Attributes of tinnitus that may predict temporomandibular joint dysfunction.

A collection of 1002 patients with severe tinnitus, drawn from the Tinnitus Data Registry, were retrospectively surveyed to determine which traits or attributes of tinnitus could indicate the possibility of temporomandibular joint dysfunction (TMD) as the cause of tinnitus. The patients were divided into two groups: (1) a TMD group, consisting of 69 patients for whom there was no known cause of tinnitus except for one or more temporomandibular joint (TMJ) indicators, and (2) a comparison group with mixed etiologies (n = 860). Seventy-three patients were eliminated due to excessive complications relating to cause. The two groups were compared seeking those attributes of tinnitus that significantly separated them. No single benchmark standard was discovered that exclusively indicated tinnitus from TMJ origins. However, a total of 10 "TMJ Indicators" were discovered. The data for each of these indicators is presented and discussed. In addition, the attributes that did not significantly separate the two groups are listed. The study concludes with a recommendation for TMJ referral for those tinnitus patients with unknown etiology who demonstrate any three or more of the TMJ indicators.


The distribution of internal derangement in patients with temporomandibular joint dysfunction--prevalence, diagnosis, and treatments.

This study consisted of 355 patients referred to a surgical practice complaining of facial pain, temporomandibular joint (TMJ) sounds, and limited jaw opening. In 247 patients, 360 TMJs were evaluated by arthrography. While 72.2% of them had internal derangement, the remaining 27.8% had normal arthrograms (NID). Among the patients with internal derangement, meniscal displacement with reduction (MDR) was the largest group (47.3%), followed by meniscal displacement without reduction (MD) (32.3%), meniscal displacement without reduction associated with perforation (MDP) (15.4%), and perforation with normal disk position (P) (5.0%). The NID, MDR, and MD groups showed similar age distributions. The MDP and P groups showed a significantly older mean age. Gender distribution was biased toward females (82.0%). Of the total number of joints, 183 (50.8%) had a history of trauma, 69.9% of which had an internal derangement. In terms of treatment, 100% of the NID group was treated by splint therapy. The MDR group was mostly treated by partial meniscectomy (49.6%) and splint therapy (41.5%). The MD group was mostly treated by total meniscectomy (53.6%) followed by splint therapy (32.1%). The MDP or P groups mostly underwent total meniscectomy (72.5% and 61.5%, respectively).


Influence of stabilization occlusal splints on sternocleidomastoid and masseter electromyographic activity.

The present work was conducted in order to determine the effect of stabilization occlusal splints on electromyographic (EMG) activity of sternocleidomastoid and masseter muscles, in subjects with tenderness to palpation in these muscles. A full-arch maxillary stabilization occlusal splint was made for each of 14 subjects. Tonic EMG activity, as well as during saliva swallowing and maximal voluntary clenching, was recorded with and without a stabilization occlusal splint inserted. Similar tonic, as well as maximal voluntary clenching EMG activity, with and without the stabilization occlusal splint, was observed. During saliva swallowing, the activity in both muscles was significantly lower with the stabilization occlusal splint. This suggests that daytime use of the stabilization occlusal splint might improve tenderness to palpation in the studied muscles, since the frequency of swallowing function is higher during waking hours.


Vectorial analysis of the instantaneous equilibrium of forces between incisal and condylar guidances.

Protrusive functional relationships between the upper and lower jaws are constrained by the structures of the temporomandibular joints (TMJs) and the opposing contacting surfaces of the anterior teeth. To check these biomechanical relationships, the link quadrilateral bell crank model was assumed in order to compute the instantaneous equilibrium of forces using vectorial analysis. Four anterior teeth configurations were analyzed to study the distribution of force components. The first represented normal bite (used as control), the second represented long anterior overjet, the third represented deep anterior overbite, and the fourth one represented freedom in centric. When three different interincisal contact positions were assumed, functional compromises concerning load/reaction between the TMJ and anterior dentition were found. In centric occlusion there was a tendency toward less loading in the joints and increased loading on the dentition. In intermediate positions and close to the edge-to-edge position, the mechanical tendencies were toward increased loading in the joints and decreased loading on the dentition.


Cine magnetic resonance imaging of the temporomandibular joint.

