamic compromise from carotid occlusive disease.

Effects of clobenpropit (VUF-9153), a histamine H3-receptor antagonist, on learning and memory, and on cholinergic and monoaminergic systems in mice

The effects of clobenpropit (VUF-9153), a potent histamine H3-receptor antagonist, on a scopolamine-induced learning deficit in the step-through passive avoidance test was studied in mice. Clobenpropit (10 and 20 mg/kg) alone showed a tendency to ameliorate the scopolamine-induced learning deficit, and clobenpropit (10 mg/kg) in combination with zolantidine (20 mg/kg), a histamine H2-receptor antagonist, ameliorated the scopolamine-induced effect. This ameliorating effect was antagonized by (R)-alpha-methylhistamine (20 mg/kg), a histamine H3-receptor agonist and pyrilamine (20 mg/kg), a histamine H1-receptor antagonist, suggesting that clobenpropit in combination with zolantidine showed the ameliorating effect via histamine H3 receptors and/or histamine H1 receptors. We also studied the effects of clobenpropit on cholinergic and monoaminergic systems. Clobenpropit did not show any significant effect on these neuronal systems except the activation of noradrenergic system. The present results suggest that the effect of clobenpropit might be partially involved with the activation of noradrenergic system, and the histaminergic system may play certain important roles in learning and memory.

[Childhood acute promyelocytic leukemia treated with all-trans retinoic acid]

We treated two children with acute promyelocytic leukemia (APL) in whom complete remission was successfully induced by oral administration of all-trans retinoic acid (ATRA). We followed these patients with conventional chemotherapy. The first patient has remained in continuous complete remission. However, the other patient relapsed during the maintenance therapy and died of progressive disease in spite of a second treatment with ATRA and chemotherapy. From a clinical point of view, the latter case had a hyperleukocytosis on admission. Also morphologically speaking, this patient had a different M3 variant than the first case. There are two major isoforms of PML/RAR alpha transcripts, so called short and long type transcripts, according to the breakpoints in the PML genes. In the first case the "long type' isoform was detected by reverse transcriptase polymerase chain reaction (RT/PCR) amplification. On the other hand the "short type' isoform was observed in the latter case. Also the second case became PCR positive at relapse, although the detectable isoform was negative during remission. The "short type' isoform may be related to the poor prognosis and RT/PCR analyses may be a powerful to detect early relapse.

Treatment-related disseminated necrotizing leukoencephalopathy with characteristic contrast enhancement of the white matter

This report describes unique contrast enhancement of the white matter on T1-weighted magnetic resonance images of two patients with disseminated necrotizing leukoencephalopathy, which developed from acute lymphoblastic leukemia treated with high-dose methotrexate. In both patients, the enhancement was more pronounced near the base of the brain than at the vertex. Necropsy of the first case revealed loss of myelination and necrosis of the white matter. Possible mechanisms causing such a leukoencephalopathy are discussed.

Effects of theophylline in p-chlorophenylalanine-treated mice in a light/dark test

The effects of theophylline were examined in a light/dark test in p-chlorophenylalanine (PCPA)-treated mice to investigate serotonergic contribution to its effects. Three consecutive treatments with PCPA (200 mg/kg once daily) barely affected parameters in the light/ dark test. In vehicle- and PCPA-treated mice, theophylline (100 mg/kg) significantly decreased time spent in the light zone, which suggested its anxiogenic-like activity. In PCPA-treated mice, theophylline (50 mg/kg) also tended to decrease the time spent in the light zone. The effects of theophylline on the contents of monoamines and their metabolites in the brains of vehicle- and PCPA-treated mice were also investigated. Treatment with PCPA significantly decreased the contents of serotonin (5-HT) and its metabolite, as well as the contents of the metabolites of noradrenaline (NA) and dopamine (DA). Theophylline increased the metabolites of 5-HT, NA and DA in the brains of vehicle-treated mice. The increases produced by theophylline in the metabolites of NA and 5-HT were extinguished in PCPA-treated mice. Behavioral and biochemical data in the present study demonstrate that theophylline-induced anxiogenic-like activity was not mediated by serotonergic neuronal systems and that NAergic neuronal systems also might not contribute to the activity.

[Quantitative measurements of cerebral blood flow using 99mTc-ECD radionuclide angiography, SPECT and one-point arterial sampling]

We quantified regional cerebral blood flow using 99mTc-bicisate ethyl cysteinate dimer (ECD) radionuclide (RN) angiography, one-point arterial sampling and static SPECT in 12 patients. The tracer was injected as a bolus into the right antecubital vein, and time-activity curves over the cerebrum and the aortic arch were sequentially recorded for 300 s with 3 s intervals in a 128 x 128 format with a large-field of view gamma camera equipped with a low-energy collimator. Blood was obtained from the femoral artery immediately after stopping the RN angiography and the arterial concentration of 99mTc-ECD was calculated. Thereafter, the SPECT data acquisition was started with the subject's head immobilized. We applied a three-compartment kinetic model: The influx constant of 99mTc-ECD from blood to brain (K1) and the transfer of ECD from diffusible compartment to nondiffusible one in the blood (k5). The K1 value was compared with the global cerebral blood flow value (Fa) measured by the 133Xe clearance technique. From the kinetic analysis, the following parameter values could be calculated: K1 = 0.21 +/- 0.05 (ml/ml/min), k5 = 0.66 +/- 0.15 (/min), Fa = 0.32 +/- 0.09 (ml/ml/min) and the extraction fraction E = K1/Fa = 0.65 +/- 0.05. There was a strong correlation between K1 and Fa (Y = 0.53X + 3.7; rs = 0.91). By combining the K1 and E values in the whole-brain, we can obtain the absolute global flow value and regional 99mTc-ECD CBF maps if the average concentration of the tracer in the whole-brain is used as a reference. Our method is less invasive and suitable for quantitation of cerebral blood flow in patients with brain disorders.

