Direct visualization of the three-dimensional shape of skyrmion strings in a noncentrosymmetric magnet

Magnetic skyrmions are topologically stable swirling spin textures that appear as particle-like objects in two-dimensional (2D) systems. Here, utilizing scalar magnetic X-ray tomography under applied magnetic fields, we report the direct visualization of the three-dimensional (3D) shape of individual skyrmion strings in the room-temperature skyrmion-hosting non-centrosymmetric compound Mn_1.4Pt_0.9Pd_0.1Sn. Through the tomographic reconstruction of the 3D distribution of the [001] magnetization component on the basis of transmission images taken at various angles, we identify a skyrmion string running through the entire thickness of the sample, as well as various defect structures, such as the interrupted and Y-shaped strings. The observed point defect may represent the Bloch point serving as an emergent magnetic monopole, as proposed theoretically. Our tomographic approach with a tunable magnetic field paves the way for direct visualization of the structural dynamics of individual skyrmion strings in 3D space, which will contribute to a better understanding of the creation, annihilation and transfer of these topological objects.

Transplantation of a bone marrow mesenchymal stem cell line increases neuronal progenitor cell migration in a cerebral ischemia animal model

Mesenchymal stem cell (MSC) transplantation is demonstrated to improve functional and pathological recovery in cerebral ischemia. To understand the underlying mechanism, we transplanted a MSC line (B10) in a rat middle cerebral artery occlusion (MCAO) model and checked the proliferation and migration of neuronal progenitor cells (NPCs). B10 transplantation increased NPCs in the subventricular zone and their migration towards the lesion area at an earlier time. Fourteen days after MCAO, some NPCs were differentiated to neurons and astrocytes. Although B10 transplantation increased total number of both astrocytes and neurons, it only increased the differentiation of NPC to astrocyte. The mRNA of polysialylation enzyme ST8SiaIV and a chemokine SDF-1 were persistently increased in B10-transplanted groups. SDF-1-positive cell number was increased in the core and penumbra area, which was expressed in macrophage/microglia and transplanted B10 cells at 3 days after MCAO. Furthermore, SDF-1 mRNA expression in cell culture was high in B10 compared to a microglia (HMO) or a neuronal (A1) cell line. B10 culture supernatant increased in vitro A1 cell migration, which was significantly inhibited by siRNA-mediated SDF-1 silencing in B10. Thus, our results suggested that MSC transplantation increased endogenous NPC migration in cerebral ischemic condition by increasing chemokine and polysialylation enzyme expression, which could be helpful for the restorative management of cerebral ischemia.

The relationship between the glenoid track and the range of shoulder motion: A cadaver study

INTRODUCTION

The concept of the glenoid track has been proposed to evaluate the risk of dislocation. The glenoid track width was demonstrated to be 84% of the glenoid width in cadaveric shoulders and 83% in live shoulders.

HYPOTHESIS

The glenoid track width seems to be affected by the range of motion.

PURPOSE

The purpose of this study was to determine the relationship between the glenoid track and the range of shoulder motion.

METHODS

Ten fresh-frozen cadaveric shoulders were used. The specimen was fixed to a shoulder-positioning device. The anterior rim of the glenoid was marked on the humeral head using a Kirschner wire with the arm in 60° of abduction. This marking was repeated with the arm in (1) horizontal flexion/extension and (2) internal/external rotations (0° to max). The distances from the Kirschner wire markings to the footprint of the rotator cuff tendon were measured.

RESULTS

The greater the angle of the horizontal extension or external rotation, the smaller the glenoid track width, whereas the greater the angle of the horizontal flexion or internal rotation, the greater the glenoid track width. There was a negative relationship between them. The horizontal flexion/extension motion was demonstrated to affect the glenoid track width more than the internal/external rotation motion.

CONCLUSION

The glenoid track width decreased with the increase of horizontal extension. We should consider the range of horizontal extension angle when applying the glenoid track concept in clinical practice.

TYPE OF STUDY

Laboratory study.

Quantification of CSF cystatin C using liquid chromatography tandem mass spectrometry

BACKGROUND

Cystatin C (CST3), a ubiquitously expressed cysteine protease inhibitor, is implicated in several neurological diseases. Here, we have developed an accurate CST3 measurement system based on liquid chromatography tandem mass spectrometry (LC-MS/MS).

METHODS

LC-MS/MS based measurement for CSF CST3 was validated by determination of assay precision, accuracy and recovery. The values were compared with those measured by immunoassay. Glycosylation of CST3 in CSF was analyzed by Western blotting and lectin blotting.

RESULTS

Measuring standard CST3 by LC-MS/MS produced a linear standard curve that correlated with assigned values (r²=0.99). Both intra- and inter-assay variation was <10%. Although showed a correlation, the average CST3 concentration measured by LC-MS/MS was significantly higher than that of immunoassay. Western blotting showed the presence of a 25KDa species along with CST3 monomer (14KDa) in CSF. The volume of 25KDa species was decreased by deglycosylation. Lectin blotting revealed a 25KDa glycosylated protein in sialidase-treated CSF, which was decreased by deglycosylation. However, deglycosylation did not alter CST3 concentration measured by immunoassay.

CONCLUSIONS

Our results suggest that LC-MS/MS-based CST3 measurement is a robust method with higher detection ability. Such method could be useful for the diagnosis and monitoring of neurological diseases.

