Therapeutic strategy for rheumatoid arthritis by induction of myeloid-derived suppressor cells with high suppressive potential

Combination treatment using fingolimod (FTY720), an immunomodulator, and a pathogenic antigen prevents the progression of glucose-6-phosphate isomerase (GPI)_325-339-induced arthritis. In this study, we focused on myeloid-derived suppressor cells (MDSCs; CD11b⁺Gr-1⁺ cells) and investigated the effects of the combination treatment on these cells. DBA/1J mice with GPI_325-339-induced arthritis were treated using FTY720 and/or GPI_325-339 for five days. The expanded CD11b⁺Gr-1⁺ cell population and its inhibitory potential were examined. The percentage of CD369⁺CD11b⁺Gr-1⁺ cells effectively increased in the combination-treated mice. The inhibitory potential of CD369⁺CD11b⁺Gr-1⁺ cells was higher than that of cells not expressing CD369. Among bone marrow cells, the expression of CD369 in CD11b⁺Gr-1⁺ cells increased following stimulation with granulocyte-macrophage colony-stimulating factor, and the expression of CD11c increased accordingly. The increased CD11c expression indicated a decrease in the potential to suppress T cell proliferation based on the results of the suppression assay. The percentage of CD11c^-CD369⁺ cells in CD11b⁺Gr-1⁺ cells that were induced by the combination treatment also increased, and these cells tended to have a higher capacity to inhibit T cell proliferation. In conclusion, the combination treatment using FTY720 and the pathogenic antigen effectively induces MDSC, which demonstrates a high potential for suppressing T cell proliferation in the lymph nodes, thereby establishing an immune-tolerant state.

Combination treatment with fingolimod and a pathogenic antigen prevents relapse of glucose-6-phosphate isomerase peptide-induced arthritis

INTRODUCTION

Combination treatment with fingolimod (FTY720) plus pathogenic antigen is thought to prevent glucose-6-phosphate isomerase (GPI)325-339-induced arthritis progression by effective induction of immune tolerance. Here, we examined the efficacy of this combination treatment on remission maintenance.

METHODS

GPI325-339-induced arthritis mice were treated for 5 days with FTY720 (1.0 mg/kg, p.o.) alone, GPI325-339 (10 μg/mouse, i.v.) alone, or with the FTY720 plus GPI325-339 combination. In some experiments, mice were resensitized with GPI325-339.

RESULTS

Following resensitization with GPI325-339, combination-treated mice exhibited neither severe relapse nor elevated lymphocyte infiltration in joints. Neither anti-human nor mouse GPI325-339 antibody levels were correlated with clinical symptoms. This suggests that combination treatment prevents relapse following resensitization via regulation of pathogenic antigen-specific T cells. The proportion of regulatory T (Treg) cells in inguinal lymph nodes was increased post treatment in the FTY720 alone and FTY720 plus GPI325-339 groups. In contrast, the proportion of glucocorticoid-induced tumor necrosis factor receptor-family-related gene/protein (GITR)(+) non-Treg cells was increased only in combination-treated mice. Furthermore, GITR(+) non-Treg cells, which were induced by the combination treatment in vivo, possess suppressive activity and high ability to produce interleukin (IL)-10.

CONCLUSION

GITR(+) non-Treg cells might play a key role in relapse prevention following resensitization. Thus, this combination treatment might establish immune tolerance by induction of GITR(+) non-Treg cells.

Functional Mechanism(s) of the Inhibition of Disease Progression by Combination Treatment with Fingolimod Plus Pathogenic Antigen in a Glucose-6-phosphate Isomerase Peptide-Induced Arthritis Mouse Model

We previously reported that combination treatment with fingolimod (FTY720) plus antigenic peptide of glucose-6-phosphate isomerase (residues 325-339) (GPI325-339) from the onset of symptoms significantly inhibited disease progression in a mouse model of GPI325-339-induced arthritis. In this study, we investigated the mechanism(s) involved. The model mice were treated from arthritis onset with FTY720 alone, GPI325-339 alone, or the combination of FTY720 plus GPI325-339. At the end of treatment, inguinal lymph nodes (LNs) were excised and examined histologically and in flow cytometry. Levels of apoptotic cells, programmed death-1-expressing CD4(+)forkhead box P3(-) nonregulatory T cells (non-Tregs), and cytotoxic T-lymphocyte antigen 4-expressing non-Tregs in inguinal LNs were markedly increased in the combination treatment group mice. Regulatory T cells (Tregs) were also increased. These results indicate that combination treatment with FTY720 plus GPI325-339 inhibits the progression of arthritis by inducing clonal deletion and anergy of pathogenic T cells and also by immune suppression via Tregs.