Magnetic resonance imaging (MRI) provides a significant amount of information about both the position of the meniscoligamentous complex and the osseous structures in evaluation of internal derangements of the temporomandibular joint (TMJ). With the advent of computer-driven cine displays, dynamic information is now available, providing cost-effective diagnostic evaluation similar to cine fluoroscopy with arthrography, but without the ionizing radiation exposure or discomfort. Using a bite block, a series of sagittal images are obtained with the patient "posing" at different degrees of jaw opening. The subsequent cine MRIs with "posed" motion are striking and very helpful in evaluating various types of TMJ dysfunction. At the authors' institution, 205 patients were examined with a history of TMJ arthralgia. Correlation of imaging studies and surgical findings reveals a sensitivity (98%) and specificity (96%) for identifying the meniscoligamentous complex.


Adverse events of acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders.

Occlusal splint therapy and acupuncture have been found to provide positive treatment in a number of studies. As with other therapies, adverse events may occur. In this paper, adverse event refers to any reaction to a treatment besides the intended treatment effect--irrespective of any correlation between the treatment and the reaction. This reaction can be positive, as well as negative, to the patient. In the present study, 61 patients with craniomandibular dysfunction (CMD) were treated with acupuncture or occlusal splint therapy and the adverse events were carefully recorded. The results show that the profile of the adverse events differed between the two treatment modes. Acupuncture seemed to have adverse events of a more general nature, e.g., relaxed feeling, improved sleep, temporarily increased pain; whereas, adverse events of occlusal splint therapy seemed to be more locally related to the orofacial region, e.g., increased/decreased salivation and tension in the teeth. The majority of the patients responded positively to both treatment modalities. Only in a few cases did the patients consider the treatment uncomfortable. No serious adverse event or complication was observed in this study.


Modified use of a dynamic bite opener--treatment and prevention of trismus in a child with head and neck cancer: a case report.

Trismus may be a complication arising during or after treatment of patients with head and neck cancer. Treatment of trismus is difficult, making prevention very important. To prevent and treat trismus in a patient with a nasopharyngeal tumor, the Contract-Relax-Antagonist-Contract (CRAC) technique was applied, with the aid of a custom-made dynamic bite opener (DBO). The CRAC technique in combination with the DBO, as a therapy/prevention program for trismus, is not referred to in the literature. The combination of CRAC and DBO appeared to be a gentle and effective method well tolerated by the patient.


[A new modification of the horse erythrocyte agglutination test for the detection of heterophilic antibodies in infectious mononucleosis].

The new modification (HEA test) is based on the presence of a singularly distinct agglutination of native horse erythrocytes in a serum dilution 1:10 and more from cases with Epstein-Barr virus infectious mononucleosis. In 1665 sera the HEA test was equally often positive as the OCH test (in 5.2%) whereas the IM test with formal-treated horse erythrocytes was positive only in 3.7%. The sensitivity of the IM test in comparison with the OCH test was 61%, the specificity 99.5%. The sensitivity of the HEA test in comparison with the OCH test was 76%, the specificity 98.7%. The specificity of the HEA test in a group of 52 sera without IgG antibodies to EB-viral capsid antigen (EB VCA) was 94%, in another group of 130 sera from hepatitis cases it was 98%. In 103 pairs of sera from infants aged 1-5 years the positivity of the OCH test, HEA test, IgM antibodies to EB VCA and the four-fold rise in the titre of EB-viral IgG were, 20%, 16%, 23% and 24% respectively. Analogous values in 159 pairs of sera from older subjects were 42%, 40%, 38% and 29%. The HEA test is recommended as useful adjunct to the OCH test for the detection of heterophile antibodies even in young children.


[Use of markers of hospital strains in studying the occurrence of nosocomial infections].

The submitted paper deals with one of the possible aspects of the investigation of nosocomial infections, i.e. investigations of the properties of hospital strains, their importance and possible use. The incidence of bacterial hospital strains was investigated in a surgical department of a district hospital of the North Bohemian region in October 1990; at the time of the survey 29 nosocomial infections (36.1%) were revealed by the prevalence method. Bacterial hospital strains were isolated from patients with a nosocomial infection, from the attending staff and the hospital environment. The following markers were investigated: biotyping, phagotyping, serotyping, toxin production, sensitivity to antimicrobial substances and sensitivity to disinfectants. Based on results of marking of hospital strains 7 incidences with a possible epidemiological association were detected where the hospital strain of equal or very similar properties dominated. The results of the investigation confirmed the important participation of the attending staff in the spread of nosocomial infections, in particular via contaminated hands, and drew attention to shortcomings as regards adherence to the hygienic and epidemiological regime in the investigated department.


