[A study on auditory disturbances after microvascular decompression for hemifacial spasm]

After establishing an operation of microvascular decompression by Jannetta in 1975, an improvement rate of hemifacial spasm have increased. However, postoperative hearing deficits, equilibrium disturbances and facial paresis have been described in some publications. Fifty-seven of 119 patients with hemifacial spasm operated from 1982 to 1989, were examined by audiometry before and after operation. In patients with tinnitus at the time of facial spasm and closing eyelids, tinnitus improved almost in many cases. Of 57 patients, 8 (5 with sensorineural hearing loss, 3 with conductive hearing loss) had postoperative hearing impairments in operated ears, and 7 (7 with sensorineural hearing loss) had in the other ears, too. Of 7 patients having sensorineural hearing loss observed for several months, 4 having slight sensorineural hearing loss recovered at the same hearing level before operation. In 2 patients having profound sensorineural hearing loss, however, hearing improvement did not observed in each case.

[Treatment of Yusho patients with cholestyramine]

Six typical Yusho patients (3 men, 48-58 years old, and 3 women, 45-55 years old) were treated with cholestyramine, 8-12 g/day, for 24 weeks. Improvement of some symptoms, such as arthralgia and malaise, was observed in 2 men, although this effect was non-specific. None of the patients showed increment of excretion of polychlorinated biphenyl or polychlorodibenzofuran into feces.

Pheochromocytoma with electrocardiographic change mimicking angina pectoris, and cyclic change in direct arterial pressure--a case report

A forty-two-year-old man was admitted because of chest pain. Electrocardiograms at admission showed horizontal ST depression in leads, II, III, aVF, V4, V5, and V6. Direct blood pressure monitoring revealed cyclic change between 160/100 mmHg and 70/50 mmHg and heart rate between 80/sec and 120/sec at fifteen minute intervals. The plasma norepinephrine and epinephrine concentrations were elevated during the episodes of hypertension. Pheochromocytoma was found in the right adrenal gland. These cyclic changes in blood pressure and heart rate are an aid for diagnosis.

Disseminated intravascular coagulation in a patient with progressive systemic sclerosis associated with necrotizing angiitis and generalized lymphadenopathy

A 47-year-old woman with progressive systemic sclerosis developed disseminated intravascular coagulation in the course of her terminal illness. She also had complicating necrotizing angiitis and generalized lymphadenopathy. The likely relationship between disseminated intravascular coagulation and vasculitis is discussed.

[Study on tinnitus masking--an evaluation of ipsilateral and contralateral masking for tinnitus]

In this study, the tinnitus masking curves measured by the ipsilateral and contralateral masking test were evaluated for the unilateral tinnitus cases of following 4 groups; 40 cases without hearing loss, 22 cases with symmetrical sensorineural hearing loss, 12 cases with unilateral deafness, and 70 cases with unilateral sensorineural hearing loss. Then the characteristics of tinnitus masking curves and central masking phenomenon for tinnitus masking were investigated. Consequently, tinnitus was masked by a masking tone given from nontinnitus ear when it reached at some definite loudness level, in spite of the presence of hearing loss or the degree of hearing loss in tinnitus ear. Then it was suggested to be a influence of central masking phenomenon in the contralateral tinnitus masking.

Low activity of gamma-glutamyl transpeptidase in serum of acute intrahepatic cholestasis

Low gamma-glutamyl transpeptidase (gamma-GTP) activity in serum was observed in 11 patients with acute intrahepatic cholestasis (cholestatic hepatitis and fulminant hepatitis), despite a marked increase in bilirubin levels. Inhibitors of gamma-GTP were not detected in sera of these patients. Their gamma-GTP levels in the liver were significantly higher than those in chronic liver diseases. An electrophoretic study of liver gamma-GTP in acute intrahepatic cholestasis showed the same mobility as in chronic liver diseases. These results suggest that the low serum gamma-GTP activity in acute intrahepatic cholestasis is due to factors inhibiting the release of the enzyme from the liver.

Multiple myeloma associated with Budd-Chiari syndrome

A 51-year-old Japanese woman with Budd-Chiari syndrome, following dermatoplasty of the leg for burns, developed multiple myeloma and amyloidosis during the four-year observation period. In Budd-Chiari syndrome, polyclonal hypergammaglobulinemia is frequently seen as the result of intestinal antigenic stimulation through the portacaval shunt. Although monoclonal gammopathy is occasionally presented in chronic liver diseases, multiple myeloma has not been previously recognized as occurring in association with Budd-Chiari syndrome. This case demonstrates that, in Budd-Chiari syndrome, the development of multiple myeloma may be the result of chronic stimulation of the intestinal microbes.