Tyrosine phosphorylation of 100-130 kDa proteins in lung cancer correlates with poor prognosis

To search for the signalling pathways in lung cancer relevant to its aggressive behaviour, we studied tyrosine phosphorylated proteins in lung cancer cell lines and surgical specimens. We found that the profiles of protein phosphorylation were closely matched among these cell lines and cancer tissues of different histological origins, and 100-130 kDa proteins were the major components of phosphorylated proteins. In surgical specimens, approximately half of the cases showed tyrosine phosphorylation of these proteins in a tumour-specific manner, and phosphorylation of these proteins showed good correlation with the survival length of patients after operation. By immunoprecipitation with specific antibodies, we found that p125FAK, p120 and beta-catenin were the major components of tyrosine-phosphorylated proteins in the surgical specimens. These results suggest that tyrosine phosphorylation of these proteins may play a role in tumour relapse and is available as a clinical marker.

Cell surface c-kit receptors in human leukemia cell lines and pediatric leukemia: selective preservation of c-kit expression on megakaryoblastic cell lines during adaptation to in vitro culture

We produced a monoclonal antibody MTK1 which recognized c-kit protein. Using MTK1, 31 leukemia cell lines and 76 leukemia blasts from pediatric patients were analyzed for expression of the c-kit receptor by flow cytometry. The c-kit receptor was detectable on four of four cell lines assigned to the megakaryo/erythromegakaryoblastic lineage and on one of seven cell lines of myeloid lineage. C-kit expression was not seen on any of 20 cell lines of erythroid and lymphoid lineages. Furthermore, c-kit was expressed on 16 of 24 nonlymphoid blasts without platelet surface antigens (67%) and on six of eight non-lymphoid blasts with platelet surface antigens (75%), but was not detectable on 44 lymphoid blasts from pediatric leukemia patients. In these cases CD34 was expressed on 26 of 32 myeloid blasts (81%) and on 27 of 44 lymphoid blasts (61%). The findings indicate a dominant expression of the c-kit receptor on established cell lines assigned to the megakaryo/erythromegakaryoblastic lineage, though a high percentage of leukemic myeloblasts also expressed the c-kit receptor on their surface.

Effects of betahistine, a histamine H1 agonist and H3 antagonist, in a light/dark test in mice

The effects of betahistine, a histamine H1 agonist and H3 antagonist, were investigated in a light/dark test measuring anxiety in mice. Betahistine significantly decreased the locomotion and rearing in the light and dark zones, shuttle crossing and time spent in the light zone in the light/dark test. These phenomena suggest that betahistine has anxiogenic effects and/or locomotor suppressive effects. Pyrilamine (6 mg/kg) and ketotifen (6 mg/kg), H1-receptor antagonists, antagonized the effects of betahistine (100 mg/kg) on all parameters in the light/dark test but zolantidine (6 mg/kg), an H2-receptor antagonist, augmented its effects on some parameters decreased by betahistine. Especially, it potentiated the decreases by betahistine in the parameters showing anxiety in this test. The decreases in the light/dark test induced by zolantidine (6 mg/kg) plus betahistine (200 mg/kg) were antagonized by pyrilamine (12 mg/kg) but antagonism of the decrease in the time spent in the light zone as a parameter showing anxiety was not significant. These results suggest that the effects via H1 receptors are involved in anxiety in the light/dark test in mice but the other factor may be simultaneously needed for induction of behaviorally detectable anxiogenic effects in this test.

Effects of thioperamide on the cholinergic system and the step-through passive avoidance test in mice

We investigated the effects of thioperamide, a histamine H3-receptor antagonist, on a scopolamine-induced learning deficit in the step-through passive avoidance test in mice, and on contents of acetylcholine and choline in the brain. In a behavioral study, thioperamide (20 mg/kg) alone slightly ameliorated scopolamine-induced learning deficit, and pretreatment with zolantidine, a histamine H2-receptor antagonist, significantly enhanced the ameliorating effect of thioperamide. This enhanced ameliorating effect of thioperamide was antagonized by pyrilamine, a histamine H1-receptor antagonist and (R)-alpha-methylhistamine, a histamine H3-receptor agonist, suggesting that thioperamide showed the ameliorating effect via histamine H3 receptors and/or histamine H1 receptors. In the biochemical study, thioperamide (20 mg/kg) in combination with zolantidine (20 mg/kg) significantly increased contents of choline in most of brain regions. These findings suggest that there is a close relationship between histaminergic and cholinergic systems in the brain, and that the histaminergic system may play certain important roles in learning and memory.

[Bone marrow transplantation for lysosomal storage diseases]

Since a successful bone marrow transplantation (BMT) for Hurler's disease reported in 1981, BMT has been established as an effective treatment for lysosomal storage diseases such as mucopolysaccharidosis or lipidosis. In general, BMT can improve the somatic disease, but the neurologic and intelligence outcomes vary widely. The understanding on whether transfer of a lysosomal hydrolase to CNS neurons can occur is indispensable to a proper prediction on CNS improvement. Furthermore the long-term therapeutic effects of BMT can be subject to multiple factors including a level of biochemical improvement, a reversibility of affected tissues, or a degree of advanced disease prior to BMT. Thus, an accumulation of clinical and biochemical follow-up study is needed to understand the therapeutic efficacy and consequence of BMT for lysosomal storage diseases.