[Filamentous micromycetes in otitis].

In 1984-1991 in the microbiological laboratory in Komárno (Slovak Republic) 4224 (100%) smears with the diagnosis of otitis were examined. From 138 (3.26%) of smears microscopic filamentous fungi were isolated, most frequently aspergillae from the group Aspergillus niger (34.1%), Aspergillus flavus (29.8%) and Aspergillus fumigatus (21.8% of 138 isolates). The strains of other species of filamentous micromycetes were found only rarely. A review on the incidence of filamentous micromycetes in otitis in different regions, based on data in the literature is presented.


[Phagotypes of the Salmonella paratyphi B strains isolated in Czechoslovakia 1986-1991].

The author presents an account of phagotypes of 70 strains of Salmonella paratyphi B isolated in 1986-1991 incl., from patients suffering from typhus B and registered carriers, isolates from river water and also from three new cases of carriers in Czechoslovakia. These isolated strains were sent for typing of Salmonellae to a Bratislava department for phagotyping. According to lytic findings with standard bacteriophages the strains were classified into 8 types. Another group is formed by strains which cannot be typed in the critical dilution (RTD) nor in its tenfold concentration (19.1%). During the investigation period the subtype 3aI (38.3%) and the phage type Taunton (21.9%) were most frequent.


[Immunochemical determination of gentamicin in serum. III. The competitive ELISA].

The author describes the use of polyclonal antibodies against gentamicin by competitive ELISA. The author used polystyrene microplates as the solid phase for antibodies. Gentamicin was marked by horse radish peroxidase and a known amount of thus labelled gentamicin competed for a bond with an antibody with an unknown amount of gentamicin in serum. The method requires 10 microliters non-diluted serum and the results can be evaluated within one hour. The accuracy of the method according to values of the coefficient of variation (CV) is 9.0-13.2% in different tests and 5.2 to 9.2% within one examination.


[Microbicidal effect of Lautercide, a new disinfectant].

The authors tested the effect of a new disinfectant Lautericide produced by Qualichem Co. Neratovice which contains as the active agent acetate amine of coconut acid. For experiments standard methods were used and standard strains for testing of the following microbial strains: St. aureus, E. coli, Ps. aeruginosa, Proteus vulgaris, Serratia marcescens, Candida albicans, spores of Bacillus subtilis, M. tuberculosis, M. fortuitum, M. avium. As a model virus E. coli bacteriophage OX 174 was used. In concentrations from 0.04% to 0.5% and exposures from 2 to 10 minutes Lautercide exerted a bactericidal and fungicidal action. On spores of B. subtilis the preparation was ineffective even in a 10% concentration and 32-minute exposure. Devitalization of mycobacteria occurred after 15 min. action of Lautercide on M. tuberculosis and M. fortuitum, in M. avium in a 10% concentration in 60 min. Lautercide is ineffective against small resistant viruses without an integument. It is recommended to use Lautercide in a 1% aqueous solution for a one-stage disinfection combined with cleaning in the health services, veterinary medicine and in the field of communal hygiene. Before cleaning objects contaminated with infectious material, 5% Lautercide with 30 min. exposure is recommended. In disinfection of objects contaminated with mycobacteria it is recommended to use a 5% solution with 10-minute exposure for M. tuberculosis and M. fortuitum and a 10% solution for M. avium with 60-minute exposure.


[Findings of body lice (Pediculus humanus L.) in Czechoslovakia].

The first finding of body lice in Czechoslovakia since year 1945 is demonstrated. The determination of the species is based on the location of the louse on the body of the infested person and on the significant differences in the length of tibia of middle legs in these lice and those collected from the head of children. Local eradication was achieved by using formulation containing permethrin, against head lice.


[Natural foci of tick-borne encephalitis in the Slovak Republic and its relation to the natural ecosystem].