Evaluation of autonomic functions of patients with multiple system atrophy and Parkinson's disease by head-up tilt test

The aim of this study was to evaluate the autonomic neural function in Parkinson's disease (PD) and multiple system atrophy (MSA) with head-up tilt test and spectral analysis of cardiovascular parameters. This study included 15 patients with MSA, 15 patients with PD, and 29 healthy control (HC) subjects. High frequency power of the RR interval (RR-HF), the ratio of low frequency power of RR interval to RR-HF (RR-LF/HF) and LF power of systolic BP were used to evaluate parasympathetic, cardiac sympathetic and vasomotor sympathetic functions, respectively. Both patients with PD and MSA showed orthostatic hypotension and lower parasympathetic function (RR-HF) at tilt position as compared to HC subjects. Cardiac sympathetic function (RR-LF/HF) was significantly high in patients with PD than MSA at supine position. RR-LF/HF tended to increase in MSA and HC, but decreased in PD by tilting. Consequently, the change of the ratio due to tilting (ΔRR-LF/HF) was significantly lower in patients with PD than in HC subjects. Further analysis showed that compared to mild stage of PD, RR-LF/HF at the supine position was significantly higher in advanced stage. By tilting, it was increased in mild stage and decreased in the advanced stage of PD, causing ΔRR-LF/HF to decrease significantly in the advanced stage. Thus, we demonstrated that spectral analysis of cardiovascular parameters is useful to identify sympathetic and parasympathetic disorders in MSA and PD. High cardiac sympathetic function at the supine position, and its reduction by tilting might be a characteristic feature of PD, especially in the advanced stage.

[A case of MM1+2 Creutzfeldt-Jakob disease with a longitudinal study of EEG and MRI]

We report a case of definite MM1 + 2 sporadic Creutzfeldt-Jakob disease (sCJD). A 66-year-old woman was admitted to our hospital with memory disturbance and disorientation for three months. On admission she presented a progressive cognitive insufficiency. Electroencephalography (EEG) revealed a frontal intermittent rhythmical delta activity (FIRDA) and the brain magnetic resonance imaging (MRI) showed high signal intensities in cerebral cortex on diffusion weighted images (DWI). After four months from the onset, she reached the akinetic mutism state followed by myoclonus. Follow up examination revealed that periodic synchronous discharge (PSD) was found in EEG, and DWI revealed enlargement of high signal intensity lesions in cerebral cortex. At seven months from the onset, PSD and high signal intensities of cortex became unclear with disappearance of myoclonus, and brain white matter lesions were evident on MRI. Serial studies of EEG and MRI revealed that PSD generalized from frontal lobe dominant pattern, while high signal intensity lesions of cortex diffusely increased on DWI. At ten months from the onset patient died. Pathological examination in brain showed moderate and diffuse neuronal cell loss and gliosis in cerebral cortex corresponding with DWI changes. The genotype at codon 129 of the prion protein (PrP) was homozygous methionine (MM) and the type of protease-resistant PrP (PrPres) was the mixed type of 1 and 2 in Western blot analysis. It has been rare to analyze the changes of EEG and MRI in the entire stage and to investigate pathological finding in the case of sCJD-MM1 + 2. A longitudinal examination of EEG and MRI is useful for early diagnosis of CJD. Also we could correlate these findings with clinical and histopathological phenotype.

Cystatin C induces apoptosis and tyrosine hydroxylase gene expression through JNK-dependent pathway in neuronal cells

Cystatin C (CysC), an endogenous cysteine protease inhibitor, has been implicated in the apoptosis and differentiation processes of neuronal cells. In this study, we have investigated the pathway involved in the process. A human neuronal hybridoma cell line (A1 cell) was treated with CysC in both undifferentiated and retinoic acid (RA)-induced differentiated conditions, which decreased overall process length in both conditions. Also, CysC increased apoptotic cell number time-dependently, as revealed by TUNEL assay. Western blot analysis demonstrated that in differentiated A1 cells, CysC treatment decreased Bcl-2 and increased active caspase-9 protein level time-dependently. Immunocytochemistry results revealed that, CysC treatment significantly increased active form of Bax expressing cell number, which co-localized with mitochondria. Mitogen activated protein (MAP) kinase inhibition experiments showed that Bax mRNA induction and Bcl-2 mRNA inhibition by CysC treatment were c-Jun N-terminal kinase (JNK)-dependent. After RA-induced differentiation, choline acetyltransferase (ChAT) and neurofilament (NF) mRNA levels were increased in A1 cells. CysC treatment inhibited NF mRNA level in both undifferentiated and RA-differentiated, and increased TH mRNA in differentiated A1 neurons. Analysis of signal transduction pathway demonstrated that TH gene induction was also JNK-dependent. Thus, our results demonstrated the significance of JNK-dependent pathways on CysC-induced apoptosis and TH gene expression in neuronal cells, which might be an important target in the management of CysC dependent neurodegenerative processes.

Transplantation of human mesenchymal stem cells promotes functional improvement and increased expression of neurotrophic factors in a rat focal cerebral ischemia model

Previous studies have suggested that intravenous transplantation of mesenchymal stem cells (MSCs) in rat ischemia models reduces ischemia-induced brain damage. Here, we analyzed the expression of neurotrophic factors in transplanted human MSCs and host brain tissue in rat middle cerebral artery occlusion (MCAO) ischemia model. At 1 day after transient MCAO, 3 x 10(6) immortalized human MSC line (B10) cells or PBS was intravenously transplanted. Behavioral tests, infarction volume, and B10 cell migration were investigated at 1, 3, 7, and 14 days after MCAO. The expression of endogenous (rat origin) and exogenous (human origin) neurotrophic factors and cytokines was evaluated by quantitative real-time RT-PCR and Western blot analysis. Compared with PBS controls, rats receiving MSC transplantation showed improved functional recovery and reduced brain infarction volume at 7 and 14 days after MCAO. In MSC-transplanted brain, among many neurotrophic factors, only human insulin-like growth factor 1 (IGF-1) was detected in the core and ischemic border zone at 3 days after MCAO, whereas host cells expressed markedly higher neurotrophic factors (rat origin) than control rats, especially vascular endothelial growth factor (VEGF) at 3 days and epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) at 7 days after MCAO. Intravenously transplanted human MSCs induced functional improvement, reduced infarct volume, and neuroprotection in ischemic rats, possibly by providing IGF-1 and inducing VEGF, EGF, and bFGF neurotrophic factors in host brain.

