Recent updates on the basic mechanisms and pathogenesis of inflammatory bowel diseases in experimental animal models

The specific pathogenesis underlining inflammatory bowel disease (IBD) is very complicated, and it is further more difficult to clearly explain the pathophysiology of 2 major forms of IBD, Crohn’s disease (CD) and ulcerative colitis (UC), and both disorders affect individuals throughout life. Despite every extensive effort, the interplay among genetic factors, immunological factors, environmental factors and intestinal microbes is still completely unrevealed. Animal models are indispensable to find out mechanistic details that will facilitate better preclinical setting to target specific components involved in the pathogenesis of IBD. Based on many recent reports, dysbiosis of the commensal microbiota is implicated in the pathogenesis of several diseases, not only IBD but also colon cancer, obesity, psoriasis as well as allergic disorders, in both human and animal models. Advanced technologies including cell-specific and inducible knockout systems, which are recently employed to mouse IBD models, have further enhanced the ability of developing new therapeutic strategies for IBD. Furthermore, data from these mouse models highlight the critical involvement of dysregulated immune responses and impaired colonic epithelial defense system in the pathogenesis of IBD. In this review, we will explain from the history of animal models of IBD to the recent reports of the latest compounds, therapeutic strategies, and approaches tested on IBD animal models.

Clinical importance of IL-22 cascade in IBD

IL-22 is a relatively new cytokine that is characterized by several unique biological properties. In the intestines, the effect of IL-22 is restricted mainly to non-lymphoid cells such as epithelial cells. Interestingly, the expression pattern and major cellular source of IL-22 have distinct difference between large and small intestines. IL-22 possesses an ability to constitutively activate STAT3 for promoting epithelial cell regeneration and reinforcing mucosal barrier integrity through stimulating the expression of anti-bacterial peptide and mucins. Of note, IL-22 is characterized as a two-faced cytokine that can play not only protective but also deleterious roles in the intestinal inflammation depending on the cytokine environment such as the expression levels of IL-23, T-bet, and IL-22 binding protein. Most importantly, clinical relevance of IL-22 to inflammatory bowel disease has been well highlighted. Mucosal healing, which represents the current therapeutic goal for IBD, can be induced by IL-22. Indeed, indigo naturalis, which can activate IL-22 pathway through Ahr, has been shown in a clinical trial to exhibit a strong therapeutic effect on ulcerative colitis. Despite the beneficial effect of IL-22, continuous activation of the IL-22 pathway increases the risk of colitis-associated cancer, particularly in patients with an extended history of IBD. This review article discusses how IL-22 regulates colitis, how beneficial versus deleterious effects of IL-22 is determined, and why IL-22 represents a promising target for IBD therapy.

Lower Triassic stromatolites in Luodian County, Guizhou Province, South China: evidence for the protracted devastation of the marine environments

Stromatolites are one of the oldest and most intriguing organosedimentary deposits. In contrast to stromatolites of the Precambrian to Early Ordovician, Phanerozoic equivalents occurred episodically under specific conditions. A group of previously undescribed stromatolites in composition occur in the Lower Triassic (Olenekian) at the Dajiang section in the Luodian region of Guizhou Province, South China. We described the textures of these stromatolites with the aim of determining the genetic mechanisms and revealing the nature of interactions between micro-organisms and marine environments. Mesoscopic features show that the stromatolites consist of several sets of stacked slices, and that they are embedded in alternating beds of fine and coarse microsphere packstones that include aggregates of microspheres, forming grapestones and lumps. Microscopically, the stromatolites consist of spar- and dolomite-infilled microspheres (average diameter, 100 μm), micrites, peloids, small-sized pyrite framboids (average diameter, 5.8 μm) and fenestrae. Micrite-dominant intercalations accentuate laminated textures at a mesoscopic level and are laterally continuous with micrite-rich parts in surrounding interstromatolites, indicating the simultaneous, widespread deposition of these layers. The microspheres and associated micrites were the products of in situ microbial activity, probably sulphate-reducing or anoxygenic phototrophic bacteria, which led to the formation of these unusual stromatolites. Even during a protracted period of harsh marine conditions, the micrite-rich carpets were deposited intermittently on the stromatolites and their surroundings under severely anoxic/sulphidic conditions. The presence of Early Triassic stromatolites and their subtle but important vertical variations in texture provide a record of temporal changes in marine conditions during geobiologically critical intervals.