[Statistical study of 41 cases with denture foreign bodies in the air and food passages and significance of the duplicated denture model]

A statistical study of 41 cases with denture foreign bodies in the air and upper food passages which were treated in our department during the past 21 years was done. (1) Males were more frequently affected. The ratio of male to female was about 2 to 1. (2) Of 41 dentures, 2, 2 and 37 were lodged in the air passages, hypopharynx and esophagus respectively. (3) There were 5 complete mandibular dentures in 41 cases. (4) The causes of the denture foreign bodies were originated to the problem of denture itself in 29 cases, that of the patient himself in 2 cases and both in 10 cases. (5) Of 39 problematic dentures, 16 showed the breakage such as plate fracture and clasp deformity, but the other 23 showed no breakage. In this latter group, poor holding of the denture was ascribed to miss-making or miss-planning. (6) Of 12 patients with problems in their physical function, 5 had suffered from cerebrovascular disease and 3 from geriatric dementia. (7) The denture foreign body in aged patients with physical hypofunction tends to increase in recent years. (8) Of 39 dentures tried to remove by esophagoscopy, 18 were done with difficulty and they were detachable partial dentures with one artificial tooth and 2-arm-clasps lodged at the first and/or second isthmus of the esophagus. Though we have a denture removed successfully at the third trial, we have no case needed external esophagotomy. (9) Duplicated denture models were made in 20 cases prior to the procedure, and we certify that these models play an important role for the safer removal of denture foreign bodies.

Effects of recombinant leukocyte interferon on ribonuclease activities in serum in chronic hepatitis B

Alkaline ribonuclease (RNase; EC 3.1.27.5) activities and 2',5'-oligoadenylate synthetase (2-5 AS; no EC no. assigned) activities in serum were measured in nine patients with hepatitis B e antigen-positive chronic hepatitis B before, during, and after treatment with recombinant human interferon alpha-2b for four weeks at daily doses ranging from 3 to 10 mega-units. Alkaline RNase activities in serum significantly increased from 65.8 +/- 9.5 units/L (mean +/- SD) to 84.3 +/- 11.9 units/L after the first week of therapy (P less than 0.001). (One unit of RNase activity is defined as that increasing the absorbance at 260 nm by 1.0 in 1 min). This increase persisted during and until two weeks after the end of the therapy, at which time the mean RNase activity in serum was still significantly increased (70.8 +/- 9.4 units/L, P less than 0.01). Before therapy, phosphocellulose chromatography of RNase showed five active peaks of enzyme activity, which were similar to that observed even when RNase activity increased immediately after therapy. There was a close correlation between RNase activities and the logarithm of 2-5 AS activities, measured simultaneously in each patient. We conclude that recombinant alpha-interferon therapy increases RNase activities in serum, associated with the increased 2-5 AS activities.

[Infections in hematological malignancies--clinical analysis of septic patients admitted to the Second Department of Miyazaki Medical College Hospital in the past ten years]

Two hundred and sixty-two patients (actual number 162) of hematological malignancies were admitted to our department from November 1977 to December 1986. Fourty-three of them (16.4%) were demonstrated to be accompanied with sepsis by blood culture. In acute non-lymphocytic leukemias (AML, APL, AMoL) the rate of sepsis was 33.8% (27 patients), while in lymphocytic malignancies (ML, HD, ATL) it was 11.7% (16 patients), particularly being 3.0% in ATL. Among the detected pathogenic microorganisms, gram-negative bacilli were 86.2% in the former and 50.0% in the latter. Especially, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli occupied 58.6% of the total in the former. Laboratory examination, when sepsis occurred, revealed peripheral neutropenia in acute non-lymphocytic leukemias (mean 831/cmm) but not in lymphocytic malignancy (mean 4,420/cmm). And 20 of the 27 cases showed remarkable neutropenia of below 500/cmm in the former. On the other hand in the latter, out of 16 only one with ATL was the case. Hypogammaglobulinemia was one of the characteristic features in lymphocytic malignancies but not in acute non-lymphocytic leukemias. Hypogammaglobulinemia in lymphocytic malignancies might be affected by long-term immunodepressant therapy. Immunologic skin reaction was demonstrated to be decreased in lymphocytic malignancies on admission. From the findings mentioned above, affecting factors to infections may be mainly neutropenia in acute non-lymphocytic leukemias and immunodeficiency in lymphocytic malignancies. And sepsis can occur frequently under neutropenic condition. In ATL both of humoral- and cellular-immunologic disturbance were detected before therapy. But peripheral neutrophil count was maintained to be normal and this could be the reason for the low septic incidence in ATL despite of total immunodepression.