Microglia transplantation attenuates white matter injury in rat chronic ischemia model via matrix metalloproteinase-2 inhibition

Chronic cerebral ischemia is thought to induce white matter lesions (WMLs), which contribute to subcortical vascular dementia. Although glial activation and protease upregulation are believed to modify WML pathology, effective therapy remains elusive. Here, we compare the efficacy of microglial cell transplantation and mesenchymal stem cell (MSC) transplantation in protecting against WML development in a chronic cerebral hypoperfusion rat model. A microglial cell line (HMO6), MSC cell line (B10) or vehicle (phosphate-buffered saline; PBS) was intravenously injected, and the appearance and severity of WMLs were evaluated. Transplanted HMO6 and B10 cells migrated to sites of WMLs, including the corpus callosum (CC) and caudoputamen (CP), reduced the severity of WMLs, and inhibited the accumulation and activation of microglia and astrocytes. Transplantation of both cell types reduced the level of matrix metalloproteinase (MMP)-2 mRNA in microglia of the CC. MMP-2 protein level and activity were also both greatly reduced in the same region. Our results indicate that transplantation of either microglial cells or mesenchymal stem cells could inhibit chronic cerebral ischemia-induced WML formation by decreasing MMP-2 expression in microglia and decreasing MMP-2 activity in the CC region.

Large voltage-induced magnetic anisotropy change in a few atomic layers of iron

In the field of spintronics, researchers have manipulated magnetization using spin-polarized currents. Another option is to use a voltage-induced symmetry change in a ferromagnetic material to cause changes in magnetization or in magnetic anisotropy. However, a significant improvement in efficiency is needed before this approach can be used in memory devices with ultralow power consumption. Here, we show that a relatively small electric field (less than 100 mV nm(-1)) can cause a large change (approximately 40%) in the magnetic anisotropy of a bcc Fe(001)/MgO(001) junction. The effect is tentatively attributed to the change in the relative occupation of 3d orbitals of Fe atoms adjacent to the MgO barrier. Simulations confirm that voltage-controlled magnetization switching in magnetic tunnel junctions is possible using the anisotropy change demonstrated here, which could be of use in the development of low-power logic devices and non-volatile memory cells.

Calculation of 10 MV x-ray spectra emitted by a medical linear accelerator using the BFGS quasi-Newton method

To calculate photon spectra for a 10 MV x-ray beam emitted by a medical linear accelerator, we performed numerical analysis using the aluminium transmission data obtained along the central axis of the beam under the narrow beam condition corresponding to a 3x3 cm2 field at a 100 cm distance from the source. We used the BFGS quasi-Newton method based on a general nonlinear optimization technique for the numerical analysis. The attenuation coefficients, aluminium thicknesses and measured transmission data are necessary inputs for the numerical analysis. The calculated x-ray spectrum shape was smooth in the lower to higher energy regions without any angular components. The x-ray spectrum acquired by the employed method was evaluated by comparing the measurements along the central axis percentage depth dose in a water phantom and by a Monte Carlo simulation code, the electron gamma shower code. The values of the calculated percentage depth doses for a 10x10 cm2 field at a 100 cm source-to-surface distance in a water phantom were obtained using the same geometry settings as those of the water phantom measurement. The differences in the measured and calculated values were less than +/-1.0% for a broad region from the shallow part near the surface to deep parts of up to 25 cm in the water phantom.

A theoretical study of the dynamic behavior of alkane hydroxylation by a compound I model of cytochrome P450

Dynamic aspects of alkane hydroxylation mediated by Compound I of cytochrome P450 are discussed from classical trajectory calculations at the B3LYP level of density functional theory. The nuclei of the reacting system are propagated from a transition state to a reactant or product direction according to classical dynamics on a Born-Oppenheimer potential energy surface. Geometric and energetic changes in both low-spin doublet and high-spin quartet states are followed along the ethane to ethanol reaction pathway, which is partitioned into two chemical steps: the first is the H-atom abstraction from ethane by the iron-oxo species of Compound I and the second is the rebound step in which the resultant iron-hydroxo complex and the ethyl radical intermediate react to form the ethanol complex. Molecular vibrations of the C-H bond being dissociated and the O-H bond being formed are significantly activated before and after the transition state, respectively, in the H-atom abstraction. The principal reaction coordinate that can represent the first chemical step is the C-H distance or the O-H distance while other geometric parameters remain almost unchanged. The rebound process begins with the iron-hydroxo complex and the ethyl radical intermediate and ends with the formation of the ethanol complex, the essential process in this reaction being the formation of the C-O bond. The H-O-Fe-C dihedral angle corresponds to the principal reaction coordinate for the rebound step. When sufficient kinetic energy is supplied to this rotational mode, the rebound process should efficiently take place. Trajectory calculations suggest that about 200 fs is required for the rebound process under specific initial conditions, in which a small amount of kinetic energy (0.1 kcal/mol) is supplied to the transition state exactly along the reaction coordinate. An important issue about which normal mode of vibration is activated during the hydroxylation reaction is investigated in detail from trajectory calculations. A large part of the kinetic energy is distributed to the C-H and O-H stretching modes before and after the transition state for the H-atom abstraction, respectively, and a small part of the kinetic energy is distributed to the Fe-O and Fe-S stretching modes and some characteristic modes of the porphyrin ring. The porphyrin marker modes of nu(3) and nu(4) that explicitly involve Fe-N stretching motion are effectively enhanced in the hydroxylation reaction. These vibrational modes of the porphyrin ring can play an important role in the energy transfer during the enzymatic process.