Solvent extraction of trivalent actinides with di(2-ethylhexyl) phosphoric acid

We carried out solvent extraction on the trivalent actinides of Am, Cm, Cf, and Fm and the lanthanides (except Pm) using di(2-ethylhexyl)phosphoric acid (HDEHP) in benzene by a batch method. The extraction constants of the HDEHP complexes for these elements were determined systematically under identical conditions. The tetrad effect was clearly observed in the variation of the extraction constants of the lanthanide series. We found that the extraction constant for Fm(III) is much smaller than that for Dy(III), which have similar ionic radii. The extraction constants for Am(III), Cm(III), and Cf(III) are similar to those for corresponding Ln(III) having similar ionic radii. Two possibilities that account for the lower extraction constant of Fm(III) is suggested.

Separation of Am(III), Cm(III), and Cf(III) using capillary electrophoresis

Trivalent actinides Am(III), Cm(III), and Cf(III) were successfully separated for the first time using capillary electrophoresis in 2-hydroxyisobutyric acid/acetic acid. It was found that the ionic radius was primarily important for separation of trivalent actinides as well as lanthanides in this condition. The stability constants of the Am(III) complexes with 2-hydroxyisobutyrate were estimated using the correlations between the molar fraction ratio of lanthanides and their ionic radii.

Role of diffusion-weighted magnetic resonance imaging in diffuse axonal injury

PURPOSE

To determine whether the signal changes on magnetic resonance imaging (MRI), including fluid attenuated inversion recovery (FLAIR), T2*-weighted gradient echo (GE) imaging, and diffusion-weighted imaging (DWI) in diffuse axonal injury (DAI) patients correlate with the clinical outcome.

MATERIAL AND METHODS

We diagnosed patients with DAI based on the following criteria: 1) a loss of consciousness from the time of injury that persisted beyond 6 h; 2) no apparent hemorrhagic contusion on computed tomography (CT); 3) the presence of white matter injury on MRI. Twenty-one DAI patients were analyzed (19 M, 2 F, mean age 34 years) with MRI (FLAIR, T2*-weighted GE imaging, and DWI).

RESULTS

325 abnormalities were detected by MRI within a week after injury. The T2*-weighted GE imaging was significantly more sensitive than FLAIR and DWI in diagnosing DAI. DWI detected only 32% of all lesions, but could depict additional shearing injuries not visible on either T2*-weighted GE imaging or FLAIR. The mean number of lesions in brainstem detected by DWI in the favorable group (good recovery/moderately disabled) was significantly smaller than in the unfavorable group (severely disabled/vegetative survival/death). This trend was not observed on the T2*-weighted GE imaging and FLAIR findings.

CONCLUSION

DWI cannot detect all DAI-related lesions, but is a potentially useful imaging modality for both diagnosing and assessing patients with DAI.

Lesions identified on T2*-weighted gradient echo images in two patients with suspected diffuse axonal injury that resolved in less than ten days

T2*-weighted gradient echo (GE) imaging is useful for detection of intracranial hemorrhage in the patients with diffusion axonal injury (DAI). However, the temporal changes in the DAI-related lesions on T2*-weighted GE images are not clear. We report two very rare cases with DAI in which lesions identified on T2*-weighted GE images resolved in less than ten days.

[An autopsied case of marked cardiac hypertrophy due to multifactorial heart disease in an 85 year-old man who had been socially active]

An autopsied 85-year-old man had suffered from a mild form of diabetes mellitus since the age of 67 and had experienced the first episode of heart failure with arapid ventricular rate of atrial fibrillation at the age of 72. He had remained socially active until he died suddenly of ventricular fibrillation, although he had complications of aortic regurgitation at the age of 76 and later mitral regurgitation at the age of 80. Chest roentgenograms showed gradual increase in the cardiothoratic ratio which reached 68.1% at the final stage. Autopsy revealedmarked left ventricular hypertrophy with a heart weight of 580 g, degeneration ofaortic valves, thickening of mitralvalve cusps and moderate coronary atherosclerosis without ischemic myocardial lesions. There were no specific lesions suggestive of primary cardiomyopathies on microscopic observations and the lesions of both aortic and mitral valves were not significant enough to explain the clinical findings of aortic and mitral regurgitation. Because the pathological examination failed to identify a single disease which was responsible for the marked cardiachypertrophy, we eventually reached the conclusion that the cardiac hypertrophy developed based on a multifactorial heart disease.