To evaluate the incidence of natural foci of tick-borne encephalitis in the Slovak Republic data of the hygiene service on the morbidity from tick-borne encephalitis during the period from 1961-1988 were used as well as data from the literature and results of the author's field studies on the incidence of the common tick. The main foci of tick-borne encephalitis are in the West Slovakian region, in the Záhorské lowland, in the Váh valley up to the distrikt of Povázská Bystrica, in the area of the Low Carpathian mountains, Tribec, Vtácnik, the Nitra and Hron hills, and Kovácov hills, in the Central Slovakian region in the Krupin hills and in the East Slovakian region in the Slovak karst and Slanské hills. The incidence of common ticks and foci of tick-borne encephalitis is linked to the original oak grove communities. In Slovakia the latter comprise hornbean and oak forests, oak groves and thermophile oak forests. Areas of original communities of beech woods and spruces which grow in higher altitudes do not provide favourable conditions for the development of the common tick. Rare foci of tick-borne encephalitis of a mountainous type found in Slovakia survive probably due to the extremely favourable microclimatic conditions in these areas. Also the hygrophilous communities of alders, moorlands and dry steppes, original as well as cultivated ones, are not suitable for the common tick. This is why ticks are not found in central, northern and northeastern Slovakia, in the Rye island and lowland along the Tisa river.(ABSTRACT TRUNCATED AT 250 WORDS)


[The effect of potential beta-adrenolytic agents on oxidation and phosphorylation processes in myocardial muscle mitochondria in vitro].

Concentrations ranging from 1-9 x 10(-7) mol.dm-3 were employed for in vitro studies. Under the selected experimental conditions, both agents markedly decreased the stimulated consumption of oxygen by the cardiac muscle mitochondria in the condition S3, the rate of the formation of energy by mitochondria as well as the respiratory control index. The coefficient of oxidative phosphorylation was not markedly changed due to the effect of the added agents. The results of the present paper suggest possible integration of the cardiac muscle mitochondria in the oxidative metabolism of the potential beta-adrenolytic agents FA33 and FP33, which requires further in vivo studies.


[Dynamics of the distribution of lymphocyte subpopulations in the human menstrual corpus luteum].

Recent evidence suggests that immunoendocrine interactions play a definitive role during development and regression of the human menstrual corpus luteum (hmCL). We studied the distribution of immune cells within individual structures of hmCL during various stages of its development. Immunoperoxidase-stained ultra-thin frozen sections were evaluated, using light microscopy fitted with an image analysis system. The results suggest that monocytes/macrophages and MHC class II positive cells are the most prominent immune cells within the hmCL throughout its lifespan. Both cell types are concentrated within the trabeculae. In addition, MHC class II positive cells are abundant also within the granulosa-luteal layer. T helper/inductor (Th/i) and T cytotoxic/suppressor (Tc/s) cells were detected only in minor amounts within the thecal trabeculae of mature tissue. Possible links between the occurrence and functional roles of the immune cells studied are discussed.


[Cell-mediated immune reactivity to sperm in disorders of human reproduction].

Besides the pathological anti-sperm humoral immunity, pathological anti-sperm cell-mediated immunity is considered as a crucial facet of the disturbances of human reproduction (male and female infertility, recurrent abortions, endometriosis, late EPH gestosis, fetal hypotrophy). A precise and objective method is designed, based on a one-step agarose Leukocyte Migration Inhibition Factor assay. The migration areas are evaluated by a computer-assisted image analysis system. Optimal concentrations of leukocytes and sperm, as well as technical conditions are described. The Radius Migration Indexes and Area Migration Indexes are computed and expressed as a Migration Index percentage for each patient or control. Preliminary clinical results indicate a highly significant association between leukocyte migration inhibition and cases of "immunopathological" infertility and repeated fetal loss.


[One-year follow-up of women treated with transdermal administration of estrogen for post-castration and climacteric syndromes].