Ameliorating effects of histidine on learning deficits in an elevated plus-maze test in mice and the contribution of cholinergic neuronal systems

We investigated the effects of histidine on scopolamine-induced learning deficits in the elevated plus-maze test in mice. In this test, transfer latency, the time mice took to move from the open arm to the enclosed arm, was used as an index of learning and memory. Intraperitoneal administration of scopolamine (0.5 mg/kg) prolonged the transfer latency on day 2 as compared with that in the saline-treated group. Histidine loading (500, 800 and 1600 mg/kg) reversed the prolongation of the transfer latency induced by scopolamine. This ameliorating effect of histidine was abolished by alpha-fluoromethylhistidine, an inhibitor of histidine decarboxylase, suggesting that histidine itself has no such ameliorating effect. Moreover, the ameliorating effect of histidine was antagonized by a histamine H1-receptor antagonist, pyrilamine, but not by zolantidine, a histamine H2-receptor antagonist. Thus, histamine, a decarboxylated product of histidine, elicited an ameliorating effect on scopolamine-induced learning deficit via histamine H1 receptors in mice. In the biochemical study, histidine significantly decreased acetylcholine (ACh) levels in the cerebral cortex and diencephalon of mice, and also significantly decreased them in the midbrain at a dose of 500 mg/kg. Histidine significantly increased and decreased levels of metabolites of noradrenaline and serotonin, respectively, in the brains of mice. Levels of dopamine and its metabolites were not very affected by histidine in the brains of mice. These findings clearly indicate that there is a close relationship between histaminergic and cholinergic system in the brain, and that histamine may play certain important roles in learning and memory.

Aberrant progenitors common to megakaryocytic and myeloid cells in a Down's infant with transient abnormal myelopoiesis

Phenotypic characteristics of blasts were studied in a Down's infant with transient abnormal myelopoiesis (TAM). Two major subpopulations were identified: (1) CD33+CD42b+ cells with platelet peroxidase activity, the commitment of which to megakaryocytic lineage was supported by an increased expression of GATA-1 mRNA; (2) CD33+CD34+CD7+CD4+ cells with immature ultrastructure, which could be either immature megakaryocytic or myeloid cells with aberrant differentiation. Mixed colonies containing megakaryocytes and monocyte/macrophages in the peripheral blood suggested the presence of progenitors common to these subpopulations. These results may indicate that subpopulations of blasts with phenotypic diversity could be derived from aberrant common progenitors to megakaryocytic and myeloid lineages in this patient.

Effects of thioperamide, a histamine H3-receptor antagonist, on a scopolamine-induced learning deficit using an elevated plus-maze test in mice

We examined the effects of thioperamide and (R)-alpha-methylhistamine, a histamine H3-receptor antagonist and an agonist, respectively, on a scopolamine-induced learning deficit using an elevated plus-maze test in mice. Thioperamide alone slightly improved the learning deficit induced by scopolamine, and pretreatment with zolantidine, a histamine H2-receptor antagonist, significantly enhanced the effect of thioperamide in this test. (R)-alpha-Methylhistamine, pyrilamine, ketotifen, terfenadine, and zolantidine alone at the doses tested had no effect. Moreover, the improvement by thioperamide plus zolantidine was antagonized by pretreatment with histamine H1-receptor antagonists such as pyrilamine or ketotifen, but not by terfenadine. Thus, thioperamide improved the scopolamine-induced learning deficit through central histamine H1 receptors in mice. The present results supported the hypothesis that histamine may play an important role in learning and memory.

Leukoencephalopathy in childhood hematopoietic neoplasm caused by moderate-dose methotrexate and prophylactic cranial radiotherapy--an MR analysis

PURPOSE

The main purpose of this study was to determine influential factors related to minor leukoencephalopathy (LEP) caused by moderate-dose methotrexate (MTX) and prophylactic cranial radiotherapy (CRT) in childhood hematopoietic malignancies. We also compared the incidence of LEP following this treatment to that reported in the literature following treatment with high-dose MTX alone.

METHODS AND MATERIALS

Thirty-eight pediatric patients of hematopoietic malignancies (37 acute lymphoblastic leukemias, 1 non-Hodgkin lymphoma) who were given CRT (18-24 Gy) as well as prophylactic intrathecal and per os MTX were studied for leukoencephalopathy by magnetic resonance (MR) imaging. All the patients were free from grave neuropsychiatric disturbances. The data were examined to elucidate the influential ones of five factors (patients' age, doses of intrathecal and per os MTX, dose of CRT, interval between treatment, and MR study) to develop LEP using multiple regression analysis. To compare the effect of moderate-dose MTX and prophylactic CRT on LEP to that of high-dose MTX alone, we conducted literature review.

RESULTS

Seven out of 38 patients (18%) developed LEP. From multiple regression analysis and partial correlation coefficients, the age and CRT dose seemed influential in the subsequent development of LEP. The incidence of LEP following treatment with moderate-dose MTX and prophylactic CRT appears to be less than that reported in the literature following treatment with intravenous high-dose MTX. However, even moderate-dose MTX in combination with CRT can result in a significant incidence of MR-detectable LEP, particularly in children 6 years of age or younger receiving 24 Gy.

CONCLUSION

Leukoencephalopathy was caused by moderate-dose MTX and prophylactic CRT in pediatric patients, probably less frequently than by high-dose MTX treatment alone. The influential factors were patient's age and CRT dose.