[A case of malignant lymphoma concomitant with multiple myeloma]

A 75-year-old woman was referred to us because of cough, high fever and skin erythema in April 1999. Malignant lymphoma (diffuse mixed cell type) was previously diagnosed in 1990 and she achieved complete remission after treatment with a series of CHOP regimen treatments. In 1998, multiple myeloma (IgG lambda type) was diagnosed and she was treated with a combination of melphalan and prednisolone. On physical examination, superficial lymphadenopathy and skin erythema were noted. Biclonal gammopathy (IgG kappa/lambda) was shown in serum, and Bence Jones protein in urine. Computed tomography showed pleural effusion and swelling of paraaortic lymph nodes. The bone marrow examination showed an increased number of abnormal plasma cells (19.2%) and no evidence of lymphoma. Left axillary lymph node biopsy revealed that she had non-Hodgkin's lymphoma (immunoblastic lymphadenopathy-like T cell lymphoma). She was treated with the CHOP regimen at reduced doses for both diseases. The lymphoadenopathy reduced after 6 courses of CHOP and 4 courses of CHOPE (CHOP + VP16), however, she had bone pain on November 1999 and received treatment with MCNU-VMP (MCNU + VDS + L-PAM + PSL). Her rib pain improved, but she died of systemic infection of herpes zoster virus. We report here a rare case of malignant lymphoma concomitant with multiple myeloma.

Expression of aluminum-induced genes in transgenic arabidopsis plants can ameliorate aluminum stress and/or oxidative stress

To examine the biological role of Al-stress-induced genes, nine genes derived from Arabidopsis, tobacco (Nicotiana tabacum L.), wheat (Triticum aestivum L.), and yeast (Saccharomyces cerevisiae) were expressed in Arabidopsis ecotype Landsberg. Lines containing eight of these genes were phenotypically normal and were tested in root elongation assays for their sensitivity to Al, Cd, Cu, Na, Zn, and to oxidative stresses. An Arabidopsis blue-copper-binding protein gene (AtBCB), a tobacco glutathione S-transferase gene (parB), a tobacco peroxidase gene (NtPox), and a tobacco GDP-dissociation inhibitor gene (NtGDI1) conferred a degree of resistance to Al. Two of these genes, AtBCB and parB, and a peroxidase gene from Arabidopsis (AtPox) also showed increased resistance to oxidative stress induced by diamide, while parB conferred resistance to Cu and Na. Al content of Al-treated root tips was reduced in the four Al-resistant plant lines compared with wild-type Ler-0, as judged by morin staining. All four Al-resistant lines also showed reduced staining of roots with 2',7'-dichloro fluorescein diacetate (H(2)DCFDA), an indicator of oxidative stress. We conclude that Al-induced genes can serve to protect against Al toxicity, and also provide genetic evidence for a link between Al stress and oxidative stress in plants.

Insertion/deletion polymorphism in the angiotensin-converting enzyme gene affects heart weight

BACKGROUND

Angiotensin (Ang) II, a major regulatory factor for left ventricular mass, is generated from Ang I by ACE. ACE levels are associated with an insertion/deletion (I/D) polymorphism in the ACE gene. The ACE polymorphism should result in varied Ang II concentrations and hence affect left ventricular mass. We therefore investigated whether ACE genotype is a predictor of heart weight.

METHODS AND RESULTS

From 693 consecutive patients autopsied between 1994 and 1998 in our hospital, patients with valvular disease, myocardial infarction, or cardiomyopathy were excluded. The remaining 443 autopsy patients were the subjects of our study. The heart weight at autopsy was corrected for body surface area. Genomic DNA was purified from the kidney, and ACE genotype was determined by polymerase chain reaction. Heart weight in the DD genotype (249. 9+/-49.9 g/m(2)) was significantly higher than that in the ID (230. 0+/-51.2 g/m(2); P<0.05) and II (226.8+/-49.8 g/m(2); P<0.01) genotypes. Heart weight was also positively related to age (r=0.145, P<0.0001) and coronary stenosis index (r=0.147, P=0.0019). Multiple regression analysis showed that a history of hypertension (P<0.0001), age (P=0.0001), and DD genotype (P=0.0154) were independent predictors of heart weight.

CONCLUSIONS

ACE genotype predicts cardiac mass; however, it was less effective than epigenetic factors such as hypertension or age.