Having gained preliminary knowledge in a selected group of 64 patients treated for three months by a transcutaneous form of estrogen therapy (Estraderm TTS) for postcastration and climacteric syndromes, the authors report in this paper on the results of a one-year follow-up of a series of 42 patients treated by ETTS 25 and 50 for the same diagnoses. Administration of ETTS makes it possible to take advantage of the therapeutic transdermal system for the transfer of 17 beta-estradiol directly into the blood stream. Estradiol in a daily dose of 25, 50 or 100 microgrammes is deposited in ethanol gel as a reservoir in a special sticking tape. From there it is absorbed across a microsporous membrane by molecular diffusion into the subcapillary plexus at a constant speed till an equilibration of the diffusion gradient between skin and the system is attained. For the aim of this study is to evaluate both the recession of the subjective as well as objective complaints in patients suffering from postcastration and climacteric syndromes and the reflection of the treatment in the blood levels of gonadotropins, estrogens, gestagens and cortisol and likewise the vaginal hormonal cytology. Both the systemic and local side-effects of treatment are subject to a careful study. On the basis of a comprehensive statistical study of these changes in every patient as well as in the whole series in the course of one year the authors reach the conclusion that the ETTS administration strikingly improves the subjective as well as objective complaints of the patients, and, in agreement with the literary data, objectively influences the laboratory results concerning especially the circulating levels of gonadotropins and of estradiol. In conclusion, the authors comment on the favourable contribution of this form of treatment to gynaecological practice in the therapy of postcastration, climacteric and estrogen-losing syndromes. A special modification of the record was prepared for this study when the running subjective evaluations of the effect of the treatment by the patient, as obtained in the course of directed interviews, as well as objective results of somatic and laboratory changes including the aggregate yearly evaluation of the effect of the treatment in every individual woman of the series are clearly arranged.


[Results of the Cattell 16 P.F. questionnaire in pregnancy].

Cattell's 16 P. F. Personality Questionnaire was used to examine 31 randomly selected pregnant women with a mean age of 24.9 years. The first and second examinations were performed at weeks 14-16 and 36-38 of pregnancy, respectively. While 13 women were examined using A form first, followed by B form, the sequence was reversed in 18 women. Results were evaluated by means of vector regression analysis. The difference in results of examination at the beginning and end of pregnancy was zero, however, there was a significant difference (p < 0.01) in the group with the AB sequence of questionnaire completion from that with the BA sequence. The difference applies especially to factors A, F, I and Q2.


[Present surgical approach to treatment of endometrial carcinoma].

The authors present the histological evaluation of preparations collected during surgery during treatment of endometrial carcinoma in a clinical group of 199 women. Decision on subsequent therapeutic procedures depends on the bioptic risk of the score which comprises the type and grading of the tumour, angioinvasion and possible spread. Subsequent adjuvant therapy according to the above criteria was administered to 50% of the women. The classification grade, as compared with the preoperative stating, was raised in almost 40% of the women. The asset of evaluation of the risk score is establishment of a more accurate diagnosis and formulation of corresponding adjuvant therapy.


Reducing tobacco use in Sri Lanka.

Tobacco use is steadily declining in wealthy countries, whereas it is increasing in poor countries. Approaches found successful in wealthy countries should be applied vigorously in Sri Lanka too. This requires sustained and active lobbying, especially by doctors. Some promising strategies are already being used in Sri Lanka which indicate that countries such as ours could develop appropriate local approaches in addition to those found useful in rich countries. These have evolved with little active support from the medical profession. If doctors actively complement these efforts, Sri Lanka could provide a model in successful smoking control for poor nations.


Serum precipitins in pulmonary aspergillosis: preliminary results.

Definitive diagnosis of pulmonary aspergillosis is difficult to establish. Thus, confirmative evidence of active fungal aggression is imperative. In this study, an immunodiffusion test was carried out on 36 cases of pulmonary aspergillosis and two groups of subjects comprising 133 patients with non-fungal diseases and 134 healthy volunteers as controls. The test was positive in 92.3% of the patients with mycetoma, in 50% of the patients with allergic bronchopulmonary aspergillosis, and in 25% of the patients with invasive aspergillosis. Results were negative in all subjects in the two control groups. The findings indicate the efficacy of the test under study for supporting the diagnosis of pulmonary aspergillosis.


Screening for Turner syndrome: how useful is the buccal smear test?

The buccal smear test was used to screen for Turner syndrome in a sample of girls with severe short stature who did not have any other clinical features of that condition. The majority of the girls did not show X chromatin bodies in the buccal mucosal cells. None of those who qualified for chromosomal analysis showed an XO chromosomal pattern either. We conclude that reliability of the buccal smear test as a screening method for Turner syndrome remains doubtful.