[A case of idiopathic interstitial pneumonia that responded well to intermittent intravenous administration of high doses of cyclophosphamide and a steroid]

A 78-year-old man was hospitalized on February 29, 2000 because of dyspnea. A chest radiograph showed diffuse bilateral interstitial shadows associated with pulmonary volume loss. We could not obtain histological evidence of idiopathic interstitial pneumonia (IIP) because of his advanced age and severe respiratory dysfunction. IIP was diagnosed on the basis of radiographic findings and clinical symptoms. The patient was intubated and mechanical ventilation was performed. After one course of pulsed cyclophosphamide (CPM) and methylprednisolone therapy, the hypoxemia improved and it became possible to wean the patient from the ventilator. After five courses of pulsed CPM therapy, the dose of oral corticosteroid was tapered. CPM was administered safely without any severe side effects. Pulsed CPM therapy appears to be a viable alternative method of treatment for IIP.

A theoretical study of alcohol oxidation by ferrate

The conversion of methanol to formaldehyde mediated by ferrate (FeO(4)2-), monoprotonated ferrate (HFeO4-), and diprotonated ferrate (H2FeO4) is discussed with the hybrid B3LYP density functional theory (DFT) method. Diprotonated ferrate is the best mediator for the activation of the O-H and C-H bonds of methanol via two entrance reaction channels: (1) an addition-elimination mechanism that involves coordination of methanol to diprotonated ferrate; (2) a direct abstraction mechanism that involves H atom abstraction from the O-H or C-H bond of methanol. Within the framework of the polarizable continuum model (PCM), the energetic profiles of these reaction mechanisms in aqueous solution are calculated and investigated. In the addition-elimination mechanism, the O-H and C-H bonds of ligating methanol are cleaved by an oxo or hydroxo ligand, and therefore the way to the formation of formaldehyde is branched into four reaction pathways. The most favorable reaction pathway in the addition-elimination mechanism is initiated by an O-H cleavage via a four-centered transition state that leads to intermediate containing an Fe-O bond, followed by a C-H cleavage via a five-centered transition state to lead to formaldehyde complex. In the direct abstraction mechanism, the oxidation reaction can be initiated by a direct H atom abstraction from either the O-H or C-H bond, and it is branched into three pathways for the formation of formaldehyde. The most favorable reaction pathway in the direct abstraction mechanism is initiated by C-H activation that leads to organometallic intermediate containing an Fe-C bond, followed by a concerted H atom transfer from the OH group of methanol to an oxo ligand of ferrate. The first steps in both mechanisms are all competitive in energy, but due to the significant energetical stability of the organometallic intermediate, the most likely initial reaction in methanol oxidation by ferrate is the direct C-H bond cleavage.

Atomic-beam alignment of inorganic materials for liquid-crystal displays

The technique used to align liquid crystals-rubbing the surface of a substrate on which a liquid crystal is subsequently deposited-has been perfected by the multibillion-dollar liquid-crystal display industry. However, it is widely recognized that a non-contact alignment technique would be highly desirable for future generations of large, high-resolution liquid-crystal displays. A number of alternative alignment techniques have been reported, but none of these have so far been implemented in large-scale manufacturing. Here, we report a non-contact alignment process, which uses low-energy ion beams impinging at a glancing angle on amorphous inorganic films, such as diamond-like carbon. Using this approach, we have produced both laptop and desktop displays in pilot-line manufacturing, and found that displays of higher quality and reliability could be made at a lower cost than the rubbing technique. The mechanism of alignment is explained by adopting a random network model of atomic arrangement in the inorganic films. Order is induced by exposure to an ion beam because unfavourably oriented rings of atoms are selectively destroyed. The planes of the remaining rings are predominantly parallel to the direction of the ion beam.

Churg-Strauss syndrome associated with pregnancy

Churg-Strauss syndrome, an uncommon condition, occurs even more rarely in association with pregnancy. One month postpartum, a 25-year-old Japanese woman was hospitalized for dyspnea, fever, diarrhea, and complaints of dysesthesia in the right lower limb and right lumbar and abdominal region. Marked eosinophilia was present. Symptoms of bronchial asthma had developed early in the pregnancy, which concluded with delivery of a healthy baby at 39 weeks of gestation. Churg-Strauss syndrome was diagnosed and prednisolone was administered with a good response leading to remission. Three years after the first pregnancy, low-dose steroid therapy was continued through another pregnancy. The patient delivered another healthy baby at 39 weeks of gestation, this time with no exacerbation of symptoms.

Acute eosinophilic pneumonia following cigarette smoking

Two cases of acute eosinophilic pneumonia following cigarette smoking are analyzed for characteristic features. The first patient noted dyspnea 14 days after initiation of smoking. The second patient noted dyspnea 12 days after beginning to smoke. Both cases had characteristic features including occurrence at an age younger than 30 years; less than 1 month duration of cigarette smoking before onset of disease; and no identifiable cause of acute eosinophilic pneumonia apart from smoking. We believe that acute eosinophilic pneumonia following cigarette smoking, which has characteristic features as described above, should be considered as a distinct subtype of AEP.