Effects of recombinant leukocyte interferon on ribonuclease activities in serum in chronic hepatitis B

Alkaline ribonuclease (RNase; EC 3.1.27.5) activities and 2',5'-oligoadenylate synthetase (2-5 AS; no EC no. assigned) activities in serum were measured in nine patients with hepatitis B e antigen-positive chronic hepatitis B before, during, and after treatment with recombinant human interferon alpha-2b for four weeks at daily doses ranging from 3 to 10 mega-units. Alkaline RNase activities in serum significantly increased from 65.8 +/- 9.5 units/L (mean +/- SD) to 84.3 +/- 11.9 units/L after the first week of therapy (P less than 0.001). (One unit of RNase activity is defined as that increasing the absorbance at 260 nm by 1.0 in 1 min). This increase persisted during and until two weeks after the end of the therapy, at which time the mean RNase activity in serum was still significantly increased (70.8 +/- 9.4 units/L, P less than 0.01). Before therapy, phosphocellulose chromatography of RNase showed five active peaks of enzyme activity, which were similar to that observed even when RNase activity increased immediately after therapy. There was a close correlation between RNase activities and the logarithm of 2-5 AS activities, measured simultaneously in each patient. We conclude that recombinant alpha-interferon therapy increases RNase activities in serum, associated with the increased 2-5 AS activities.

[A case of hepatocellular carcinoma associated with chronic renal failure on haemodialysis]

A 36 years old man with chronic renal failure on haemodialysis therapy presented with a hepatic mass which was diagnosed by ultrasonography, and was admitted to our hospital. Computer tomography and hepatic angiography revealed hepatocellular carcinoma of the right anterior superior segment of the liver. His liver function test, alpha-fetoprotein (AFP) and carcinoembryonic antigen levels in the serum were within the normal range. HBs antigen was also negative. Resection of right antero-superior segment was done following transcatheter arterial embolization. The tumor was homogeneous and light yellowish in color, and well demarcated by the capsule. Nontumorous tissue did not show either fibrosis or any inflammatory reaction. In general, hepatocellular carcinoma is associated with a positive HBs antigen and altered liver function. We here report a rare case of hepatocellular carcinoma in a man who was undergoing haemodialysis treatment for chronic renal failure with normal liver function test and negative HBs antigen.

Surgery of giant bulla with tube drainage and bronchofiberoptic bronchial occlusion

A case of emphysematous bullae and right lung cancer is presented. At first, left giant bulla was managed by minithoracotomy and tube drainage combined with bronchofiberoptic bronchial occlusion to preserve the respiratory function. Four weeks later, right lung cancer was successfully resected.

[Seroepidemiological analysis of the age specific prevalence of anti HTLV-I in Miyazaki Prefecture]

Antibody for HTLV-I in sera from 11,224 residents in Miyazaki Prefecture, Japan, was determined by indirect immunofluorescent antibody method to compare age- and sex-specific antibody prevalence among three geographically divided areas of the prefecture. There was a significant difference in the positive rate of older age groups among three areas, 9.0% for the northern part, 14.5% for the southern part and 8.4% for Miyazaki City, in spite of little variation in younger age groups. A marked rise of positive rate in the southern part at the age of 40th was observed, which suggests that changes of some conditions for mother-to-child transmission happened in the time of their birth. Six seroconversions were observed by the follow-up study for five years of the 971 residents. They were between 28 and 38 years of age, four men and two women. This may provide another reason for the increase in antibody positive rate by age in the adult. However, it could not be investigated if the seroconversion was caused by a horizontal transmission from their spouse. The possibility of the long latency of the virus in man as in the experimental animal may also have to be considered.