Intensive care experience in Guillain-Barre syndrome.

In a retrospective study of 34 patients with acute Guillain-Barre syndrome admitted to an intensive care unit (ICU) during a six year period from January 1984 to December 1989, for bulbar paresis or impending respiratory failure, 4 required endotracheal intubation to protect the airway, and 27 required mechanical ventilation. A high incidence of respiratory complications was noted. Two patients died of cardiovascular instability. Close monitoring of respiratory and cardiovascular status is essential to ensure survival.


Synthetic mesh in the repair of incisional hernia.

A series of 30 incisional hernia repairs with knitted monofilament polypropylene is presented. The recurrence rate was 3.3% (one patient). No patch has sloughed or required removal. There was one postoperative death. Synthetic mesh allows defects of any size to be repaired without tension with a low recurrence rate.


Charles Darwin's anthropological observations on Ceylonese.

In his 1871 work, The Descent of Man and Selection in Relation to Sex. Darwin has made three anthropological observations pertaining to the nose, beard and polygamy in Ceylonese. He never visited Ceylon, and his observations were based on the works of Sir J. Emerson Tennent (1859) and Sir J. Lubbock (1865).


Adult filarial worm (Wuchereria bancrofti) in a benign ovarian tumour.

A case of an adult filarial worm (Wuchereria bancrofti) associated with a benign ovarian tumour and a cyst is presented. Possible reasons for the findings of a well preserved part of the worm and a foreign body granuloma in the lymphatic subendothelium are discussed.


[An ultrastructural classification of carcinomas of the lung].

For the purpose of providing more accurate histological typing of lung carcinoma, it is necessary to classify carcinomas of the lung by electron microscopy. One hundred and fifty cases of resected lung carcinoma were examined under electron microscope. The results of ultrastructural typing of lung carcinoma were as follows: 1. carcinomas showed differentiated features of glandular and squamous epithelium, including squamous cell carcinoma (28 cases), adenocarcinoma (35 cases), and adenosquamous carcinoma (29 cases). Among them, some cases were associated with neuroendocrine differentiation. In addition, solid mucinous cell carcinoma (4 cases) and adenoid cystic carcinoma (2 cases) were seen. 2. Carcinomas showed differentiated features of bronchioloalveolar epithelium, subdividing into clara cell (9 cases), type II pneumocyte (3 cases), mucinous cell (5 cases) and mixed type (4 cases). 3. Carcinomas showed differentiated features of neuroendocrine cell (Kulchitsky cell), including well differentiated (carcinoid, 13 cases), intermediately differentiated (atypical carcinoid, 12 cases), and poorly differentiated (small cell carcinoma, 6 cases). Among them, some cases were associated with squamous differentiation. The ultrastructural classification was compared with histological classification of lung carcinomas and the differences between them are discussed.


[The ultrastructural characteristics of minor glomerular abnormalities].

Among 1168 patients in whom clinical data and light microscopic, immunofluorescence and electron microscopic findings of renal biopsies were available, 329 had minor glomerular abnormalities. These 329 cases included 38 with glomerular minimal change (MC), 32 with glomerular minor lesion, 143 with mild mesangioproliferative GN, 14 with mild mesangioproliferative IgM nephropathy, 4 with C1q nephropathy, 37 with IgA nephropathy, 12 with Henoch-Schönlein purpura GN, 17 with lupus nephritis, 16 with early stage membranous nephropathy (eMN), 4 with Alport's syndrome (ALS), 7 with thin basement membrane nephropathy (TMN) and 5 with nonglomerular haematuria. Their histologic appearances were nearly normal, and immunofluorescence was negative or mild positive. But electron microscopic appearances were diagnostic. Electron microscopy is the only diagnostic method for MC, ALS, TMN and eMN.


[Application of electron microscopy in the diagnosis of neoplasms].