[Focal segmental glomerulosclerosis associated with type C virus hepatitis and decrement of proteinuria by interferon-alpha therapy]

Focal segmental glomerulosclerosis (FSGS) associated with type C virus (HCV) hepatitis has not been described in the literature to date. However, we experienced a 30-year-old man, who had had HCV hepatitis, developed nephrotic syndrome and was admitted to our hospital. The first renal biopsy showed FSGS which was diagnosed by light, immunofluorescent, and electron microscopic study. FSGS diagnosis was based upon the findings of focal segmental glomerular sclerosis associated with hyalinosis and foam cells, segmental deposition of IgM and C3 on glomeruli, and epithelial cell vacuolization in the Bowman's space. HCV hepatitis was treated with interferon-alpha (INF-alpha) over 6 months. The treatment brought the disappearance of not only HCV-RNA from the blood, but also the manifestation of nephrotic syndrome. Therefore, the second renal biopsy was performed, but did not reveal any great pathological improvement. Five months later after the remission, he again had an elevated HCV-RNA level and a relapse of nephrotic syndrome. He was retreated with the same therapy and achieved a second remission of nephrotic syndrome. FSGS associated with HCV hepatitis is described first and the implication of INF-therapy in the improvement of proteinuria is discussed.

Acquisition of aluminum tolerance in Saccharomyces cerevisiae by expression of the BCB or NtGDI1 gene derived from plants

Eleven aluminum stress-induced genes derived from plants (wheat, Arabidopsis and tobacco) were introduced into Saccharomyces cerevisiae to test if expression of these genes confers Al tolerance. Al sensitivity tests showed that expression of two genes, either an Arabidopsis gene for blue copper binding protein (BCB), or a tobacco gene for the GDP dissociation inhibitor (NtGDI1), conferred Al tolerance. Determinations of total content and localization of Al ions in these transformants suggested that the BCB gene product functions in restricting Al uptake, while expression of the NtGDI1 gene promotes release of Al ions after uptake.

Raman scattering tensors of tyrosine

Polarized Raman scattering measurements have been made of a single crystal of L-tyrosine by the use of a Raman microscope with the 488.0-nm exciting beam from an argon ion laser. The L-tyrosine crystal belongs to the space group P2(1)2(1)2(1) (orthorhombic), and Raman scattering intensities corresponding to the aa, bb, cc, ab and ac components of the crystal Raman tensor have been determined for each prominent Raman band. A similar set of measurements has been made of L-tyrosine-d4, in which four hydrogen atoms on the benzene ring are replaced by deuterium atoms. The effects of NH3-->ND3 and OH-->OD on the Raman spectrum have also been examined. In addition, depolarization ratios of some bands of L-tyrosine in aqueous solutions of pH 13 and pH 1 were examined. For comparison with these experimental results, on the other hand, ab initio molecular orbital calculations have been made of the normal modes of vibration and their associated polarizability oscillations of the L-tyrosine molecule. On the basis of these experimental data and by referring to the results of the calculations, discussions have been presented on the Raman tensors associated to some Raman bands, including those at 829 cm-1 (benzene ring breathing), 642 cm-1 (benzene ring deformation), and 432 cm-1 (C alpha-C beta-C gamma bending).

Protective roles of two aluminum (Al)-induced genes, HSP150 and SED1 of Saccharomyces cerevisiae, in Al and oxidative stresses

We isolated two yeast cDNA clones whose transcripts are induced by aluminum (Al) metal stress. Partial nucleotide sequencing showed that one is the HSP150 gene encoding a secreted heat shock protein, and the other corresponds to the SED1 gene encoding a putative membrane protein. To clarify the biological functions of these genes, we analyzed the sensitivity of gene-disrupted mutants to Al stress and to oxidative stresses. The Al tests indicated that the HSP150 protein served a basal protective role in Al stress, but SED1 did not; both of the genes had protective roles for oxidative stresses. The results for the HSP150 gene suggest that there is an overlap between Al ion stress, oxidative stress and heat shock stress in yeast.