[Assessment of anxiolytics (2)--An elevated plus-maze test]

When rodents are placed on an elevated plus-maze which consisted of two enclosed arms and two open arms, they enter the enclosed arms more frequently and spend more time on the enclosed arms than on the open arms since they prefer the enclosed arms to the open arms. The elevated plus-maze test can measure effects of drugs based on this tendency of rodents. Anxiolytics increase the time spent on the open arms and number of entries into open arms, and anxiogenics decrease them. We investigated the basal behavior of mice and the effects of diazepam in the elevated plus-maze test using 4 mazes with different size. The basal behavior of mice were changed by the maze size, especially by the width of the open arms. Further, we suggested that the maze size might affect anxiolytic activity of drugs detected in this test. This test is very useful because it needs neither complicated training for rodents nor an expensive apparatus, and the anxiolytic effects of drugs can be easily measured. However, this test is difficult to detect putative anxiolytics acting on serotonin receptors. When this method is used for measuring the activity of drugs, the choice of experimental conditions and evaluation of the results should be carefully done.

The effects of anxiolytics and anxiogenics on evaluation of learning and memory in an elevated plus-maze test in mice

We examined the effects of anxiolytics and anxiogenics on evaluation of learning and memory in the elevated plus-maze test in mice. Transfer latency (TL), the time mice took to move from the open arm to the enclosed arm, was used as an index of learning and memory. The TL on day 2 was shorter than that on day 1 with the maze at a height of 40 cm, and was not affected by anxiolytics and anxiogenics such as 8-OH-DPAT (0.4 mg/kg), picrotoxin (2 mg/kg), and FG-7142 (20 mg/kg), but was affected by diazepam (8 mg/kg). On the other hand, the TL on day 2 was prolonged by changing the experimental room between day 1 and day 2. TL on day 1 and day 2. TL on day 2 was prolonged by treatment with scopolamine before the trial on day 1 compared with vehicle-treated groups. This scopolamine-induced prolongation of TL was reversed by pretreatment with physostigmine and piracetam. The TL on day 2 was also prolonged by treatment with cycloheximide or normobaric hypoxia initiated immediately after the trial on day 1. The cycloheximide- and hypoxia-induced prolongation of TL were reversed by pretreatment with piracetam. These results indicate that disruption of learning and memory and its amelioration, induced by the treatments described above, can be detected using the plus-maze test, suggesting that the elevated plus-maze test could be used for evaluation of learning and memory without influence of anxiolytics and anxiogenics.

Ameliorating effects of histidine on scopolamine-induced learning deficits using an elevated plus-maze test in mice

We investigated the effects of histidine on scopolamine-induced learning deficits in the elevated plus-maze test in mice. In this test, transfer latency (TL), the time mice took to move from the open arm to the enclosed arm, was used as an index of learning and memory. Intraperitoneal administration of scopolamine (0.5 mg/kg) prolonged the TL on day 2 compared with that in the saline-treated group. Histidine loading (500, 800 and 1600 mg/kg) reversed the prolongation of the TL induced by scopolamine. This ameliorating effect of histidine was abolished by alpha-fluoromethylhistidine, an inhibitor of histidine decarboxylase, suggesting that histidine itself has no such ameliorating effect. Moreover, the ameliorating effect of histidine was antagonized by a histamine H1 receptor antagonist, pyrilamine. However, zolantidine, a histamine H2 receptor antagonist, showed no antagonism of the effect of histidine. Thus, histamine, a decarboxylated product of histidine, elicited an ameliorating effect on scopolamine-induced learning deficit via histamine H1 receptors in mice. These findings clearly indicated that there is a close relationship between histaminergic and cholinergic systems in the brain, and that histamine may play certain important roles in learning and memory.

[Intrasubject comparison of regional cerebral blood flow between N-isopropyl-p-[123I]iodoamphetamine SPECT and 99mTc-hexamethylpropyleneamine oxime SPECT in patients with ischemic cerebrovascular disease]

We compared regional cerebral blood flow (CBF) of CBF-SPECT brain imaging in two brain perfusion agents, N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) and 99mTc-hexamethylpropyleneamineoxime (99mTc-HMPAO), in the same patients with ischemic cerebrovascular disease. In eight healthy volunteers and 16 patients with chronic stage of cerebral infarction, single photon emission computed tomography (SPECT) data was normalized to the count density of the tracer in the whole brain, and then converted to the absolute units of CBF by multiplying average 133Xe-CBF in the whole-brain. One-way analysis of variance (ANOVA), grouped by the affected and contra lateral hemispheres of patients and right and left hemispheres of normal volunteers, was used to assess the changes in pattern of regional CBF (rCBF) among disease and control groups. Regional CBF was significantly reduced in patients compared with normal controls in all the brain regions on both tracers: F = 6.6-14 and p = 9.1 x 10(-4) - 1.6 x 10(-6) in IMP, and F = 5.8-14.8 and p = 2 x 10(-3) - 8.2 x 10(-7) in HMPAO. F value was higher in IMP than that of HMPAO in five of nine brain regions of interests (the frontal, temporal and occipital cortices, thalamus and the striatum), whereas F value was higher in HMPAO than IMP in the other four regions (the central lobule, parietal cortex, hippocampus and the centrum semiovale).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of 1-amino-5-bromouracil on the benzodiazepine-GABAA receptor complex

We investigated the effects of 1-amino-5-bromouracil on the benzodiazepine-gamma-aminobutyric acid (GABA)A receptor complex to elucidate its central action. 1-Amino-5-bromouracil neither displaced nor enhanced [3H]muscimol, [35S]t-butylbicyclophosphorothionate (TBPS), or [3H]dehydroepiandrosterone sulfate binding to the rat brain synaptosomal membranes. The anesthesia induced by 1-amino-5-bromouracil was potentiated by diazepam, pentobarbital, and muscimol, and was antagonized by picrotoxin but not by bicuculline. 1-Amino-5-bromouracil protected mice from picrotoxin-induced seizure and slightly ameliorated TBPS-induced seizure, but did not antagonize bicuculline-induced seizure. Diazepam antagonized both the bicuculline- and the picrotoxin-induced seizure, and pentobarbital antagonized the picrotoxin- and the TBPS-induced seizure. Our in vivo studies suggest that part of the central action of 1-amino-5-bromouracil is concerned with the benzodiazepine-GABAA receptor complex including the chloride channel.