The majority of neoplasms can be diagnosed by light microscopy, but in some cases the diagnosis remains ambiguous due to poor differentiation, even though special stainings have been employed. This paper presents 34 cases of neoplasms in which the tumors were diagnosed by electron microscopy. This includes distinguishing (1) anaplastic carcinoma from lymphoma; (2) anaplastic carcinoma from amelanotic melanoma; (3) APUDoma from other tumors; (4) different mesenchymal tumors. The diagnoses of 4 cases of malignant melanoma, 11 cases of APUDoma, 7 cases of poorly differentiated carcinoma or anaplastic carcinoma, 2 cases of non-Hodgkin's lymphoma, 9 cases of mesenchymal tumors and 1 cases of other tumors have been resolved by electron microscopy. It is obvious that in some cases, electron microscopy can be of help in establishing a correct diagnosis.


[Histopathological and immunopathological studies on experimental pulmonary candidiasis].

Experimental pulmonary candidiasis was produced by intratracheal inoculation of candida albicans in mice. The pathological changes could be divided into two stages, dominated by polymorphonuclear leukocyte infiltration and granuloma formation respectively. Preincubation of C. albicans with mouse anti-C. albicans antibody showed no obvious effect on pathological changes of the lungs as compared with the changes in the control mice, indicating that specific antibody did not play a crucial role in the defence mechanism of the lungs against C. albicans infection in normal mice. In the mice injected with antineoplastic drugs and hormones, abundant pseudohyphae were found in the lungs. Tissue necrosis and hemorrhage were obvious.


[Observation on the phenotypic changes of tumor-infiltrating lymphocytes(TIL) during cultivation in vitro].

Tumor-infiltrating lymphocytes (TIL) were isolated from 5 malignant tumors and their phenotypes were analyzed by flow cytometry when co-cultured with recombinant human interleukin-2 (rIL-2). It was shown that 84% (+/- 8%) of TILs were OKT3+in phenotype after three weeks of cultivation. Among these, OKT8+subpopulations amounted to 77%(+/- 13%), while OKT4+subpopulations were only 14%(+/- 11), and the ratio of OKT4+/OKT8+changed from 0.5:1 (in the first week) to 0.18 (in the third week). Two parameters (mode and peak) in the histogram of flow cytometry varied in accordance with the variations of TIL's phenotypes. The results suggested that TILs stimulated by rIL-2 could be enriched predominantly in a single subpopulation (OKT8+), which might be related with their specific effects against tumor growth.


[The effects of different lipoproteins on cholesterol metabolism in smooth muscle cells of rabbit aorta].

In the present experiment, M-SMC were cultured from rabbit aorta by an explant method and I-SMC cultured by the explant method from cannulated aortic intima of rabbits, and the effects of LDL, A-LDL, OX-LDL and HDL on the cholesterol metabolism in both types of cells were investigated by using 14C oleic acid as the source of cholesterol re-esteri fication in cells. The results showed that LDL enhanced cholesterol re-esterification in both types of cells and HDL had an opposite effect, A-LDL could increase CE synthesis only in I-SMC, while OX-LDL showed a complex effect on the level of CE in different cells by different concentration. The present experiment has studied the relationship between lipoprotein and cholesterol metabolism in SMC at the level of cell metabolism, and suggests that lipoproteins play a key role in AS.


[Localization of fibronectin in atherosclerotic lesions by immunohistochemistry and immunoelectron microscopy].

This paper reports the results of a study on the distribution of fibronectin (FN), its form, character and source in atherosclerotic lesions, using immunohistochemistry (PAP method) and immunoelectron microscopic technique. The results showed that large amounts of FN were localized in fatty streaks, gelatinous lesions and early atherosclerotic plaques. The intima smooth muscle cells in atherosclerotic lesions synthesized more FN, and it is likely that FN represents a new marker of smooth muscle cell modulated from "contractile" to "synthetic" state. With the maturation of atherosclerotic plaque, FN did not fill the whole plaque but was concentrated only in the fibrous cap surface and basocentral part of the atheroma. We also proved that procollagen III peptide (PIIIP) distribution in atherosclerotic plaque was similar to that of FN.


[Histopathological and ultrastructural changes in 57 cases of high altitude heart disease].