Solitary bronchioloalveolar adenoma of the lung

A case of an unusual pulmonary neoplasia, called bronchioloalveolar adenoma of the lung, is reported. The neoplasm presented as a solitary peripheral lesion of the left lung on computed tomography. Examination of the tumor revealed a focal proliferating lesion consisting of cuboidal or peg-shaped epithelial cells with slight nuclear atypia. Immunohistochemical study with anti-carcinoembryonic antigen antibody, anti-surfactant apoprotein antibody, and anti-Clara cell antibody suggested that this neoplasia has the characteristics of a type II pneumocyte. It is likely that more of these small peripheral lesions, which have potential for evolution to carcinoma, will now be encountered due to the introduction of helical CT of the chest.

Factors influencing response to treatment of pulmonary tuberculosis

We analyzed 150 patients with pulmonary tuberculosis from 1990 to 1996 (i) to evaluate the frequency of drug resistance, (ii) to elucidate factors influencing the response to chemotherapy, and (iii) to attempt to improve the therapeutic approach. Multidrug-resistant tuberculosis strains were not found. By univariate analysis, there were 8 factors associated with an increased sputum conversion time: male gender, prior treatment, complications, progressive chest radiographic findings, a high Ziehl-Neelsen stain score, lymphocytopenia, a high erythrocyte sedimentation rate (ESR), and hypoproteinemia. Complications, prior treatment, a high Ziehl-Neelsen stain score, and a high ESR were independent predictive factors in a Cox proportional hazard model. Recursive partitioning and amalgamation (RPA) defined 3 subgroups that responded to treatment. In order to reduce the time to sputum conversion, poor responders according to the RPA should be treated with a 4-drug regimen containing pyrazinamide.

[Bronchiolo-alveolar cell carcinoma of the lung presenting as spontaneous pneumothorax]

A 30-year old man visited a local clinic complaining of dyspnea and chest pain. He had a history of hepatocystadenocarcinoma 10 years before. Pneumothorax was diagnosed. Immediately, the patient was referred to us and underwent a tube thoracostomy. Cytologic examination of pleural effusion specimens revealed malignant cells. Because pleural drainage and pleurodesis using anti-cancer agents were not effective, we performed a thoracotomy. A tumor with accompanying bulla was detected in the right S6 region and a right lower lobectomy was performed. Histologic examination of tumor specimens disclosed bronchiolo-alveolar cell carcinoma. We speculated that bullae formed by tumor invasion, had burst, resulting in pneumothorax. This was a case of asynchronous double cancer in a relatively young patient, and the first report in Japan of bronchiolo-alveolar cell carcinoma presenting with spontaneous pneumothorax as an initial symptom.

Lung cancer associated with pulmonary bulla. case report and review of literature

A few reports have suggested the possible association between lung cancer and bullous disease. We report a surgical case of lung adenocarcinoma located in close proximity to pulmonary bullae. A 48-year-old nonsmoker, asymptomatic male was found to have a pulmonary tumor mass and giant bulla in the right lung. Thoracotomy identified a tumor arising from a firm, scarred and contracted area close to the bulla wall. Based on this report and review of other cases in the literature, we emphasize the need for physicians to be aware of the potential development of lung cancer in patients with pulmonary bulla.

Biosynthesis and turnover of anandamide and other N-acylethanolamines in peritoneal macrophages

Polyunsaturated N-acylethanolamines (NAEs), including anandamide (20:4n-6 NAE), elicit a variety of biological effects through cannabinoid receptors, whereas saturated and monounsaturated NAEs are inactive. Arachidonic acid mobilization induced by treatment of intact mouse peritoneal macrophages with Ca2+ ionophore A23187 had no effect on the production of NAE or its precursor N-acylphosphatidylethanolamine (N-acyl PE). Addition of exogenous ethanolamine resulted in enhanced NAE synthesis by its N-acylation with endogenous fatty acids, but this pathway was not selective for arachidonic acid. Incorporation of (18)O from H2 (18)O-containing media into the amide carbonyls of both NAE and N-acyl PE demonstrated a rapid, constitutive turnover of both lipids.

Benign asbestos pleural effusion associated with pulmonary aspergilloma

A rare case of benign asbestos pleural effusion associated with aspergilloma is reported. A chest radiograph of a 75-year-old Japanese man who was admitted with right chest pain showed a right pleural effusion and nodular shadows in the right apex and left middle lung field. Thoracocentesis revealed an exudate with atypical mesothelial cells. An open lung biopsy showed aspergilloma in the right S2 area and no evidence of malignancy. Many reactive mesothelial cells were found in the pleura. A quantitative asbestos digestion study of the lung tissue biopsy showed high-grade asbestos exposure.

Novel mitochondrial DNA mutation in tRNA(Lys) (8296A-->G) associated with diabetes

Mutation in the mitochondrial gene at position 3243 was recently identified in a large pedigree of diabetes mellitus and deafness. As the mitochondria play an important role in glucose-stimulated insulin secretion in pancreatic beta-cells, we therefore searched for such mutations to detect a candidate gene for diabetes. We screened 10 diabetic subjects with clinical features suggesting mitochondrial DNA mutations. An adenine to guanine point mutation in tRNA(Lys) in at position 8296 (the 8296 mutation) was newly identified. Subsequently, we screened 1216 diabetic subjects, 44 patients with sensorineural deafness subjects and 300 non-diabetic control subjects for this mutation. We identified the mutation in 11 (0.90%) unrelated diabetic subjects, one (2.3%) patient with deafness and no non-diabetic control subject. Seven of these 12 subjects showed maternal inheritance. Deafness was seen in 7 of 12 probands. Four family pedigrees showed maternal inheritance of diabetes over two or three generations. Subjects carrying the 8296 mutation may develop diabetes and the mutation can explain as high as ca. 1% of the causes of diabetes.