[A case of alcoholic cirrhosis demonstrating long-term poor-visualization of the hepatic image on 99mTc-phytate scintigraphy]

A 27-year-old female patient with alcoholic cirrhosis was reported. She was admitted to the hospital because of jaundice and ascites after heavy drinking. She had a history of drinking Japanese Sake in quantities of more than 5 go/day (900 ml/day) for 7 years. On admission, she was icteric, and had both hepatosplenomegaly and ascites. Laboratory data showed an elevation of serum transaminase and bilirubin, and a decrease in the albumin and prothrombin values. A biopsy specimen of the liver showed pericellular fibrosis, fatty change, Mallory bodies and regenerative nodules, and revealed findings compatible with alcoholic cirrhosis. A 99mTc-N-pyridoxyl-5-methyltryptophan scintigram showed hepatomegaly. On the 99mTc-phytate scintigram, the uptake of radioisotope to the liver was markedly decreased with the increased uptake to the spleen and bone marrow. Even 6 months after the onset, poor visualization of the hepatic image on 99mTc-phytate scintigram continued. This is the first report of alcoholic cirrhosis demonstrating a long-term poor visualization of the hepatic image on 99mTc-phytate scintigraphy.

[Clinical and etiological studies of tsutsugamushi disease in Miyazaki district--correlation of serological type of R. tsutsugamushi to clinical feature]

The correlation of pathogenic and immunologic characteristics of Rickettsia tsutsugamushi to clinical findings of patients with tsutsugamushi disease in Miyazaki was investigated. In two immunological types, Hirano type strains seemed to have higher virulence to mice than Irie from the findings during the course of infection and on autopsy. A strain of Hirano type was so virulent as to succumb to the infection. As to clinical findings, incidence of hepatomegaly was slightly higher in Hirano type patients than Irie, which is one of the signs in severe type tsutsugamushi disease. This was supported by the higher mean value and frequent appearance of abnormality in liver function test, sGOT, sGPT and LDH, in this type of patients.

Correction of serious iron overload in a chronic hemodialysis patient by recombinant human erythropoietin and removal of red blood cells: confirmation by follow-up liver biopsy

A chronic hemodialysis case, a 46-year-old woman with secondary hemosiderosis induced by parenteral iron and blood transfusion due to a refractory anemia, was effectively treated with recombinant human erythropoietin and the removal of red blood cells. The cumulative dose of the iron removed was 5,712 mg. Plasma ferritin decreased from 8,290 to 2,203 micrograms/l during 18 months. Concomitantly, liver histology performed before and after the therapy revealed a prominent regression of the deposited iron.

Effects of recombinant leukocyte interferon on serum immunoglobulin concentrations and lymphocyte subpopulations in chronic hepatitis B

To investigate immune effects of interferon (IFN) therapy in hepatitis B e antigen (HBeAg)-positive chronic hepatitis B, serum immunoglobulin concentrations and peripheral lymphocyte subpopulations were sequentially studied before, during, and after therapy in nine patients who were treated with recombinant human alpha-IFN in doses ranging from 3 to 10 million units per day for 28 days. Serum immunoglobulin A levels decreased significantly, from 414 +/- 23 mg/dl (mean +/- SE) to 379 +/- 28 mg/dl (P less than 0.05), after the first week of therapy and to a bottom value of 323 +/- 20 mg/dl (P less than 0.001) at the fourth week. Immunoglobulin G levels decreased significantly, from 2603 +/- 175 to 2328 +/- 169 mg/dl (P less than 0.005), after the first week of therapy and to a bottom value of 2005 +/- 199 mg/dl (P less than 0.001) at the fourth week. Immunoglobulin M levels were also reduced significantly after 3 weeks of therapy (from 229 +/- 23 to 188 +/- 15 mg/dl; P less than 0.01). These reductions in immunoglobulins A, G, and M returned to pretreatment levels by 4 months after the end of the therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of omentopexy for bronchial fistula and pyothorax following the right completion pneumonectomy with combined resection of pericardium, diaphragm and chest wall]

A 68-year-old male underwent the right completion pneumonectomy with combined resection of pericardium, diaphragm and chest wall. Three months later, he was diagnosed as a bronchial fistula with bloody sputum and decreasing of right pleural effusion level on chest X-ray film. The conservative therapy with pleural drainage and endoscopic practice with fibrin matrix was failed to close a fistula and pyothorax was developed. Therefore, surgical treatment with simple omentopexy without thoracoplasty and/or muscle transposition was performed onto fistula and SILASTIC sheet used for the repair of diaphragm at initial operation was left in the thoracic cavity. Although pleural fluid remained the contamination with bacteria for one month postsurgically, infection did not develop and fistula closed successfully. Moreover, infection did not prolong in the presence of artificial SILASTIC sheet followed by simple omentopexy. Omentopexy may be very useful for the treatment of bronchial fistula with the presence of infection.