Normal dispersion femtosecond fiber optical parametric oscillator

We propose and demonstrate a synchronously pumped fiber optical parametric oscillator (FOPO) operating in the normal dispersion regime. The FOPO generates chirped pulses at the output, allowing significant pulse energy scaling potential without pulse breaking. The output average power of the FOPO at 1600 nm was ∼60  mW (corresponding to 1.45 nJ pulse energy and ∼55% slope power conversion efficiency). The output pulses directly from the FOPO were highly chirped (∼3  ps duration), and they could be compressed outside of the cavity to 180 fs by using a standard optical fiber compressor. Detailed numerical simulation was also performed to understand the pulse evolution dynamics around the laser cavity. We believe that the proposed design concept is useful for scaling up the pulse energy in the FOPO using different pumping wavelengths.

Selective expression of MHC class I in the affected muscle of a patient with idiopathic inflammatory myopathy

The dominant clinical feature of polymyositis/dermatomyositis is weakness in proximal, rather than distal, musculature. Although rare, cases of focal/localized myositis in which polymyositis-like muscle inflammation is present in only one muscle or extremity have also been reported. The underlying mechanisms dictating involvement of specific muscle groups in polymyositis/dermatomyositis and focal/localized myositis have not been identified. Here, we describe a rare case of dropped-head syndrome due to localized idiopathic inflammatory myopathy (IIM) in the splenius capitis (neck extensor) muscle where major histocompatibility complex (MHC) class I expression was up-regulated in involved muscle fibers. Interestingly, the adjacent trapezius muscle was not affected, corresponding to muscle biopsy findings that did not show any sign of inflammation or MHC class I expression. Our case report therefore suggests that selection of affected muscle in IIM might be influenced by the MHC class I expression of the muscle.

p53AIP1 expression can be a prognostic marker in non-small cell lung cancer

AIMS

p53AIP1 is a potential mediator of p53-dependent apoptosis that is mutated in many kinds of carcinoma. To investigate the role of this gene for non-small cell lung cancer, we compared the relationship between p53AIP1 gene expression and clinicopathological status of lung cancer.

MATERIALS AND METHODS

Seventy samples from non-small cell lung cancer patients were obtained between 1997 and 2003. For quantitative evaluation of RNA expression by polymerase chain reaction (PCR) we used the Taqman PCR methods. Exons 5-8 of the p53 gene were analysed using PCR-single-stranded conformation polymorphism and sequenced for mutation analysis.

RESULTS

p53AIP1 gene expression levels in the lymph node metastasis-positive group were significantly lower than in the negative group (positive 35.1+/-83.9; negative 64.2+/-113.4; P=0.0486). The overall survival of the p53AIP1 low expression group was significantly worse than that of the p53AIP1 high expression group (P=0.0206). In the multivariate Cox proportional hazard model, p53AIP1 (P=0.0489) was the independent predictor for overall survival. When we investigated mutation analyses of the p53 gene, we could find several point mutations in 15.7% of all samples. However, there was no relationship between p53AIP1 expression and p53 status.

CONCLUSIONS

These data suggest that the p53AIP1 gene is important for non-small cell lung cancer progression and may be a possible prognostic marker.

Intake of purple sweet potato beverage affects on serum hepatic biomarker levels of healthy adult men with borderline hepatitis

OBJECTIVE

To examine the effect of purple sweet potato (PSP) beverage rich in acylated anthocyanins on serum hepatic biomarkers in healthy Japanese men.

DESIGN

A randomized, double-blind, placebo-controlled, parallel study.

SETTING

Kumamoto in Japan.

SUBJECTS

Healthy adult men (30-60 years) with borderline hepatitis who had one or more of serum gamma-glutamyl transferase (GGT), aspertate aminotransferase (AST) and alanine aminotransferase (ALT) levels over normal ranges, and who were negative for hepatitis virus were openly recruited by an advertisement. Of the 48 persons enrolled, 38 (mean age 43.0 years (30-54 years)) completed the study.

METHODS

The subjects were randomly assigned to the PSP group and the placebo group. During the 8-week intervention, the subjects in the PSP group consumed two bottles of the PSP beverage with acylated anthocyanins (200.3 mg anthocyanins per 125 ml per bottle) per day, and the subjects in the placebo group, two bottles of a placebo beverage (1.7 mg anthocyanins per 125 ml per bottle). All of the data measured were analyzed by two-way repeated measures analysis of variance (ANOVA) with groups and times. The data of the hepatic markers were analyzed using the Dunnett multiple comparison among the time points and t-test between groups at the same time point. Two-sided P<0.05 were defined as the level of significance.