[Relation of asymptomatic myocardial ischemia to impaired communication, cerebrovascular disease, and lack of ability to perform activities of daily living in elderly patients]

Patient's reports of angina pectoris depend on cognition and communication, and on the patient's physical and mental activity. In elderly people, these functions are often impaired, and we therefore looked for evidence of myocardial ischemia in 770 consecutive autopsies. We defined the coronary stenosis index (CSI) as the sum of the stenosis scores of three coronary arteries: 0% = 1, 25% = 2, 50% = 3, 75% = 4, 90% = 4.5 95 or 100% = 5. A total score of more than 13.0 and a score of 5.0 in one vessel was assumed to have been associated with myocardial ischemia. Patients assumed to have had myocardial ischemia were classified according to the presence or absence of angina pectoris: 24 had angina pectoris and 92 were asymptomatic. As controls, 86 patients in whom the CSI was lower than 10.0 were studied. Death due to myocardial infarction was most frequent in patients with angina (67%). Acute myocardial infarction was more common in asymptomatic patients than in controls (27% vs. 1%). Small myocardial infarctions and inferior myocardial infarctions were more frequent in asymptomatic patients than in those with angina. Cerebrovascular disease, problems doing activities of daily living, and communication disturbance were more common in asymptomatic patients than in those with angina. Electrocardiographic evidence of an old myocardial infarction was found in 40.9%, 16.6%, and 2.3% of patients with angina, asymptomatic patients, and controls, respectively (p < 0.05). Morphologic details of the myocardial infarction, coexistence of cerebrovascular disease, inability to perform activities of daily living, and impaired communication are associated with asymptomatic myocardial ischemia. Patients with asymptomatic myocardial ischemia should be identified and treated because of their relatively poor prognosis. Ischemic events might be detected by careful observation and prevented by appropriate treatment.

[Gastric cancer in the elderly]

Gastric cancer in the elderly was evaluated with regard to age-related pathomorphological changes. Resected gastric cancer was studied with regard to location, stage, morphology and histology in male young old (65-74 years old) which were 25 cases and 31 lesions, respectively male middle old (75-84 years old); 104 cases and 120 lesions, male very old (85 years-); 96 cases and 110 lesions, female young old; 22 cases and 31 lesions, female middle old; 91 cases and 106 lesions, female very old; 51 cases and 55 lesions. Multiple gastric cancers were more frequent in female older group. In early cancer the frequency of elevated type increased significantly and that of depressed type decreased in very old group. In advanced cancer Borrmann I type was not so common in very old group. Histologically the frequency of signet ring cell cancer decreased and of tubular adenocarcinoma and of papillary adenocarcinoma increased significantly in female very old group. Hepatic metastasis increased significantly in male very old group. Lymph node metastasis and peritoneal metastasis did not show any change in age-related frequency.

[Morphometric study of age-related changes of the spinal cord]

The relation of aging to the length of the spinal cord and to the cross-sectional area at the levels of C6 and L3 of the spinal cord was studied in 140 autopsy cases who between the age of 47 to 105 without spinal cord lesions. In addition the effect of being bed-ridden on the spinal cord was studied in 11 of 140 cases. As pathological controls, we referred to 40 autopsy cases with compression change of the cervical cord. The length of the spinal cord had no correlation with aging but had a significant positive correlation with the height of the subject. A significant decrease in the cross-sectional area of the spinal cord was observed after the age of 80, in particular at C6. However, the extent of the decrease was not as serious as that of pathological control cases. Decrease of cross-sectional area was associated with that of white matter area. In addition, effect of being bed-ridden on the spinal cord was reflected in a significant decrease of the grey matter of the lumbar cord.

[Neuropathological study of amyotrophic lateral sclerosis in relation to aging]

It has been assumed that amyotrophic lateral sclerosis (ALS) involves precocious senility as one of its pathogenetic aspects. The authors studied 55 autopsied cases of ALS in relation to age at death, ranging from 42 to 86. The materials consisted of 8 cases in the fifth decade, 8 in the sixth, 20 in the seventh, 12 in the eighth, and 7 in the ninth. The total duration of illness ranged from 6 months to 14 years. The most distinct relationship was observed in the anterior horn lesion of the cervical enlargement which became less severe with advancing age, irrespective of the length of illness. Fifth decade cases showed marked atrophy with severe neuronal loss and fibrillary gliosis in the anterior horn, while those in the ninth decade showed slight changes which were similar to age-matched controls. On the other hand, pyramidal tract degeneration did not show any correlation to age at death or to length of illness. Pyramidal tract degeneration was found in all younger age group cases, being always severe. In the older age groups, however, the degeneration varied extremely in degree from case to case. Some cases showed severe degeneration comparable with that in the younger age groups, while the others had no findings suggesting degeneration. In addition, cases on artificial respirators had a longer duration of illness, and more marked degeneration in the anterior horn, irrespective of age. Our study did not reveal that senile changes including senile plaques and neurofibrillary tangles were more marked in ALS cases. No clinicopathological correlation with dementia was recognized.(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnosis of paraaortic and pelvic lymph node metastasis by ultrasound guided percutaneous fine needle aspiration biopsy (FNAB)]