Effects of a non-xanthine adenosine antagonist, CGS 15943, and a phosphodiesterase inhibitor, Ro 20-1724, in a light/dark test in mice

We investigated the effects of a non-xanthine adenosine receptor antagonist, CGS 15943, and a non-xanthine phosphodiesterase inhibitor, Ro 20-1724, in a light/dark test in mice. CGS 15943 at a dose of 50 mg/kg had no significant effects on any parameter, although at 10 mg/kg it significantly antagonized decreases in locomotion and rearing behavior induced by treatment with A1 and A2 selective agonists, N6-cyclopentyladenosine and CGS 21680 respectively. On the other hand, Ro 20-1724 decreased locomotion and rearing behavior in the light and dark zones, number of shuttle crosses between both zones, and the time spent in the light zone dose-dependently at doses ranging from 1-10 mg/kg. In conclusion, the phosphodiesterase inhibitor decreased all parameters in the light/dark test, while the adenosine antagonist showed no effect.

Effects of xanthine derivatives in a light/dark test in mice and the contribution of adenosine receptors

We investigated the effects of adenosine receptor antagonists, caffeine, theophylline, 8-phenyltheophylline, and 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), in a light/dark test in mice. All antagonists decreased the time spent in the light zone in this test, which suggested that these compounds have anxiogenic effects. The anxiogenic effects of theophylline were reduced by pretreatment with CGS 21680, an A2-selective agonist, but not by N6-cyclopentyladenosine (CPA), an A1-selective agonist. However, the antagonism of the theophylline-induced anxiogenic effects by CGS21680 was only observed in the time spent in the light zone, and DPCPX-induced anxiogenic effects were neither reversed by CGS 21680 nor by CPA. Finally, it is notable that xanthine-derived adenosine antagonists tested here commonly showed anxiogenic effects in the light/dark test in mice. It is suggested that there is a minor contribution of adenosine receptors to these effects, although theophylline-induced anxiogenic effects were antagonized by an A2 receptor agonist.

Effect of 1-amino-5-bromouracil on brain monoamine metabolism in rats

The effect of 1-amino-5-bromouracil (ABU), a novel central-acting agent, on monoaminergic neurotransmitter levels of rat brain was investigated. Under the nonstressed condition, ABU (20 and 30 mg/kg intraperitoneally [IP]) did not affect monoamine metabolism, whereas diazepam (5 mg/kg IP) increased the 3-methoxy-4-hydroxyphenylethylene glycol (MHPG)/noradrenaline (NA) ratio. One-hour immobilization stress increased the MHPG/NA ratio in various brain regions of drug-naive rats, but did not increase the homovanilic acid (HVA) plus 3,4-dihydroxyphenylacetic acid (DOPAC)/dopamine (DA) ratio or the 5-hydroxyindole acetic acid (5-HIAA)/serotonin (5-HT) ratio. Pretreatment with ABU or diazepam suppressed the activation of noradrenergic neurons induced by immobilization stress. By contrast, electric foot shock stress increased the MHPG/NA and HVA+DOPAC/DA ratios. Pretreatment with ABU or diazepam suppressed the activation of noradrenergic and dopaminergic cortical neurons by electric foot shock stress. These results indicate that these two physiologic stresses affected monoaminergic neurons differently and that their effects were suppressed by ABU and diazepam.

Effects of intracerebroventricular administration of N-acetylhistamine on body temperature in mice

The purpose of this study was to examine the effects of intracerebroventricular (i.c.v.) administration of N-acetylhistamine on rectal temperature, histamine level, histidine decarboxylase (HDC) activity, and the turnover rate of monoamines in mice. More than 60 micrograms of N-acetylhistamine induced hypothermia. The maximum effect of hypothermia was observed 20 min after administration of N-acetylhistamine (60-120 micrograms/mouse). A significant drop in rectal temperature of 3 degrees C was induced by 120 micrograms of N-acetylhistamine. Concurrent with the appearance of hypothermia, the histamine levels were increased. However, both histamine H1 and H2 antagonists did not prevent hypothermia. The i.c.v. administration of N-acetylhistamine inhibited HDC activity, but had no effect on the turnover rates of monoamines. These data confirmed that endogenous N-acetylhistamine may be a metabolite which lacks significant physiological roles, and demonstrated that exogenous N-acetylhistamine is not a good pharmacological tool for the study of the functions of the brain histaminergic system in mammals.

Discriminative stimulus properties of diazepam and the novel anxiolytic agent 1-amino-5-bromouracil in rats

A stimulus cue of 1-amino-5-bromouracil (ABU, CAS 127984-93-4) was compared with that of diazepam (DZP) using a drug discrimination paradigm in rats. Groups of rats were trained to discriminate DZP (1 mg/kg i.p.) or ABU (20 mg/kg i.p.) from vehicle. Generalization of the cue of the trained drug to pentobarbital was shown in DZP- and ABU-trained rats at a dose of 5 mg/kg. The stimulus cue of ABU showed a tendency to generalize to DZP in ABU-trained rats but generalization of that of DZP to ABU in DZP-trained rats was only partial. Also partial generalization of that of DZP to imipramine and clonidine was found but not to 8-hydroxy-2-(di-n-propylamino)tetraline (8-OH-DPAT) in DZP-trained rats. Full generalization of the stimulus cue of ABU to imipramine and partial generalization of that of ABU to clonidine and 8-OH-DPAT was observed in ABU-trained rats. The results suggest that the discriminative stimulus properties of ABU differ from those of DZP.