RESULTS

Serum GGT, AST and ALT levels showed interactions (P<0.05) between the beverage groups and time; the others were not affected. The PSP beverage group showed lower hepatic marker levels than the placebo group during the ingestion period, particularly the GGT level (-14.1 IU/l, 95% Confidence intervel (CI) -25.4 to -2.7, P=0.017 at 2 weeks; -16.8 IU/l, 95% CI -36.2 to 2.5, P=0.081 at 4 weeks; -26.7 IU/l, 95% CI -47.6 to -5.7, P=0.014 at 6 weeks and -27.9 IU/l, 95% CI -49.9 to -5.9; P=0.014 at 8 weeks). No correlation between alcohol consumption and each hepatic biomarker level before and after the ingestion was observed.

CONCLUSION

The intake of the PSP beverage significantly decreased the serum levels of hepatic biomarkers, particularly the GGT level, in healthy men with borderline hepatitis.

[Bronchial lipoma treated by surgical resection; report of a case]

We report a case of bronchial lipoma, which relapsed after endoscopic treatment, and was treated by surgical resection. An abnormal shadow on chest X-ray was noted at the annual medical checkup of a 44-year-old man. Chest computed tomography (CT) demonstrated a tumor in the right basal bronchus and linear opacity on the peripheral side of that tumor. Bronchoscopic examination demonstrated a smooth polipoid tumor occluding the right basal lobe bronchus. Bronchoscopic biopsy specimens were not sufficient for histological diagnosis. We performed endobronchial resection of the tumor using electrosurgical snare, but 2 months after endoscopic treatment, the tumor relapsed. We therefore performed right S(9+10) segmentectomy. The tumor was 11 x 9mm in size and the histological diagnosis was an endobronchial lipoma. More than 4 years after resection, the patient is alive without recurrence.

Plasma angiotensin II concentrations in the early neonatal period

BACKGROUND

There have been only a few reports on the renin-angiotensin system in low birthweight infants; in particular, plasma angiotensin II concentrations have not been studied.

AIM

To investigate plasma angiotensin II concentrations in early neonatal infants including low birthweight infants.

METHODS

Forty six patients were studied, of whom 14 weighed not less than 2500 g (normal birth weight), 16 weighed less than 2500 g but not less than 1500 g (moderately low birth weight), and 16 weighed less than 1500 g (very low birth weight). Blood samples were collected twice, on day 0 and day 7. Angiotensin II concentration was assayed using an enzyme immunoassay kit with a microplate.

RESULTS

Geometric means of angiotensin II concentrations on day 7 were 19 pg/ml in the normal birthweight group, 28 pg/ml in the moderately low birthweight group, and 76 pg/ml in the very low birthweight group. The concentrations on day 7 in the very low birthweight group were significantly higher than those in the normal birthweight and moderately low birthweight groups (p = 0.005, p = 0.031). There were significant correlations between angiotensin II concentration on day 7 and gestational age (r(s) = -0.4, p = 0.007) and birth weight (r(s) = -0.36, p = 0.016).

CONCLUSIONS

Specific physiological conditions associated with a very low birth weight are thought to be responsible for the increased concentration of angiotensin II on day 7. It is necessary to measure angiotensin II concentration for a longer period after birth and study the factors that could influence it.

[Thoracolithiasis detected during video-assisted thoracoscopic surgery for spontaneous pneumothorax: report of a case]

A 32-year-old male was admitted to our hospital for treatment of right recurrent spontaneous pneumothorax. Chest X-ray showed right pneumothorax but chest X-ray and computed tomography (CT) examinations did not demonstrate intrathoracic abnormal mass shadow or abnormal calcifications. We performed video-assisted thoracoscopic surgery for spontaneous pneumothorax. At surgery, an egg-shaped milky white free mass was found in the thoracic cavity, and easily removed. This substance was hard and smooth on the surface and measured 12 x 9 mm. Histologically this mass was composed of fatty necrosis surrounded by hyalinized connective tissue. These findings led to a diagnosis of thoracolithiasis. Thoracolithiasis without any history of chest trauma or intervention is pathologically rare, with only 15 cases including our case in Japan, having been reported in the literature to date.