[Effects of tricyclic antidepressant drugs on receptor binding sites and Ca2+ binding to sarcoplasmic reticulum in rat heart]

The effects of tricyclic antidepressant drugs on cardiac receptor binding sites and Ca2+ binding to cardiac sarcoplasmic reticulum were investigated in rats. 1) Quinupramine was found to possess higher affinity for muscarinic cholinergic receptor binding sites in brain and heart, compared with imipramine. 2) Repeated quinupramine treatment induced a significant increase in the Bmax value in cardiac muscarinic cholinergic receptors. 3) In imipramine treated heart, isoproterenol-induced stimulation of ornithine decarboxylase activity was significantly decreased compared with that in the vehicle control. 4) Repeated quinupramine and imipramine treatment caused a significant reduction of Bmax of 45Ca2+ binding in cardiac sarcoplasmic reticulum fractions. 5) After single quinupramine treatment, its concentrations in heart were higher than those in brain and plasma. 6) After the repeated quinupramine treatment, its concentration in heart was 2.4 times higher than that after single treatment. These results demonstrate that repeated tricyclic antidepressant drug treatment caused a functional impairment in Ca2+ binding sites of cardiac sarcoplasmic reticulum and adaptive changes of receptor binding sites.

[Renal function in patients with yusho]

Renal functions were examined in 102 patients with yusho in 1988, Frequencies of proteinuria, microhematuria and history of renal diseases were not different from 20 age-matched controls. The means of blood urea nitrogen, serum creatinine and serum uric acid levels of yusho patients did not differ from those of controls. The levels of serum beta 2-microglobulin and its urinary excretion showed no difference between two groups. Serum concentrations of sodium, potassium, chloride, calcium and phosphorus revealed no abnormality in all patients except for one who had hypophosphatemia. Urinary excretions of phosphorus, however, were significantly higher in yusho patients than in controls. Serum PCB levels, which were still higher in yusho patients, did not correlate with urinary excretions of phosphorus. The mechanism and the clinical significance of this phenomenon remain to be elucidated.

Chronic sinusitis and woodworking as risk factors for cancer of the maxillary sinus in northeast Japan

In the period 1983 to 1985, 66 patients presented to six Japanese university hospitals with squamous cell carcinoma of the maxillary sinus. Using self-administered questionnaires, a case-control study was conducted to examine history of nasal diseases, occupational exposures, and other possible risk factors for this disease. For each patient, two controls were selected from the general population, matched to the patient by sex, age (+/- 5 years), and district of residence. A history of chronic sinusitis was associated with a 2.3-fold increase in risk (p = 0.05). A high relative risk was also observed in males with an occupational history of woodworking or joinery, particularly when these jobs involved sanding or lathing practices (RR = 7.5, p = 0.02). No association between cigarette smoking and maxillary sinus cancer was observed in this study and no evidence was found that indoor air pollution in the home is involved in cancer development.

Suppression of tuberculin skin reaction in healthy HTLV-I carriers from Japan

Although it is thought that infection with human T-lymphotropic virus type I (HTLV-I) is immunosuppressive, this has not been clearly demonstrated among healthy carriers, and there are no data concerning delayed-type hypersensitivity (DTH). To evaluate this hypothesis, DTH to purified protein derivative (PPD) of tuberculin was measured in 126 healthy adults from an endemic area for HTLV-I infection in southern Japan. Among the 39 HTLV-I carriers, only 15% had detectable induration following PPD exposure, compared to 46% of the 87 non-carriers. In addition, the size of erythema among those carriers with a positive reaction was about 70% of that among non-carriers. Overall, there was a significantly inverse association between the degree of DTH response and prevalence of antibody. In relation to subjects with strong to moderate reaction, those with negative or indefinite reaction were 6 times more likely to be a carrier. This association was much stronger among subjects aged 60 years or older than among younger persons. These findings indicate that there is subclinical immunosuppression among HTLV-I carriers, which increases with age.