Two familial mesothelioma cases with high concentrations of soluble cytokeratin 19 fragment in pleural fluid

We report two cases of diffuse malignant pleural mesothelioma occurring almost simultaneously in one family. Patient 1 was a 42-year-old Japanese man who had worked as an electrical engineer for 25 years. Patient 2, his mother, was 69 years old. She lived for 10 years with patient 1 after he started his work, and also worked at a shipyard herself for 6 years. The concentrations of cytokeratin subunit 19 fragment (CYFRA 21-1) in pleural fluid of the two patients were 1,500 ng/ml, and 1,200 ng/ml, respectively. Measurement of CYFRA 21-1 concentration in the pleural fluid may be a useful tool for a diagnosis of malignant mesothelioma.

The usefulness of CYFRA 21-1 in diagnosing and monitoring malignant pleural mesothelioma

Five patients with malignant pleural mesothelioma (MPM) were studied to determine whether CYFRA 21-1 is useful for diagnosis of this disease. In pleural effusions, the median concentration of CYFRA 21-1 from 4 patients with MPM was significantly higher than for 34 patients with benign diseases. The sensitivity of serum CYFRA 21-1 for diagnosis of MPM was 40% and its concentration changed in proportion to disease activity in all cases. Immunohistochemically, anticytokeratin 19 antibody revealed strong staining in both epithelial and sarcomatous MPM tissues. Based on these results, we conclude that measurement of CYFRA 21-1 in pleural effusions and serum may be useful for diagnosing and monitoring MPM.

Serum interleukin-5 levels in a case with allergic granulomatous angiitis

A 50-year-old woman with allergic granulomatous angiitis (AGA) presented with an elevated serum interleukin-5 (IL-5) level upon admission to a hospital. Administration of prednisolone showed marked improvement of asthmatic symptoms, reduced eosinophil counts of peripheral blood, and normalized serum IL-5 levels. This is the first report describing an elevated serum level of IL-5 in AGA. The present findings suggest that IL-5 is involved in the pathogenesis of AGA.

Adult respiratory distress syndrome induced by a Chinese medicine, Kamisyoyo-san

We report the first case of Kamisyoyo-san-induced adult respiratory distress syndrome (ARDS). A 59-year-old female was given Kamisyoyo-san for treatment of seborrheic dermatitis. She then presented with a respiratory illness having clinical, radiologic and functional characteristics of ARDS. Bronchoalveolar lavage fluid showed an increased number of lymphocytes, neutrophils and eosinophils. The lymphocyte stimulation test with Kamisyoyo-san was positive.

[A case of benign cystic teratoma growing in the thoracic cavity]

A case with benign cystic teratoma growing in the thoracic cavity, which is rare in Japan, in a 49-year-old woman is reported. She complained a chest pain suddenly. Chest X-ray examination revealed an abnormal shadow and pleural effusion in the right lung field. Chest CT scan and MRI disclosed a capsulated tumor in the thoracic cavity. During surgery the tumor had adhered to the part of the parietal pleura with no continuity with anterior mediastinum. The tumor measured 11.0 x 9.5 cm in size and was a mature cystic teratoma with pancreatic tissue, histologically. The fluid levels of amylase extracted from the tumor was highly elevated. Rupture due to autodigestion by pancreatic amylase of the tumor was supposed to be a cause of chest pain.

Soluble intercellular adhesion molecule 1 (ICAM-1) antigen in sera of bronchial asthmatics

Previous studies have suggested that intercellular adhesion molecule 1 (ICAM-1, CD54) may be involved in the pathogenesis of asthma. In addition, a soluble form of ICAM-1 (sICAM-1) has been detected in increased concentrations in the sera of patients with certain inflammatory conditions. To determine whether bronchial asthma is associated with increased levels of sICAM-1 in serum and to assess the effects of therapy on these levels, the concentrations of sICAM-1 were measured in sera of healthy donors and asthmatic patients. The mean (+/- SD) level of serum sICAM-1 for 60 asthmatic patients (304.0 +/- 82.5 ng/mL) was significantly higher than that for 39 healthy volunteers (260.9 +/- 67.2 ng/mL; p = 0.004). Twenty-two patients considered to have atopic asthma and 24 patients with nonatopic asthma did not differ in their levels of sICAM-1. In 14 patients, serum concentrations of sICAM-1 were higher during asthma attacks than in the same patients during remission (p = 0.035). Serum sICAM-1 levels were lower in nine patients during treatment with oral prednisolone (2.5 to 40 mg/d) than during periods without systemic corticosteroid therapy (p = 0.002). Thus, active bronchial asthma is associated with the presence of increased levels of sICAM-1 in serum, and these levels may be modulated by corticosteroid therapy.

[A case of chondrosarcoma of the low grade malignancy originated in rib]

A case with chondrosarcoma of rib, which is relatively uncommon in Japan, in a 61-year-old man is reported. Chest X-ray examination revealed an abnormal shadow in the right of the chest wall. Chest CT scan and MRI disclosed the tumor to have been arosen from the right 5th rib protruding into the thoracic cavity. Surgical resections of the tumor with parts of the 4th and 5th ribs and parietal pleura were performed. The defect of the chest wall was repaired with muscle. The tumor measured 3.0 x 3.0 x 3.5 cm in size and was a chondrosarcoma of the low grade malignancy, histologically. Post operative course was uneventful with no adjuvant therapy.