[Right delayed traumatic diaphragmatic hernia; report of a case]

An 80-year-old woman was admitted to our hospital with abnormal shadow on chest X-ray 8 years after a chest trauma during which multiple ribs on the right side were fractured causing hemothorax. A diagnosis of right delayed traumatic diaphragmatic hernia was based on the findings on plain X-ray and multislice computed tomography. We performed surgery via thoracic approach with thoracoscopic assist. The transverse colon, liver, and omentum were dislocated into the right thoracic cavity and hardly adhered to the lung. We successfully repaired the ruptured diaphragm. The postoperative course was uneventful and the patient was discharged on the 33rd postoperative day.

Serum levels of neutrophil activation cytokines in Kawasaki disease

BACKGROUND

The aim of the present study was to investigate whether neutrophils are early effector cells for vascular endothelial damage in the acute phase of Kawasaki disease (KD) by examining serial changes in neutrophil counts and serum levels of neutrophil activation cytokines, such as granulocyte colony stimulating factor (G-CSF) and interleukin (IL)-8.

METHODS

From October 1994 to June 1998, a total of 52 patients with KD were included in the study. Thirty-three patients had some infectious diseases, while 20 healthy children served as control subjects. Serial changes in neutrophils were counted by the optimal Wright-Giemsa staining method and serum levels of IL-8 and G-CSF in patients with KD were measured by an enzyme-linked immunosorbent assay system.

RESULTS

Serum G-CSF levels both before and after intravenous immunoglobulin therapy (IVIG; P<0.05) and neutrophil counts after IVIG (P<0.005) were higher in KD patients with coronary arterial lesions (CAL) than those without CAL. However, serum IL-8 levels before and after IVIG showed no significant differences in these two groups.

CONCLUSIONS

These data suggest that neutrophils may be important as early effector cells for vascular endothelial damage and that G-CSF may play a more important role than IL-8 in KD.

Esophageal adenocarcinoma that probably originated in the esophageal gland duct: a case report

A case of primary esophageal adenocarcinoma in a 64-year-old man is reported. An ulcerating tumor was located in the middle intrathoracic esophagus. Histopathological examination revealed a moderately differentiated adenocarcinoma, which had invaded down to the adventitia. The cancerous tubuli were lined by flattened cuboidal cells with eosinophilic cytoplasm, which were analogous with the esophageal gland ducts and syringoma of the skin. The carcinoma was spread widely in the lamina propria mucosae without intraepithelial neoplastic elements. An immunohistochemical profile of individual cytokeratins and other epithelial markers in the carcinoma was similar to that of the esophageal gland ducts. Barrett's metaplastic epithelium or ectopic gastric mucosa was not found around the tumor. It is strongly suggested that this unique carcinoma is derived from the esophageal gland ducts.

Changes in proteasome levels in spinach (Spinacia oleracea) seeds during imbibition and germination

Proteasomes are the major cytosolic protease complexes responsible for energy-dependent and extra-lysosomal proteolysis. Ubiquitinated proteins are degraded by the 26S proteasome which is composed of a 20S proteasome and two regulatory complexes. Changes in the 20S and 26S proteasome activity levels and protein abundance in spinach seeds during imbibition and germination were examined by using glycerol density gradient centrifugation. The 26S proteasome activity level decreased transiently during imbibition, reached a minimum one day after starting imbibition, and then increased again. During the period of minimal accumulation, the protein being detected with an anti-26S proteasome antibody shifted to a lower sedimentation coefficient fraction. In contrast, the 20S proteasome activity level increased during imbibition, and remained high for two days. The change in the 20S proteasome level corresponded to the change in the 20S proteasome activity level.

Plant 21D7 protein, a nuclear antigen associated with cell division, is a component of the 26S proteasome

Previously, we cloned a carrot (Daucus carota L.) cDNA encoding a 45-kD protein, 21D7, located in the nuclei of proliferating cells. The 21D7 protein is similar to the partial sequence of a regulatory subunit of the bovine 26S proteasome, p58 (G. DeMartino, C.R. Moomaw, O.P. Zagnitko, R.J. Proske, M. Chu-Ping, S.J. Afendis, J.C. Swaffield, C.A. Slaughter [1994] J Biol Chem 269: 20878-20884) and to the deduced sequence encoded by the Saccharomyces cerevisiae gene SUN2 (M. Kawamura, K. Kominami, J. Takeuchi, A. Toh-e [1996] Mol Gen Genet 251: [146-152]). In our work, the expression of plant 21D7 cDNA rescued the yeast sun2 mutant. Fractionation of carrot and spinach (Spinacia oleracea L.) crude extracts showed that the 21D7 protein sedimented with the active 26S proteasomes. The cessation of cell proliferation in carrot suspensions at the stationary phase caused 26S proteasome dissociation and, correspondingly, the 21D7 protein sedimented together with the free regulatory complexes of the 26s proteasomes. Large-scale purification of carrot 26s proteasomes resulted in co-isolation of the 21D7 protein. Polyacrylamide gel electrophoresis under nondenaturing conditions showed that the 21D7 protein had the same mobility as the 26S proteasome and that proteasome dissociation changed the mobility of the 21D7 protein accordingly. We conclude that the 21D7 protein is a subunit of the plant 26S proteasome and that it probably belongs to the proteasome regulatory complex.