Ultrasonography (US) was performed in patients with gynecologic malignancies to detect paraaortic and pelvic lymphadenopathy. US of paraaortic lymph nodes was performed in 32 patients. Of the 32 patients 17 had lymphadenopathy, and ultrasound-guided percutaneous fine needle aspiration biopsies (FNAB) were therefore performed in 16 of these 17 cases. Of these 16 patients, 11 were positive and 5 were negative FNAB. US of pelvic lymph nodes was performed in 68 patients. Of the 68 patients 14 had lymphadenopathy, and FNAB were performed in 8 of these. All 14 of these FNABs were positive. There were no major complications from due to FNAB. It is therefore concluded that ultrasound-guided percutaneous FNAB is very useful in detecting metastatic lymph nodes of gynecologic malignancies.

Investigation of amplitude and phase distributions of a diffracted Gaussian beam through an annular lens

Diffraction field distributions of amplitude and phase are obtained for Gaussian beam incidence through an annular aperture lens. They show the effects of the Gaussian amplitude distribution of the incident field. The encircled energy of the diffraction field is also obtained. From the results the position of the waist of the field is defined.

[Primary carcinoma of the fallopian tube: its clinical aspects and problems in the postoperative staging system]

Clinical features of primary carcinoma of the fallopian tube were studied in 13 patients treated in Osaka National Hospital between 1961 and 1987. The relationship between clinical staging and prognosis in each patient is discussed. The incidence of this disease among all cases of malignant tumor in the gynecological department during the same 27-year period was 0.18%. The mean age of the patients was 50.7 years. Twelve patients (92%) were within the age range from 41 to 59 years, the most common age of onset. Six patients (46%) were nulligravida and 9 (69%) were nulliparous, suggesting infertility as a possible important risk factor for the disease. None of the six who underwent cervical cytodiagnosis showed tumor cells. Three were positive for cytodiagnosis by aspiration biopsy. The concomitant use of many drugs, including CDDP given postoperatively to 2 patients with advanced disease, was markedly effective. The radiotherapy carried out in 4 patients was ineffective. When the patients were staged according to the classifications of Dodson et al. and Schiller et al., there was no difference between these classifications in advanced cases. However, Dodson et al.'s classification was considered unsuitable for patients with early-stage cancerous lesions localized in the fallopian tube, while that of Schiller et al. was considered to be superior in evaluating prognosis.

Deterioration of B cell proliferation correlates with dendritic reticulum cell destruction in germinal centers of an AIDS patient. Case study

A lymph node from a bisexual Caucasian male infected with human immunodeficiency virus (HIV) and in the persistent generalized lymphadenopathy (PGL) stage was studied. Dendritic reticulum cells (DRCs) were well preserved in over half of the germinal centers (GCs), while in the rest, they showed marked destruction, producing patchy or rather wide DRC-depleted areas. Proliferation-associated antigens, i.e., PC antigen and DNA-polymerase alpha, were demonstrated in nuclei of germinal center B cells in areas where the DRC network was intact, while they were prominently depleted in areas where the DRC network was lost. The p-24 viral core antigen was shown to be localized in DRCs, especially those in the process of degeneration. These results suggest that the DRC in this patient, when infected with HIV, were destroyed, and that the resulting DRC depletion led to the suppression of B cell proliferation in GCs.

Light and electron microscopic studies of a case with simultaneous Mondini and Michel deformities of the inner ears

We performed light and electron microscopic studies on the temporal bones of a patient with genetic aplastic deafness, in which the right ear had a Mondini-type defect and the left ear a Michel-type anomaly. The round window of each ear was absent. The stapedial foot plate of the right ear was depressed at its central part and was covered by thin membrane. The course of the internal auditory meatus of the left ear was deviated ventrally. There was total aplasia of the cochlea in the left ear, while that of the right ear showed only three-quarters of a turn. In this ear, three sites of spherical bulging were found and were believed to represent outer hair cells. Other structures of the normal cochlear duct were not present. The modiolus of the left ear was round and dome-shaped, contained sparse nerve fibers and a primitive spiral ganglion. The saccule, utricle and semicircular canals of each ear were missing, so that a common cavity of the vestibular system was present. Several otoliths could be seen under the surface of the membrane covering the common cavity. No sensory cells or their related tissues could be found in either ear.