Human cytomegalovirus neutralizing antibody response in Japanese children with bone marrow transplantation

Thirty-two children with bone marrow transplantation (BMT) received intravenous injections of gammaglobulin (IVIG) with a high titer of neutralizing (NT) antibody against human cytomegalovirus (HCMV) (200 mg/kg/week) from 1 week before to 4 months after transplantation. NT antibody titers before BMT and the highest levels in serial determinations conducted after BMT were compared for each patient. They were classified into three groups according to the antibody response: primary HCMV infection as group I, endogenous reactivation or external reinfection as group II, and indeterminable cases as group III. Two (6.3%) out of 32 patients examined had BMT-associated primary HCMV infections, but did not show any clinical symptoms. Significant changes in clinical parameters were also lacking in all the other 30 patients, independent of whether they shed viruses into the urine, or demonstrated on antibody boost. It was concluded from the group variation that the antibody response was indeed due to the engraftment of BMT, rather than to a direct effect of treatment with IVIG. Our results further indicate that passive immunization with HCMV antibody does not prevent infection, but confers some protection against symptomatic disease.

Potentiated maturation with a high proliferating activity of acute promyelocytic leukemia induced in vitro by granulocyte or granulocyte/macrophage colony-stimulating factors in combination with all-trans retinoic acid

All-trans retinoic acid (ATRA) induces differentiation of acute promyelocytic leukemia (APL), but the effect of cytokines regulating myeloid differentiation on ATRA-induced APL cells is poorly understood. In this study, maturation and proliferation of fresh APL cells were examined when induced in vitro by granulocyte or granulocyte/macrophage colony-stimulating factors (G-CSF or GM-CSF) in combination with ATRA. APL cells showed a low proliferating activity when induced by ATRA alone. In contrast, cells induced by G-CSF or GM-CSF alone showed increased DNA syntheses, the levels of which were not significantly affected by the combination of ATRA with CSFs. Interestingly, G-CSF or GM-CSF potentiated the capability of ATRA-induced cells to reduce nitroblue tetrazolium (NBT), while G-CSF or GM-CSF alone induced no NBT reduction. Furthermore, in several patients examined, APL cells induced by ATRA with G-CSF showed an increased activity of chemotaxis and CD11a expression. These findings suggest that G-CSF or GM-CSF can potentiate differentiation of ATRA-induced APL cells while stimulating their proliferating activity as well, and that G-CSF, rather than GM-CSF, may be a useful adjunct to promote ATRA-induced differentiation of APL.

Evaluation of biological characteristics of lung cancer by the human 28 kDa vitamin D-dependent calcium binding protein, calbindin-D28k

We evaluated the biological characteristics of lung cancer by measuring their contents of human 28 kDa vitamin D-dependent calcium binding protein (calbindin-D). Calbindin-D concentrations were determined in tumor tissue and normal lung tissue extracts from patients with lung cancer by enzyme immunoassay. The percentage of high calbindin-D containing tissues in small cell lung cancer (SCLC) was significantly higher than that in non-small cell lung cancer (NSCLC) and the calbindin-D concentration was low in normal lung extracts. In addition, most of the NSCLC which had a significantly high level of calbindin-D were at the advanced cancer stage with lymph node metastasis. Calbindin-D concentrations were also determined in lung cancer cell lines. The percentage of high calbindin-D containing cell lines was high in classic type SCLC, followed in order by variant type SCLC and NSCLC. In addition, in order to examine the usefulness of calbindin-D as a marker of neuroendocrine properties of lung cancer, we compared the sensitivity and specificity of calbindin-D for distinguishing classic from variant type SCLC with neuron-specific enolase (NSE) and aromatic L-amino acid decarboxylase (AADC) by relative operating characteristic curves. The diagnostic accuracy of AADC was the highest of the three and that of calbindin-D was as high as that of NSE. These findings suggest calbindin-D to be related to the neuroendocrine properties of lung cancer.

[Quantitation of regional cerebral blood flow by single photon emission computed tomography of CBF-tracer combined with whole-brain CBF: a comparison between 123I-IMP and 99mTc-HMPAO in healthy volunteers]

A simple, noninvasive method of measuring cerebral blood flow (CBF) that uses single-photon emission computed tomography (SPECT) of CBF-tracer and whole brain CBF obtained by xenon-133 (133Xe) clearance technique was developed. In nine healthy volunteers, SPECT data were normalized to the count density of 123I-IMP or 99mTc-HMPAO uptake in the whole-brain, and then converted to the absolute units of CBF by multiplying average 133Xe-CBF in the whole brain. The CBF values measured by 99mTc-HMPAO CBF-SPECT was significantly lower in the high flow regions of cortical gray matter (bilateral frontal lobe; p < 0.05 and right occipital lobe; p < 0.05), and was significantly higher in the bilateral white matter (p < 0.05 or 0.01) and the cerebellum (p < 0.005) compared with the flow values measured by 123I-IMP CBF-SPECT. Whereas, the IMP-CBF values were significantly lower in the bilateral striatum (p < 0.02 or 0.05) compared with the HMPAO-CBF values. Good correlations were found between IMP-CBF and the HMPAO-CBF values in the cortical gray matter (rs = 0.761; p < 0.001, n = 108), the white matter (rs = 0.739; p < 0.001, n = 18) and the cerebellum (rs = 0.731; p < 0.001, n = 18). In the striatum (rs = 0.58; p < 0.05, n = 18) and the thalamus (rs = 0.628; p < 0.05, n = 18), the correlations between IMP-CBF and HMPAO-CBF values were inferior to those of the other three regions.(ABSTRACT TRUNCATED AT 250 WORDS)