Superior vena cava syndrome due to a permanent transvenous pacing lead

Superior vena cava (SVC) syndrome after pacemaker implantation is a very rare complication. We present a 56-year-old man with severe swelling of the face, neck, and upper arms about 6 years after pacemaker implantation. Digital subtraction angiography showed occlusion of the left innominate vein and severe stenosis of the SVC. The patient eventually required surgical treatment, since anticoagulant therapy and balloon venoplasty were not effective. We conclude that surgical repair is the most effective method for treating similar patients.

Transesophageal echocardiographic diagnosis of thoracic aortic dissection with the completely thrombosed false lumen: differentiation from true aortic aneurysm with mural thrombus

The conventional criteria of aortic dissection with a completely thrombosed false lumen by transesophageal echocardiography is separation of the intima from the layer of thrombus; however, it is not always easy to distinguish from true aortic aneurysm with mural thrombus. Thus we proposed a new transesophageal echocardiographic diagnostic criteria. Seventeen operative patients with suspected subacute or chronic thoracic aortic dissection in whom it was difficult to exclude true aortic aneurysm with mural thrombus underwent transesophageal echocardiography. In thoracic aortic dissection with in completely thrombosed false lumen, the inner lesion surface composed of intima may be smooth and crescent-shaped thrombus may appear inside the wall surface. Therefore our criteria were on the basis of any two of the following: (1) high-echogenic lesion surface, suggesting intima, over the thrombus, (2) smooth lesion surface, and (3) crescent-shaped thrombus. Imaging data were referenced to intraoperative findings. According to the present criteria only two out of 17 patients were misdiagnosed, whereas according to the conventional criteria six patients were misdiagnosed. The sensitivity was significantly higher than when the conventional criteria were used (90% versus 40%; p < 0.05), whereas the specificity was similar. We conclude that the present transesophageal echocardiographic criteria for detection of thoracic aortic dissection with a completely thrombosed false lumen is clinically useful.

Purification and characterization of the 26 S proteasome from spinach leaves

The 26 S proteasome complex catalyzing ATP-dependent breakdown of ubiquitin-ligated proteins was purified from spinach leaves to near homogeneity by chromatography on DEAE-cellulose, gel filtration on Biogel A-1.5, and glycerol density gradient centrifugation. The purified enzyme was shown to degrade multi-ubiquitinated, but not unmodified, lysozymes in an ATP-dependent fashion coupled with ATPase activity supplying energy for proteolysis and isopeptidase activity to generate free ubiquitin. By nondenaturing electrophoresis, the purified enzyme was separated into two distinct forms of the 26 S complex, named 26 S alpha and 26 S beta proteasomes, with different electrophoretic mobilities. The 26 S proteasome was found to consist of multiple polypeptides with molecular masses of 23-35 and 39-115 kDa, which were thought to be those of a 20 S proteasome with multicatalytic proteinase activity and an associated regulatory part with ATPase and deubiquitinating activities, respectively. The subunit multiplicity of the spinach 26 S proteasome closely resembled that of rat liver with minor differences in certain components. No sulfhydryl bond was involved in the assembly of this multicomponent polypeptide complex. Electron microscopy showed that the 26 S proteasome complex had a "caterpillar"-like shape, consisting of four central protein layers, assumed to be the 20 S proteasome, with asymmetric V-shaped layers at each end. These structural and functional characteristics of the spinach 26 S proteasome showed marked similarity to those of the mammalian 26 S proteasomes reported recently, suggesting that the 26 S proteasome is widely distributed in eukaryotic cells and is of general importance for catalyzing the soluble energy- and ubiquitin-dependent proteolytic pathway.