[Studies on Campylobacter and Salmonella in feces of pregnant women and newborn infants]

Fecal cultures from five thousand four hundred and twenty-seven pregnant women, who were delivered at Osaka National Hospital from January 1, 1980 to December 31, 1984, were examined to detect intestinal Campylobacter and Salmonella during 30 and 36 gestational weeks. In addition, the feces of newborn infants were cultured three days after delivery to check for the presence of Campylobacter and Salmonella. During pregnancy, Campylobacter was detected in the feces of 116 women (2.14%), and Salmonella in 99 cases (1.82%). By administering antibiotics to the affected cases, the number of women whose fecal cultures were positive for Campylobacter and Salmonella at the time of delivery was reduced to 8 and 15, respectively. Neonatal fecal cultures revealed that Salmonella infection occurred in two among fifteen (13.33%) and Campylobacter infection in three among eleven (27.27%) infants whose mothers had been affected. These findings suggest the importance of adequate management for these bacterial infections during pregnancy and the perinatal period to prevent danger to the newborn.

[Relationship between circulating androgens and ovarian hyperstimulation syndrome in anovulatory patients treated with hMG-hCG]

In order to evaluate relationship between circulating androgens levels and development of ovarian hyperstimulation syndrome (OHS) in anovulatory patients treated sequentially with hMG and hCG, serum concentrations of androstenedione (A), testosterone (T) as well as estradiol (Ed) were measured serially in a total of 17 anovulatory patients including 9 who did not develop OHS and 8 who developed mild or moderate OHS. Increase of Ed levels during the period of hMG treatment varied remarkably in individual patients with OHS ranging from 7.2 to 190.1 times as much the pretreatment value. On the other hand, increase of A levels during the hMG treatment was recorded in the range from 2.0 to 3.2 times as much the pretreatment value in 4 patients with mild OHS, and from 1.5 to 5.9 in 4 patients with moderate OHS. However, the ratio of A increase remained within 1.4 times in patients without OHS. A transient increase of circulating T was observed in 2 days after commencement of hCG treatment, ranging between 1.4 and 3.2 times in patients without OHS, between 1.8 and 2.4 times in patients with mild OHS and between 3.8 and 6.8 times in patients with moderate OHS. It is concluded that serial measurements of A and T during the course of hMG and hCG treatments respectively appear to be an additional index other than Ed to predict development of OHS.

[A progesterone-dependent step in HCG-induced ovulation in immature rats (author's transl)]

The effect of antiserum to progesterone on follicular rupture during the ovulatory process was studied. Mean number of ova shed following treatment of immature rats sequentially with PMS and hCG was reduced in a dose-dependent manner by simultaneous injection with increasing doses of antiserum to progesterone. When the animal received 1.2 ml of the antiserum, hCG-induced ovulation was blocked completely. To be effective, antiserum treatment had to be within 6 h of hCG treatment; antiserum given 9 h after hCG was ineffective. Progesterone restored' the antiserum blocked ovulation completely or incompletely when administered intravenously within 6 h of treatment with hCG. The first 6 h was shown to be a progesterone-dependent step in the ovulatory process in this experimental system.

A progesterone-dependent step in ovulation induced by human chorionic gonadotrophin in immature rats primed with pregnant mare serum gonadotrophin

In immature rats primed with pregnant mare serum gonadotrophin, antiserum to progesterone could prevent or reduce ovulation in response to injected human chorionic gonadotrophin (HCG). To be effective, antiserum treatment had to be within 6 h of gonadotrophin treatment; antiserum given 9 h after HCG was ineffective. Progesterone restored the antiserum blocked ovulation completely or incompletely when administered intravenously within 6 h of treatment with HCG. The first 6 h was shown to be a progesterone-dependent step in the ovulatory process in this experimental system.