[Clinical study of bronchial asthma in adult, intractable asthmatics after introduction of guideline therapy]

Introduction of Guideline for asthma treatment proposed by the committee of Japanese allergology have a tremendous impact on patients with bronchial asthma. Intractable asthmatics who have had to take some oral steroid to overcome disease severity, may have also some merit by this treatment, so that some of them might be no longer considered as intractable asthmatics. To clarify this, multicenter study was conducted. In this study, a case who have had more than 5 mg of prednisolone and/or 800 mu g of beclomethasone dipropionate throughout the year, was diagnosed as intractable asthmatics. In 845 case, 14.7%, 123 cases were diagnosed as intractable. These cases were significantly to be non-atopic and adult onset. Also, they have a significant tendency to be deteriorated by infection and careless drug administrations. Using the multiquantification method to examine the most powerful factor on intractable asthmatics, type of asthmatics was the most important and the past history of severe attack was the second. When intractable asthmatics diagnosed mainly by their BDP usage (BDP-intractable) were compared with intractable diagnosed by oral PSL (PSL-intractables), BDP-intractables were significantly atopic compared to PSL-intractables.

[A case of tuberculosis in which hemoptysis was caused by bleeding from intercostal arteries]

A 60-year-old man was referred to our hospital because of persistent hemoptysis. Chest roentgenogram and computed tomogram revealed that the right hemithorax was almost completely occupied by solid material with scattered calcifications. Mycobacteria were detected in the sputum culture. Administration of antituberculosis agents began after admission. Four months after admission, massive hemoptysis occurred. Topical treatment via fiberoptic bronchoscopy resulted in no improvement. Surgical resection of the right lung would probably have been difficult because of the almost complete collapse of the right lung and the extensive calcifications within the right hemithorax. Angiographic examination revealed extravasation of contrast medium from the right 7th, 8th, 9th, 10th, and 12th intercostal arteries. After transcatheter embolization of each of these intercostal arteries, hemoptysis stopped. It is unclear how bleeding from intercostal arteries caused massive hemoptysis, but the bleeding may have caused a right hemothorax that drained into an airway.

[Computed tomography findings of malignant pleural mesothelioma]

Computed tomography (CT) findings were assessed in 7 patients with malignant mesothelioma. CT findings were also reviewed in 9 patients with lung cancer and pleuritis carcinomatosa and in 11 patients with tuberculous pleuritis. Five patients with malignant mesothelioma underwent CT scans twice, on admission and from 1 to 7 months after admission. Tuberculous pleuritis could be distinguished from pleuritis carcinomatosa and malignant mesothelioma by the presence or absence of pleural nodularity and chest wall invasion. Although it was difficult to identify specific CT features clearly distinguishing malignant mesothelioma from pleuritis carcinomatosa, characteristic findings of malignant mesothelioma appeared to include the rapid development and progression of pleural rind and a tendency to spread directly into the chest wall. We divided the pleura into the four regions; upper anterior, upper posterior, lower anterior and lower posterior regions. Pleural changes were more frequently seen in the lower pleural regions than in the upper pleural regions, in malignant mesothelioma.

[Serum levels of soluble ICAM-1 in asthmatic patients]

Serum soluble intercellular adhesion molecule-1 (sICAM-1) levels were measured in 54 asthmatic patients and 32 healthy subjects by sandwich enzyme-linked immunosorbent assay. Serum sICAM-1 levels in the asthmatic patients not undergoing steroid therapy were significantly higher than those in the healthy subjects and those in the asthmatic patients undergoing steroid therapy (p < 0.01 and p < 0.001, respectively). Serum sICAM-1 levels in the asthmatic patients during attack were not significantly different from those in the patients in remission. We studied changes in serum ICAM-1 levels in 13 asthmatic patients in remission and during attack and found that serum ICAM-1 levels during attack were significantly higher than those in remission (p < 0.05). The origin of serum soluble ICAM-1 in asthmatic patients still remains unclear, but the up-regulated expression of ICAM-1 on the endothelium of the respiratory tract may contribute to the recruitment of eosinophils, neutrophils and lymphocytes to the airway in bronchial asthma.

A novel 37-Kd adhesive membrane protein from cloned murine bone marrow stromal cells and cloned murine hematopoietic progenitor cells

The adhesion of hematopoietic progenitor cells to bone marrow stromal cells is critical to hematopoiesis and involves multiple effector molecules. Stromal cell molecules that participate in this interaction were sought by analyzing the detergent-soluble membrane proteins of GBI/6 stromal cells that could be adsorbed by intact FDCP-1 progenitor cells. A single-chain protein from GBI/6 cells having an apparent molecular weight of 37 Kd was selectively adsorbed by FDCP-1 cells. This protein, designated p37, could be surface-radiolabeled and thus appeared to be exposed on the cell membrane. An apparently identical 37-Kd protein was expressed by three stromal cell lines, by Swiss 3T3 fibroblastic cells, and by FDCP-1 and FDCP-2 progenitor cells. p37 was selectively adsorbed from membrane lysates by a variety of murine hematopoietic cells, including erythrocytes, but not by human erythrocytes. Binding of p37 to cells was calcium-dependent, and was not affected by inhibitors of the hematopoietic homing receptor or the cell-binding or heparin-binding functions of fibronectin. It is proposed that p37 may be a novel adhesive molecule expressed on the surface of a variety of hematopoietic cells that could participate in both homotypic and heterotypic interactions of stromal and progenitor cells.

[Serum levels of soluble CD25 (soluble interleukin 2 receptor) in asthmatic patients]

Serum sCD25 levels were measured in 64 asthmatic patients and 22 healthy subjects by enzyme-liked immunosorbent assay. Serum sCD25 levels in the asthmatic patients were significantly higher than those in the healthy subjects (p < 0.02). Serum sCD25 levels in the asthmatic patients during attack were slightly higher than in those in remission, but there was no significant difference between the two groups. We studied changes of serum sCD25 level in 13 asthmatic patients in remission and during attack and found that serum sCD25 levels were significantly higher during attack than in remission (p < 0.02). Serum sCD25 levels in the asthmatic patients undergoing steroid therapy were significantly lower than in those who were not (p < 0.05). The significance of serum sCD25 in bronchial asthma still remains unclear, but these results suggest that T cells play an important role in bronchial asthma.