[A diagnosis of venous anomaly with dextrocardia by magnetic resonance imaging and transesophageal echocardiography]

A 56-year-old woman was admitted with the chief complaint of dyspnea. Chest radiograph and echocardiography disclosed mirror image dextrocardia with massive pleural effusion. Magnetic resonance imaging (MRI) and transesophageal echocardiography (TEE) revealed dilated coronary sinus and persistent right-sided superior vena cava which entered the coronary sinus. These findings were compatible with those of digital subtraction angiography. Anomalies of the venous system must be recognized before surgery because adequate venous drainage is essential for extra-corporeal circulation. MRI and TEE are noninvasive and useful methods and should be performed first to detect anomalies of the venous system associated with dextrocardia.

Benefits of rate-responsive pacing in patients with sick sinus syndrome

The effect of changing a rate-responsive pacemaker program (which reacts to evoked QT interval) to fixed-rate ventricular pacing was studied in 10 patients with sick sinus syndrome (SSS). After the patients had been in the rate-responsive mode (VVIR) for at least one year, the exercise capacity (maximal oxygen consumption [peak VO2], anaerobic threshold [AT], and cardiac output [CO] at these points) was examined. Three hours later on the same day, the pacemaker was reprogrammed to the fixed-rate pacing (VVI) and the exercise capacity was examined again (VVI-S). One month later, a similar exercise test was also done in the VVI mode (VVI-L). There was no significant difference in peak VO2 and AT between VVIR and VVI-S, but both peak VO2 and AT were significantly lower in VVI-L than in VVIR. However, there were no significant differences in the CO at peak VO2 or AT between any of the pacing modes. These findings indicate that a VVIR pacemaker should not be reprogrammed to the VVI mode in SSS patients, because the change can cause the exercise capacity to deteriorate.

[Assessment of the relation between bone mineral metabolism and mitral annular calcification or aortic valve sclerosis in elderly patients]

We assessed the effect of bone mineral metabolism on mitral annular calcification (MAC) and aortic valve sclerosis (AVS) in elderly patients. Both MAC and AVS were derived by 2-D echocardiography and bone mineral content (BMC) of vertebral body was obtained by quantitative computed tomography using a calibrated phantom system. The 162 patients were classified according to the echocardiographic finding into three groups; CNT group consisted of the 79 control patients (31 males, 48 females) without MAC or AVS. MAC group: 42 patients (11 males, 31 females) with MAC, and AVS group: 41 patients (19 males, 22 females) with AVS. The results were as follows: 1) The incidence of MAC and AVS in both males and females were increased in proportion to aging. 2) The incidence of MAC in females (31%) was higher than that of males (18%). 3) The AVS in males (31%) was more frequent than that in females (22%). 4) In females of eighth and ninth decades, the BMC in MAC group was significantly decreased than that in CNT group, but not different in males. 5) In both males and females, the BMC in AVS group was not significantly different from that in CNT group. These results suggest that the MAC may be attributed to the ectopic deposit, probably related to the de-calcification from the spinal bone. On the other hand, the AVS may be caused by the other factors, mainly prolonged and sustained pressure or stress loading.

MR visualization and clinical significance of the anterior longitudinal epidural venous plexus in cervical extra-axial lesions

A thin band of intermediate signal intensity behind the cervical vertebral bodies, demonstrated on sagittal MR images, was attributed to the anterior longitudinal epidural venous (AEVP). Percentage visualization and clinical significance of this structure were evaluated in extra-axial lesions of the spinal cord. In review of 50 normal controls, the percentage visualization of this structure at each cervical vertebral level was 25.5% on T1 weighted sagittal SE images, while that of T2 or proton density weighted SE images was 26.0%. AEVP was demonstrated by sagittal MRI in 29 of 128 extra-axial lesions of the cervical cord (22.7%), including cervical spondylosis, ossification of the posterior longitudinal ligament (PLL), herniated disk and spondylosis at a single level. AEVP in these conditions was often thickened compared with normal controls, probably due to venous engorgement and contribution of the dura mater and PLL. Posterior displacement of this structure or "lifted band appearance" indicated herniated disk or posteriorly protruding osteophyte, demonstrating true anteroposterior diameter of the spinal canal. Demonstration of AEVP on sagittal MRI was important in the diagnosis of extra-axial lesions of the cervical cord.

Increased MR signal intensity secondary to chronic cervical cord compression

Magnetic resonance images of 128 patients with compressive lesions of the cervical spinal canal were reviewed to determine whether a high signal intensity lesion within the spinal cord was present on T2 and proton density weighted spin echo images. Such high signal intensity was observed in 24 cases or 18.8%. The incidence was higher in herniated disk (32.4%), atlanto-axial dislocation (28.6%), and ossification of the posterior longitudinal ligament (22.7%), whereas the abnormality was found sporadically in cervical spondylosis and vertebral body tumors. The high intensity lesion on T2 weighted images was generally observed in patients with constriction or narrowing of the spinal cord. The lesion was not demonstrated on T1 weighted spin echo images. Spinal cord constriction or localized narrowing seemed to be the most important predisposing factor in producing such a high signal intensity. The pathophysiologic basis of such an abnormality was presumed to be myelomalacia or cord gliosis secondary to a long-standing compressive effect of the spinal cord.