[Regional left ventricular diastolic dysfunction in patients with apical hypertrophy]

Differences in cardiac function between the apical and the chordal parts of the left ventricle in apical hypertrophy (APH) were investigated by M-mode echocardiography. The subjects consisted of 10 patients with APH (APH Group) and 10 normal controls (N Group). The M-mode echocardiograms of the interventricular septum (IVS) and left ventricular posterior wall (LVPW), both in the apical and chordal parts were simultaneously recorded with the electrocardiogram and phonocardiogram. There were no significant differences in the blood pressures, heart rates, left ventricular end-diastolic internal diameters, and left ventricular end-systolic internal diameters between the APH Group and the N Group. The hypertrophy was localized to the IVS and LVPW of the apical part in the APH Group. In the chordal part, there were no significant differences in the peak negative dD/dt (-dD/dt) and the time to the peak filling rate (TPFR) between the APH Group and N Group. In the apical part, -dD/dt of the APH Group tended to increase compared with that of the N Group. The TPFR of the APH Group was significantly longer than that of the N Group (APH Group: 167 +- 33 msec and N Group: 126 +- 19 msec, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Sudden deafness: an investigation of hearing loss

The expression 'profound hearing loss' used in the diagnostic criteria for sudden deafness should be changed to 'moderate to profound hearing loss'. In clinical diagnosis, a 30-dB hearing loss at 1 kHz can be used as a tentative criterion for sudden deafness.

Clinical study of sudden deafness with special reference to onset

In a comparative study, patients with sudden deafness were classified into four groups according to type of onset. The results showed that those who noticed deafness occurring when awakening had a better prognosis than others, particularly those who found themselves already suffering from deafness on awakening. These findings suggest that among patients who have deafness on awaking, the disorder may not be sudden deafness in sensu strictu.

Thyroid function in "yusho" patients exposed to polychlorinated biphenyls (PCB)

Thyroid function was investigated in 123 yusho patients who were exposed to toxic levels of polychlorinated biphenyls (PCBs) 16 years ago. In yusho patients, compared with the patients without evidence of yusho or normal controls, the serum triiodothyronine (T3) and thyroxine (T4) levels were significantly higher, while thyroid stimulating hormone (TSH) levels measured by sensitive assay were normal. There was no difference in serum levels of albumin, alkaline phosphatase, total cholesterol, and thyroxine binding globulin (TBG) between the two groups and the prevalence of positive antithyroid autoantibodies was almost the same, suggesting that hyperthyroxinemia in yusho patients was not due to increased TBG binding or abnormal autoimmune mechanism. Serum free T4 levels, however, were not elevated, although T4/TBG ratio was significantly higher. The thyroid hormone levels were higher than normal value in 4 of 123 yusho patients but only 1 case had clinical symptoms such as excessive perspiration. Despite higher serum PCBs in yusho patients, there was no correlation between PCB levels and levels of T3, T4, or TSH. The present results suggest hyperthyroxinemia without obvious clinical symptoms in yusho patients long after exposure to PCBs.

Binding characteristics of [3H]quinupramine to rat brain membrane fractions

The binding characteristics of [3H]quinupramine to rat brain membrane fractions were studied. The specific binding of [3H]quinupramine to rat brain membrane fractions was stable, reversible and saturable. Scatchard analysis of the data from saturation experiments indicated that the specific binding was a single population with an affinity (KD) of 3.04 nM, a maximal binding site number (Bmax) of 714 fmol/mg protein, and a Hill coefficient (nH) of 1.08. Compounds known to inhibit muscarinic cholinergic receptors such as atropine and quinuclidinyl benzilate were the most potent competitors of [3H]quinupramine binding. When the drug potencies in inhibiting [3H]quinupramine binding were tested in the presence of 10 nM atropine, mianserin was the most potent competitor. Studies of the subcellular fractions showed that there was an enrichment of [3H]quinupramine binding sites in the synaptosome fraction. The regional distribution study revealed the highest densities of binding sites in the cerebral cortex and the lowest in the cerebellum. Thus, the specific binding of [3H]quinupramine observed here can be accounted for by both muscarinic cholinergic and serotonin S2 receptors.

Chloroplast Genome Evolution in the Genus Avena

The genus Avena contains five different chloroplast genomes, I-V. A physical map of chloroplast (ct) DNA of Avena sativa (type I chloroplast genome) was constructed using three restriction endonucleases, PstI, SalI and SmaI. This genome is ca. 135.5 kbp in size, and contains two inverted repeats of ca. 22.5 kbp each, separated by a large (ca. 79.0 kbp) and small (ca. 12.5 kbp) single copy region. The rbcL gene which codes for the large subunit of ribulose 1,5-bisphosphate carboxylase, was located in the map. Restriction fragment patterns of all five chloroplast genomes were compared, and among them five fragment size and five restriction site mutations were disclosed. Four site mutations were found in two or more chloroplast genomes, the other site and five fragment size mutations were specific to one or another of the chloroplast genomes. A dendrogram showing phylogenetic relationships among the five chloroplast genomes, based on the distribution of the common and specific mutations among them, indicates that chloroplast genome divergence characterized by three restriction site mutations occurred first between two diploid groups, each carrying A and C genome (nuclear), respectively, followed by further speciation in each group.