A fully automated apparatus for a light/dark test measuring anxiolytic or anxiogenic effects of drugs in mice

We developed a fully automated light/dark apparatus which detects locomotion, rearing and time spent in light and dark zones, and shuttle crossing of mice. This apparatus is controlled by a personal computer and detects these parameters by using infrared beamsensors. We used this apparatus to investigate the effects of the anxiolytics, diazepam (DZP) and pentobarbital (PB); the putative anxiolytic, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT); and the anxiogenics, picrotoxin, methyl-beta-carboline-3-carboxylate (beta-CCM), and ethyl-beta-carboline-3-carboxylate (beta-CCE), on each parameter measured by a light/dark test in mice. DZP (5 mg/kg) and 8-OH-DPAT (0.1 and 0.2 mg/kg) significantly increased the time spent in the light zone. PB (10 mg/kg) also significantly increased the number of shuttle crossings between the dark and light zones. Conversely, picrotoxin (1 and 2 mg/kg) significantly decreased locomotion, rearing and time spent in the light zone. beta-CCM (10 mg/kg) and beta-CCE (5 mg/kg) also significantly decreased rearing and time spent in the light zone. Although the same dose of beta-CCE significantly decreased shuttle crossing and rearing in the dark zone, beta-CCE did not change locomotion in either zone. Our results indicate that this apparatus is useful for the assessment of the anxiolytic and anxiogenic activities of drugs in mice.

Quantitation of rCBF by 99mTc-hexamethylpropyleneamine oxime single photon emission computed tomography combined with 133Xe CBF

A simple, noninvasive method of measuring CBF that uses single photon emission computed tomography (SPECT) of 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) and whole-brain CBF obtained by 133Xe clearance technique was developed. SPECT data were normalized to the count density of HMPAO uptake in the whole brain and then converted to the absolute units of CBF by multiplying average CBF in the whole brain obtained by 133Xe. Mean CBF values in healthy volunteers (n = 12) were 49 +/- 7 and 30 +/- 5 ml 100 g-1 min-1 for gray matter and white matter, respectively, with a global flow value of 45 +/- 5 ml 100 g-1 min-1. The mean flow value was 19 +/- 7 ml 100 g-1 min-1 for the core of the infarct and 31 +/- 5 ml 100 g-1 min-1 for the contralateral region (n = 13). CBF values were reproducible for all brain regions. The method was convenient to use and suitable for the routine measurement of regional CBF in normal and pathologic states.

Pharmacological profile of the novel putative anxiolytic agent 1-amino-5-bromouracil

The newly synthesized compound, 1-amino-5-bromouracil (ABU, CAS 127984-93-4), showed unique anxiolytic activity in rats and mice. Its minimum effective dose was 10 mg/kg p.o. in the Geller type conflict test in rats, and it showed anxiolytic activity at a dose of 20 mg/kg i.p. in the Vogel type conflict test in mice. ABU also induced loss of the righting reflex in mice. The ED50, a dose level that induces loss of the righting reflex in 50% of mice, was 86.4 mg/kg p.o. On the other hand, ABU showed only weak activities both potentiating the drug-induced anesthesia and myorelaxing in comparison with diazepam. Furthermore ABU did not show an affinity for benzodiazepine receptor. Thus, the pharmacological profile of ABU is concluded to be different from that of diazepam.

Characteristics of the two newly established cell lines of human pulmonary adenocarcinoma and their sensitivity to anticancer agents

Two adenocarcinoma cell lines were established from metastatic lymph node of lung cancer patients. The cell lines were named NUTLC-1 and NUTLC-3. They were found to have the following biological characterization and sensitivity to anticancer agents by comparison with clinical effect of the drugs on each donor patient: 1) By chromosomal analysis, the tumor cells of two cell lines were human-origin cells. Number of chromosomes of these cell lines ranged from 67 to 77 in NUTLC-1 cells and from 61 to 66 in NUTLC-3 cells, with the modal numbers of 73 and 64, respectively. 2) The tumor cells of the two cell lines were heterotransplanted subcutaneously into nude mice, but, no natural distant metastasis was observed 2 months after transplantation. 3) Sensitivity to anticancer agents on NUTLC-1 and NUTLC-3 cells differed individually according to methylthiazol tetrazorium (bromide) (MTT) colorimetric assay. NUTLC-1 cells were sensitive to Mitomycin C (MMC) and Adriamycin (ADM), and insensitive to Cisplatinum (CDDP), 5-Fluorouracil (5-FU) and Etoposide (VP-16). Antitumor effect of CDDP and 5-FU on recurrent tumor of donor patient was not observed clinically. NUTLC-3 cells were sensitive to CDDP, MMC and ADM, and insensitive to 5-FU and VP-16. Sensitivity to CDDP and MMC on NUTLC-3 cells also correlated to clinical effect of the drugs on the donor patient. From these results, it appears that these new cell lines are useful materials for studies on lung cancer.