Percutaneous transluminal angioplasty of the ilio-femoro-popliteal arteries: initial and long-term results

Percutaneous transluminal angioplasty has been widely used for dilatation and recanalization of occluded or stenosed vessels, but clinical experience in Japan is not extensive. Follow-ups of 78 ilio-femoro-popliteal angioplasties were performed for up to 51 months to assess the initial and long-term results. The initial technical success rate was 91%. The three-year cumulative patency rate was 75%. This study demonstrates that the long-term results of PTA of ilio-femoro-popliteal arterial lesions are competitive with reconstructive surgery. PTA should be the treatment of choice in patients with atherosclerotic narrowing or occlusion of the lower extremities.

Development of a new universal neuroangiographic unit

A new neuroangiographic unit has been developed with use of a "C" type gantry, which is capable of rotation and angulation for various angiographic projections. Two sets of a twin focal X-ray tube and an imaging system are mounted on the gantry. Each imaging system consists of a 9 inch image intensifier and a 14 X 14 rapid film changer, which can be exchanged in position rapidly. Stereoscopic magnification and stereoscopic contact angiography, fluoroscopy and DSA are performed in monoplane and biplane and switched over to each other expeditiously and easily. The detailed angiographic information is obtained with lower complication rate and lower exposure to patients. Interventional neuroradiologic procedures are performed efficiently on this unit.

Cerebral vasculitis secondary to Wegener's granulomatosis: computed tomography and angiographic findings

The central nervous system is rarely involved by Wegener's granulomatosis. A case of Wegener's granulomatosis with involvement of the cerebral arteries was reported. Computed tomography showed extensive brain edema with angiographic demonstration of cerebral vasculitis.

Stereoscopic DSA of the central nervous system

Stereoscopic DSA is performed with alternate exposures from a twin focal X-ray tube (6,5 cm focal separation). Excellent intravenous and intra-arterial DSA images of the cerebral vessels are obtained with separation of overlapping parts of the normal and abnormal vasculature. The clinical value of DSA has been enhanced by use of stereoscopic DSA.

Stereoscopic technique in digital subtraction angiography

Stereoscopic technique was applied to digital subtraction angiography (DSA) with alternate exposures from twin focus spots (6.5-cm separation) of an x-ray tube. Correct identification of two crossed aluminum wires was obtained more than 90% of the time when there was separation of more than 5 mm. Excellent clinical images of intravenous as well as intraarterial DSA have been obtained, and the clinical value of DSA was enhanced by application of the stereoscopic technique.

Diagnostic accuracy of intravenous digital subtraction angiography for peripheral vascular diseases

Intravenous digital subtraction angiography (IV DSA) was performed on 406 regions of 241 patients with peripheral vascular diseases. The results were compared with conventional angiograms for 167 arteries. There was excellent correlation between conventional angiograms and IV DSA. The diagnostic accuracy was 95 with 97% sensitivity and 94% specificity when more than 60% stenoses were taken into consideration. DSA is a less-invasive procedure which can be performed on out-patients for screening and follow-up evaluation of peripheral vascular diseases.

The effects of two physiological salines, Locke's and van Harreveld's, on the midgut red chromatophores of the freshwater shrimp, Caridina denticulata

It was reported previously that the red chromatophores on the midgut of a freshwater shrimp, Caridina denticulata, are affected by Locke's and van Harreveld's solutions differently, i.e., the pigment disperses in Locke's solution and concentrates with the addition of crude eyestalk extract, but in Harreveld's solution the chromatophores do not change in the saline alone nor do they respond to eyestalk extract. The differences were probably due to the osmotic pressure and Mg ion concentrations of the two solutions not being the same. Harreveld's solution is commonly used as a physiological saline for freshwater crustaceans such as crayfish. Consequently, this solution was employed at first in a previous study (Miyawaki and Tsuruda, 1985). But this solution completely inhibited pigment migration in the chromatophores. But when Locke's solution was subsequently tried, migration of the pigment in the midgut chromatophores occurred. It seemed worthwhile to examine further the effects of both solutions on these chromatophores. The results of this study are presented below.