Mitogenic and antimitogenic transforming growth factors secreted by adenovirus 2- and simian virus 40-transformed hamster cells: possible roles in promoting tumorigenesis

Adenovirus 2 (Ad2)- and simian virus 40 (SV40)-transformed hamster embryo cells differ markedly in a number of phenotypic properties including their potential for inducing tumors in hamsters. Both Ad2- and SV40-transformed cells are immortalized and readily induce tumors in immunoincompetent newborn syngeneic hamsters, but only SV40-transformed cells are highly oncogenic in both adult syngeneic and allogeneic immunocompetent hamsters. The reasons for the difference in the oncogenic potential of the Ad2- and SV40-transformed phenotypes remain elusive. However, recent studies with transforming growth factors (TGFs) indicate that these factors play an important role in determining many phenotypic characteristics of transformed cells. To determine whether TGFs secreted by Ad2- and SV40-transformed hamster embryo cells differ, we have examined the ability of media conditioned by these two transformed cell phenotypes to modulate thymidine uptake in quiescent, untransformed cells. We found that both transformed phenotypes secrete very similar TGF alpha-like mitogenic factors which inhibit binding of 125I-labeled epidermal growth factor to its receptor. Our results also show that SV40-transformed cells, but not Ad2-transformed cells, secrete a powerful mitogenic inhibitor (MI). The MI secreted by SV40-transformed cells is inhibitory for several transformed and untransformed cell types and exerts a cytostatic, not cytolytic, action on untransformed primary hamster embryo cells. MI elutes from size exclusion high-performance liquid chromatography columns with a molecular weight of 24,000. Although MI has about the same molecular weight as TGF beta, it differs from TGF beta in two important respects: it is heat labile and it has a different target specificity for antimitogenic activity. The MI secreted by SV40-transformed cells also inhibits thymidine uptake by concanavalin A-stimulated spleen lymphocytes. This finding suggests that MI might contribute to the extreme oncogenicity of SV40-transformed cells by inhibiting mobilization of immune effector cells at the site of tumor cell proliferation.

Alterations in myocardial systolic and diastolic function in patients with active systemic lupus erythematosus

Echocardiographic studies were performed to evaluate myocardial function in active patients with systemic lupus erythematosus (SLE). Fourteen patients were studied in the active stage before corticosteroid therapy (active SLE); 10 of them were reexamined after therapy (inactive SLE). Computer-assisted analysis of digitized echoes of the left ventricular dimension was performed. The peak rate of change in dimension during systole (-dD/dt) was reduced in active SLE compared with normal control subjects (2.57 +/- 0.15 cm/sec vs 3.37 +/- 0.14 cm/sec, p less than 0.01). The peak rate of change in dimension during diastole (+dD/dt) was also reduced in active SLE compared with normal control subjects (3.16 +/- 0.19 cm/sec vs 4.41 +/- 0.20 cm/sec, p less than 0.01). After therapy, -dD/dt in inactive SLE was improved compared with active SLE (from 2.56 +/- 0.20 cm/sec to 3.13 +/- 0.19 cm/sec, p less than 0.001). Positive dD/dt in inactive SLE was also improved compared with active SLE (from 3.29 +/- 0.22 cm/sec to 4.23 +/- 0.23 cm/sec, p less than 0.01). No significant differences were found between inactive SLE and normal control subjects as to -dD/dt and +dD/dt. Significant correlations were found between anti-DNA antibody titers and both -dD/dt and +dD/dt (r = -0.97 p less than 0.0001, and r = -0.71 p less than 0.05, respectively). These results suggest that active SLE patients have left ventricular dysfunction that may be caused by an immunopathologic mechanism in SLE.