[Laboratory and clinical studies on cefoperazone in pediatrics treatment (author's transl)]

Laboratory and clinical studies of cefoperazone (CPZ), a new semisynthetic cephalosporin, were investigated and following results were obtained. (1) Blood level: CPZ was given intravenous dose of 25 mg/kg and 50 mg/kg to each 3 children. In the former, the blood level of 15 minutes after injection was 194.2 mcg/ml on average and the half life was 106.2 minutes. In the latter, the blood level was 320.0 mcg/ml on average and half life was 102.2 minutes. (2) Urinary concentration: In the cases of the dose of 25 mg/kg, 35.9% of CPZ was recovered on average from the urine within 6 hours after injection, and the urinary concentration reached to 2,148.6 mcg/ml (0 approximately 2 hours). And in the cases of the dose of 50 mcg/kg, the recovery rate in urine was 43.6%, and the urinary concentration was 3,008.3 mcg/ml. (3) Cerebrospinal fluid level: CSF level was determined in a patient with bacterial meningitis by S. pneumoniae. Ninety mg/kg of CPZ were given intravenous injection. After 60 minutes CSF level was 3.35 mcg/ml, and after 80 minutes the blood level was 192.0 mcg/ml. (4) Bacteriological evaluation: Against 164 strains isolated clinical specimens, the bacteriological evaluation on CPZ was performed in comparison with cefotaxime (CTX), cefazolin (CEZ) and piperacillin (PIPC) by inoculum size of 10(8) cells/ml. CPZ showed antibacterial activity against Gram-negative bacteria almost similar to CTX and PIPC. (5) CLINICAL RESULTS: CPZ was given 48.3 approximately 360 mg/kg/day (average 146.1 mg/kg/day) by intravenous route to 46 patients with various infection. The overall efficacy rate was 80.4%. The rate of bacteriological effectiveness was 78.9% in 19 cases. (6) Side effects: As side effects, diarrhea, fever, rash, urticaria, leukopenia, eosinophilia, elevation of GOT, GPT, and LDH were observed, but not seriously.

[Dual action of prostaglandins in the regulation of HCG-induced ovulation in immature rats (author's transl)]

With the aid of indomethacin, a potent inhibitor of prostaglandin synthesis, the mechanism of action of prostaglandins on follicle rupture was studied. Mean number of ova shed following treatment of immature rats sequentially with PMS and hCG was reduced in a dose-dependent manner by simultaneous injection with increasing doses of indomethacin. The minimum effective dose to block ovulation completely was 90 micrograms. However, the anti-ovulatory action of the minimum effective dose at 0 h became progressively less potent as the time between hCG injection and indomethacin administration was increased. Another dose-dependent relationship was found 10 h after hCG injection, the closest time prior to the onset of ovulation, the minimum effective dose necessary to prevent ovulation was 8 times higher than at 0 h, suggesting that prostaglandins acted differently on ovulation in the later stage of the preovulatory process. It is concluded that prostaglandins may mediate the action of hCG on ovulation at least through two mechanisms.

Inhibition by indomethacin of ovulation induced by human chorionic gonadotrophin in immature rats primed with pregnant mare serum gonadotrophin

Treatment of immature rats with pregnant mare serum gonadotrophin followed by human chorionic gonadotrophin (HCG) caused an acute and temporary increase in concentrations of progesterone, testosterone and oestradiol in plasma with maximum levels 3 h after the administration of HCG. Concurrent injection of indomethacin and HCG reduced, in a dose-dependent manner, the mean number of ova shed and this was accompanied by a dose-dependent decrease in concentrations of plasma progesterone and testosterone but not of oestradiol when they were measured 3 h after the injection of HCG. The minimum effective dose that blocked ovulation completely at 0 h abolished the acute increase of progesterone and testosterone, suggesting that prostaglandins act on ovulation by stimulating steroidogenesis at an early stage in the preovulatory process. The anti-ovulatory action of the minimum effective dose at 0 h became progressively less potent as the time between injection of HCG and administration of indomethacin was increased, although plasma concentrations of progesterone and testosterone measured at autopsy 18 h after treatment with HCG had not changed appreciably. When indomethacin was administered 10 h after HCG, the relationship between the dose of indomethacin and the mean number of ova differed from that observed when simultaneous injections of indomethacin and HCG were given, and the minimum effective dose that prevented ovulation was much higher than that at 0 h, suggesting that prostaglandins act differently on ovulation in the later stage of the preovulatory process. It was concluded that prostaglandins may mediate the action of HCG on ovulation through two mechanisms which operate at different stages of the preovulatory process.