Intraarterial digital subtraction angiography vs conventional angiography of abdominal diseases

Seventy-five patients with various abdominal diseases were studied by intraarterial digital subtraction angiography (IA DSA) during conventional abdominal angiographic examinations. The image quality, tumor stain, and arterial encasements were evaluated and diameters of vessels visualized by IA DSA were measured. The vessels greater than 2.0 mm or more in diameter were equally well demonstrated on IA DSA. IA DSA demonstrated tumor stains and portal system to good advantage. Real time imaging was also advantageous during an embolization procedure.

The structure and function of the hepatopancreas of a terrestrial isopod, Armadillidium vulgare

The fine structure of the hepatopancreas of the isopod, Armadillidium vulgare was studied in intact and in experimentally treated animals. The gross anatomy of the hepatopancreas of this species is simpler than that of decapods, but microscopically the cells are similar in both. Accordingly, the function of this organ is probably the same in decapods and Armadillidium. Some phylogenetic considerations are also presented. In a previous paper Miyawaki et al. (1984), presented experimental results which indicated that the hepatopancreas of the crayfish, Procambarus clarki, had an important role in the absorption of digested food materials. These results confirmed earlier reports by Yonge (1924) and van Weel (1955) on the decapods, Nephrops norvegicus and Atya spinides, respectively. In the present study, we wished to determine whether the isopod hepatopancreas has a function like that of the decapods. A terrestrial isopod, Armadillidium vulgare collected on the University campus, and reared in the laboratory at room temperature was used. The methods of study were similar to those employed in the study with Procambarus clarki (Miyawaki et al., 1984).

Absorption of experimentally administered materials by the hepatopancreas cells of the crayfish, Procambarus clarki

After long term starvation, the crayfish, Procambarus clarki was administered protein silver, iron lactate and olive oil, and its hepatopancreas was subsequently examined by electron microscopy. The reserve cells showed changes suggesting the absorption of these materials from the acinar lumen had taken place. In contrast, the hindgut of crayfish seemed to have no absorptive ability. In crustaceans the hepatopancreas is the largest gland in the body. The chief functions of this gland are the secretion of digestive juice into the stomach and absorption of digested food. It is also where materials which are necessary for hardening of animals that have undergone ecdysis are stored. Although these roles are commonly accepted, the absorptive ability of the gland has been rarely studied. Yonge (1924) and van Weel (1955) attempted to obtain evidence for the absorptive function of hepatopancreas cells of Nephrops norvegicus and Atya spinides using iron lactate and iron saccharate, and obtained some positive results. They used the histochemical Prussian blue test to demonstrate absorbed iron. Vonk (1960) referred to the results of a few authors who had tried to show fat deposits in reserve cells of the hepatopancreas after the administration of olive oil to the animals. But because starvation did not affect the quantity of stored fat in the hepatopancreas cells, the attempt failed to reveal the absorption of fat by the hepatopancreas. In the present paper, the authors describe the results of studies on the absorption of experimentally administered materials by hepatopancreas cells of the crayfish, Procambarus clarki, using electron microscopy.

The microvilli of the midgut epithelium in the freshwater shrimp, Caridina denticulata

The ultrastructure of the epithelial cell microvilli of the midgut of a decapod, Caridina denticulata , was studied. The microvilli have an axial bundle of filaments extend from the tip of the microvilli deeply into the interior cytoplasm of the epithelial cells. Basal globules were present at the base of the microvilli in the premolt stage animals. The length and arrangement of the microvilli change during the molting cycle.

The value of digital subtraction angiography in peripheral vascular diseases

The iliac and subclavian arteries and their distal branches were studied by digital subtraction angiography (DSA) in 79 patients and the results compared with conventional angiograms for 35 patients. Techniques, results, advantages and disadvantages are described. DSA (both intravenous and intra-arterial) looks very promising in the diagnosis of peripheral vascular disease.

Evaluation of prototype equipment for digital subtraction angiography in diagnosing intracranial lesions

Two prototype units for digital subtraction angiography have been developed by Japanese manufacturers. Their performance in demonstrating various intracranial lesions in 121 patients was evaluated. Comparison with conventional selective catheter angiography was possible in 77 patients. Digital subtraction angiography proved useful in preoperative evaluation of pituitary tumors when transsphenoidal surgery was being considered; demonstration of faint tumor stains which might be missed on conventional angiography; demonstration of larger aneurysms, arteriovenous malformations, and tumors as a screening technique; demonstration of abnormalities involving the dural sinuses; and follow-up of patients after surgery or embolization.