Down-regulation of central serotonin S2 receptors after repeated treatment with quinupramine in rats

The present studies were undertaken to determine whether the repeated administration of quinupramine caused down- or up-regulation of beta-, alpha 2-adrenergic, serotonin S2, imipramine and muscarinic cholinergic receptors, as had been demonstrated for tricyclic and atypical antidepressant drugs. Quinupramine administered at 10 mg/kg (p.o.) twice daily for 10 days caused a down-regulation of serotonin S2 receptors in the frontal cortex of the rat as determined by [3H]ketanserin binding. However, quinupramine did not alter the binding populations of beta-adrenergic, muscarinic cholinergic and alpha 2-adrenergic receptors in the rat brain as determined by the Scatchard analysis of the [3H]ligand binding data. Differing from quinupramine, imipramine caused down-regulation of beta-adrenergic and serotonin S2 receptor bindings, and it caused slight but significant up-regulation of muscarinic cholinergic receptor bindings. These results show that the antidepressant activity of quinupramine is associated with the central serotonin system, but not with the beta-adrenergic system. Accordingly, quinupramine, chemically one of the typical tricyclic antidepressant drugs, seems to be pharmacologically one of the atypical antidepressant drugs, and it was suggested that the central serotonin system plays an important role in the antidepressant activity of quinupramine.

[Two cases of glioblastoma involving the orbit and maxillary sinus]

Two cases of glioblastoma involving orbit and maxillary sinus are presented. Case 1: A 49-year-old male was admitted on May 20, 1982, with complaints of headache and impairment of memory. On July 27, 1982, operation was carried out. The tumor in the left temporal lobe was totally removed, and he subsequently received chemotherapy and irradiation. The postoperative course was uneventful. On Oct. 26, 1983, he was readmitted with complaints of disturbance of gait and memory. A CT scan revealed no local recurrence of the tumor but a diffusely enhanced mass in orbit and maxillary sinus. Reoperation was carried out on Nov. 10, 1983. No recurrence was seen at the original site where the first operation was done. The dura was intact so far as observed from inside and was protruding into the cavity from the side of the sphenoidal ridge. The tumor showed destructive growth to orbit and maxillary sinus. He died on May 20, 1984. The autopsy was refused. Case 2: A 33-year-old male was admitted on Oct. 24, 1981, with complaints of headache, vomiting and impairment of memory. A CT scan revealed a right temporal mass lesion. He was operated on three times, on Oct. 27, 1981, Feb. 23, 1984 and Sep. 6, 1984, respectively. He also received chemotherapy and irradiation. Finally, a CT scan revealed the recurrence of the tumor in the right frontal, temporal, parietal lobe and basal ganglia, and an invasion into orbit on a CT scan. He died on Nov. 26, 1984. We discussed the course of the extension of tumors and the reports in the literature were reviewed.

Cardiac function of patients with essential hypertension during exercise and isoproterenol infusion

The left ventricular function of patients with essential hypertension was examined during exercise and isoproterenol (ISP) infusion echocardiography. Twenty-eight hypertensive patients without cardiac hypertrophy (Group NH), 20 patients with cardiac hypertrophy (Group HH), 7 patients with cardiac dilatation (Group D), and 13 normotensives (Group N), were studied during multistage exercise using a supine bicycle ergometer. In addition, 23 hypertensives (Group NH: 13 patients, Group HH: 10 patients) and 10 normotensives were studied during ISP infusion (0.005 microgram/kg/min, and 0.01 microgram/kg/min, respectively, for 5 min). To assess the left ventricular function, an M-mode echocardiogram was utilized at rest and during exercise and ISP infusion. At rest, the isovolumic relaxation time (IRT) of each hypertensive group was significantly longer than that of Group N. IRT of Group HH and Group D was significantly longer than that of Group NH. Only the shortening fraction (SF) of Group D was significantly smaller than that of Group N. During exercise the SF increased in all groups, and only the SF of Group D was significantly smaller than that of Group N at a load of 75 W as well as at rest. The SF of Group HH tended to be smaller. There was no significant difference in peak negative dD/dt (-dD/dt) between any of the groups at rest; however, the -dD/dt of Group HH was significantly smaller than that of Group N during ISP infusion. We concluded that left ventricular diastolic function was disturbed in each hypertensive group at rest. Diastolic dysfunction worsened in Group HH and Group D. Only the left ventricular systolic function of Group D was already depressed at rest. Furthermore, unmanifested systolic dysfunction of the left ventricle seemed to be present in Group HH, because SF during exercise tended to be smaller and -dD/dt during ISP infusion was significantly smaller than that of Group N.