Long-term effects of bone marrow transplantation for inborn errors of metabolism: a study of four patients with lysosomal storage diseases

Long-term effects of bone marrow transplantation (BMT) were evaluated in patients with I-cell disease, metachromatic leukodystrophy (MLD), Maroteaux-Lamy syndrome or Hunter syndrome (mild form). Donors were human leukocyte antigen (HLA)-matched siblings, and the follow-up periods were 24-71 months after BMT. The enzyme activities were increased in leukocytes, plasma or liver tissues compared with pre-BMT levels. A patient with I-cell disease acquired development of 4-8 month old infants and showed no further progression in cardiac dysfunctions. A patient with MLD showed a decelerated disease progression and an improved peripheral neuropathy, but progressive brain atrophy was not prevented. Patients with Maroteaux-Lamy syndrome or Hunter syndrome showed improvements in hepatomegaly, joint contractures, short stature and tight skin, and this greatly increased their quality of life. These results indicated that the long-term therapeutic effects achieved by BMT were subject to multiple factors including biochemical improvements, a reversibility of affected tissues, or advanced states of disease and central nervous system impairments in inborn errors of metabolism.

Decreased cerebrovascular dilatory capacity in subjects with asymptomatic periventricular hyperintensities

BACKGROUND AND PURPOSE

The clinical significance of the periventricular hyperintensity incidentally found on magnetic resonance images of the brain is questionable. We evaluated resting cerebral blood flow and cerebrovascular dilatory capacity of subjects with asymptomatic periventricular hyperintensities to study their cerebral hemodynamics.

METHODS

Magnetic resonance imaging of the brain was performed in 28 asymptomatic subjects with cerebrovascular risk factors to determine the severity of periventricular hyperintensity. Mean gray matter flow was computed by a 133Xe-clearance technique in subjects at rest and after the administration of 1 g acetazolamide. Flow values were correlated with the scores for periventricular hyperintensity.

RESULTS

Resting gray matter flow was not significantly correlated with the severity of periventricular hyperintensity for the whole brain (rs = -.364), whereas flow after acetazolamide loading (rs = -.783, P < .001) and the absolute value of increased flow (rs = -.567, P < .01) were significantly and negatively correlated with the severity of periventricular hyperintensity.

CONCLUSIONS

A decrease in vasodilatory capacity and compensatory vasodilation occur in the cerebral cortex of subjects with asymptomatic periventricular lesions and maintain cerebral blood flow.

[Therapeutic effect of lisuride maleate on post-stroke depression]

Twenty post-stroke depressive patients who obtained more than 11 points on Self-Rating Questionnaire for Depression, were treated with 0.075 mg/day lisuride maleate for 12 weeks. The drug effect on depression was evaluated quantitatively by the Hamilton Rating Scale for Depression. The relationships between brain CT or MRI and SRQ-D score were investigated in 24 subjects. More than 80% of post-stroke depressive patients improved after lisuride maleate treatment for 8 or 12 weeks. In particular, depressed mood, hypobulia, sleep disturbance, anxiety, etc. were significantly improved compared to the baseline condition. As for the relationships with CT and/or MRI findings, the group with moderate to severe brain atrophy had a significantly higher grade of depressive state than those without.

Striking similarities between the nucleotide sequence and genome organization of citrus tatter leaf and apple stem grooving capilloviruses

The sequence of the 3'-terminal 2956 nucleotides, excluding the poly(A) tail, of the citrus tatter leaf virus (CTLV) genome was determined and compared with that of the apple stem grooving virus (ASGV) genome. The sequence of the 3'-terminal region of CTLV contains two overlapping open reading frames (ORFs) and a 3'-terminal non-coding region of 142 nucleotides. The long, incomplete ORF1 ends at UAG (position 2812) and encodes a protein with at least 938 amino acids (M(r) > 108,703). This protein contains the GDD motif associated with the RNA polymerase. ORF2, in a different frame within ORF1, starts at AUG (position 1248) and stops at UGA (position 2208) encoding a protein with an M(r) of 36,179 (36K). Partial homologies were found among the 36K protein of CTLV, the 50K protein of apple chlorotic leaf spot closterovirus, the 40K protein of potato virus T and the gene 1 products of caulimoviruses. The arrangement of ORFs in the 3'-terminal region of the CTLV genome is in perfect agreement with that of the ASGV genome. The sequence of the 3'-terminal 2956 nucleotides, excluding the poly(A) tail, of the CTLV genome shows 86.1% identity to that of the ASGV genome. Similarities of amino acid sequences encoded by ORF1 and ORF2 of CTLV with the corresponding regions of ASGV are 86.1% and 97.3%, respectively. These results indicate that CTLV is a capillovirus closely related to ASGV.

[Study on extravascular lung water and polymorphonuclear leukocyte elastase during acute phase following radical treatment of lung cancer: effect of ulinastatin on respiratory functions]

We studied respiratory functions, extravascular lung water (EVLW) as measured by a thermodilution method using double Na indicators, and variations in polymorphonuclear leukocyte elastase (PMNE) during the acute phase following radical treatment of lung cancer, as well as to investigate clinical effect of ulinastatin. Using 16 patients with lung cancer who had undergone surgery of R 2 a or more, 10 patients without ulinastatin therapy were compared with six patients given 300,000 U/day of this drug by drip infusion from Day 0 and 4 of disease. It was found that EVLW value decreased most on Day 1, and gradually increased thereafter but did not return to the preoperative level. PMNE value increased from immediately after surgery and peaked on Day 3, but returned nearly to the preoperative level by Day 5. Although this was different from the variations in EVLW value, there was a correlation between these two parameters on Day 3 when PMNE peaked. Further, ulinastatin tended to inhibit PMNE and improve oxygenation index. Respiratory and circulatory parameters vary in complex manners during the acute phase following radical treatment of lung cancer, and could not be accurately evaluated by means of thermodilution using Na. PMNE is considered a contributing factor to pulmonary tissue disorders following radical treatment of lung cancer, and ulinastatin appeared to be effective in the postoperative management of patients undergoing radical treatment of lung cancer.