[Serum soluble CD23 and soluble CD25 in bronchial asthmatic patients]

Serum sCD23 and sCD25 levels in asthmatic patients and healthy subjects were assayed. Serum sCD23 levels in asthmatic patients were significantly higher than those in healthy subjects (p < 0.05). Serum sCD25 levels in asthmatic patients were also significantly higher than those in healthy subjects (p < 0.02). There was a significant correlation between serum sCD23 and sCD25 levels in asthmatic patients (r = 0.52, p < 0.001). It is well known that sCD23 and sCD25 levels are regulated by different cytokines, and this study suggests that T cells play important roles in the pathogenesis of asthma.

Induction of upmodulation of homing receptors in cloned hemopoietic progenitors by growth factors

Recognition and selective seeding of hemopoietic cells to the marrow after intravenous transplantation is a function of membrane protein known as homing receptor (HR), which is a lectin with galactosyl and mannosyl specificities. We have previously shown that ex vivo incubation of marrow cells with IL-3 or GM-CSF enhances the seeding efficiency and that this enhancement may be the result of upmodulation of homing receptors. In the present work, we have shown that incubation of two cloned progenitor cell lines, FDCP-1 and FDCP-mix, with IL-3 or GM-CSF resulted in a dose-dependent increase in the number of HR per cell. Interferon-gamma did not have such an effect. The upmodulation of receptors was the result of enhanced de novo synthesis and transport of the protein as it was ablated by cyclohexamide, monensin or NH4Cl. On the other hand, degradation of the protein was not affected by the growth factors. The possible mechanisms whereby a brief exposure to growth factor ex vivo could lead to enhancement of homing efficiency are discussed. Induction of upmodulation of HR by ex vivo incubation of donor cells with certain hemopoietic growth factors, could be a useful strategy for enhancing marrow reconstitution after bone marrow transplantation. This could reduce the cost and prevent the side effects of in vivo growth factor therapy.

Enhancement of the grafting efficiency of transplanted marrow cells by preincubation with interleukin-3 and granulocyte-macrophage colony-stimulating factor

To improve the grafting efficiency of transplanted murine hematopoietic progenitors, we briefly preincubated mouse bone marrow cells with interleukin-3 (IL-3) or granulocyte-macrophage colony-stimulating factor (GM-CSF) ex vivo before their transplantation into irradiated recipients. This treatment was translated into an increase in the seeding efficiency of colony-forming unit-spleen (CFU-S) and CFU-GM after transplantation. Not only was the concentration of CFU-S in the tibia increased 2 and 24 hours after transplantation, but the total cell number and CFU-S and CFU-GM concentrations were persistently higher in IL-3- and GM-CSF-treated groups 1 to 3 weeks after transplantation. In addition, the survival of animals as a function of transplanted cell number was persistently higher in IL-3- and GM-CSF-treated groups compared with controls. The data indicate that the pretreatment of marrow cells with IL-3 and GM-CSF before transplantation increases the seeding efficiency of hematopoietic stem cells and probably other progenitor cells after transplantation. This increased efficiency may be mediated by upward modulation of homing receptors. Therefore, ex vivo preincubation of donor marrow cells with IL-3 and GM-CSF may be a useful tactic in bone marrow transplantation.

[CEA and CA19-9 in BALF from patients with idiopathic interstitial pneumonia]

Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were measured in bronchoalveolar lavage fluid (BALF) in 21 patients with idiopathic interstitial pneumonia (IIP) and 7 healthy volunteers. The concentrations of both CEA and CA19-9 in the BALF were significantly higher in patients with IIP than those in healthy subjects. Significant correlations were present between the concentration of CEA and neutrophil percentage of the total BALF cells and between the concentration of CA19-9 and neutrophil percentage of the total BALF cells in the patients with IIP. Immunohistochemical study of tissue CEA and CA19-9 in the postmortem lungs of patients with IIP showed that CEA staining was present in the epithelia of respiratory bronchioles and alveoli, and it was especially increased in the region of alveoli where type II pneumocytes proliferate. CA19-9 staining was present in the epithelia of the respiratory bronchioles but absent in the epithelia of alveoli. It seems that assay of CEA in BALF may be useful to estimate the degree of pathological change and the activity of IIP.

Tuberculous mediastinal lymphadenitis in an adult patient

A 40-year-old woman was presented with a fever, which proved to be due to mediastinal tuberculous lymphadenitis. Up to 1988, 149 cases of tuberculous mediastinal lymphadenitis have been reported in the literature in Japan. This case was very rare because a chest plain film revealed neither mediastinal widening nor lung parenchymal involvement. On the other hand, a CT scan of the chest was very useful because it showed unsuspected mediastinal lymph nodes enlargement. The diagnosis of tuberculous mediastinal lymphadenitis was made by the findings of a supraclavocular lymph node biopsy, which showed granulomas, compatible with tuberculosis. A good response from the patient to antituberculous therapy confirmed this diagnosis.

A case of intralobar pulmonary sequestration with high serum CA19-9 levels

A 38-year-old female presented with cough and fever. A chest X-ray examination revealed an abnormal shadow in the posteroinferior portion of the left hemithorax, and a laboratory examination showed that the serum carbohydrate antigen 19-9 (CA19-9) level was markedly high (1000 U/ml). A left thoracotomy showed an intralobar pulmonary sequestration of the left lower lobe, and after a left lower lobe lobectomy, the serum level of CA19-9 decreased to normal. Increased CA19-9 activity was detected by immunohistochemistry in the epithelia of bronchioles in the pulmonary sequestration. This communication is the first to report a case of increased activity of CA19-9 in pulmonary sequestration.