This paper reports the histopathologic and ultrastructural changes in 37 children and 20 adults with high altitude heart disease. Its clinicopathologic features, diagnostic criteria and differential diagnosis from Ke-shan disease and other heart diseases are discussed. The right heart of 37 children showed hypertrophy and dilatation. Microscopically, necrosis and scarring were found mainly in the right ventricular wall (29/37) and the anterior papillary muscles (29/37) of the right ventricle. The hearts of 20 adults (19 Hans and 1 Tibetan) were enlarged and increased in weight. Heart weight increased to 400-500g in 15 cases, and hypertrophy of both ventricles was seen in 16 cases. Necrosis and scarring were found mainly in the papillary muscles (20:16) and the ventricular walls (11:19) of the left and right ventricles. Electronmicroscopy showed that myofibrils were dissolved or degenerated, mitochondria swelled, endoplasmic reticula dilated and glycogen granules decreased. As regards the pathogenesis, the authors stress the role of chronic hypoxia which causes myocardial damage, and advocate the importance of early diagnosis and treatment.


Generation of Minute phenotypes by a transformed antisense ribosomal protein gene.

Antisense RNAs have been used for gene interference experiments in many cell types and organisms. However, relatively few experiments have been conducted with antisense genes integrated into the germ line. In Drosophila reduced ribosomal protein (r-protein) gene function has been hypothesized to result in a Minute phenotype. In this report we examine the effects of antisense r-protein 49 expression, a gene known to correspond to a Minute mutation An antisense rp49 gene driven by a strong and inducible promoter was transformed into the Drosophila germ line. Induction of this gene led to the development of flies with weak Minute phenotypes and to the transient arrest of oogenesis. Parameters that may affect the success of antisense gene inactivation are discussed.


Broad-complex function during oogenesis in Drosophila melanogaster.

The Broad-Complex (BR-C) appears to encode factors that mediate ecdysone effects during the larva-adult transition. The main goal of this study was to gain insight into what roles the BR-C might play during oogenesis. The main findings are as follows. First, as determined by heteroallele studies and clonal analysis, de12 is a somatic line mutation that appears to fall into the broad domain of the BR-C. Second, the de12 mutation is associated with the insertion of the gypsy transposon at position 169.5 (Chao and Guild, Embo J, 1986, 5:143-150) in the BR-C domain. In its new context this gypsy element exhibits ovarian-specific activation. Both this gypsy activation and the de12 phenotype are partially suppressible by su(f) and su(Hw). Third, we have identified a set of transcripts that cross-hybridize with BR-C sequence spanning the gypsy insertion site (166-179). There are significant differences in these cross-hybridizing species, both in size and relative abundance, between de12 and its parent strain. Finally we have determined that in de12 there is a premature arrest of chorion gene amplification in the late stages of oogenesis.


Sequential up-regulation of thyroid hormone beta receptor, ornithine transcarbamylase, and carbamyl phosphate synthetase mRNAs in the liver of Rana catesbeiana tadpoles during spontaneous and thyroid hormone-induced metamorphosis.

During both spontaneous and thyroid hormone (TH)-induced metamorphosis, the Rana catesbeiana tadpole undergoes postembryonic developmental changes in its liver which are necessary for its transition from an ammonotelic larva to a ureotelic adult. Although this transition ultimately results from marked increases in the activities and/or de novo synthesis of the urea cycle enzymes, the precise molecular means by which TH exerts this tissue-specific response are presently unknown. Recent reports, using RNA from whole Xenopus laevis tadpole homogenates and indirect means of measuring TH receptor (TR) mRNAs, suggest a correlation between the up-regulation of TR beta-mRNAs and the general morphological changes occurring during amphibian metamorphosis. To assess whether or not this same relationship exists in a TH-responsive tissue, such as liver, we isolated and characterized a cDNA clone containing the complete nucleotide sequence for a R. catesbeiana urea cycle enzyme, ornithine transcarbamylase (OTC), as well as a genomic clone containing a portion of the hormone-binding domain of a R. catesbeiana TR beta gene. Through use of these homologous sequences and a heterologous cDNA fragment encoding rat carbamyl phosphate synthetase (CPS), we directly determined the relative levels of the TR beta, OTC, and CPS mRNAs in liver from spontaneous and TH-induced tadpoles. Our results establish that TH affects an up-regulation of mRNAs for its own receptor prior to up-regulating CPS and OTC mRNAs. Moreover, results with cultured tadpole liver demonstrate that TH, in the absence of any other hormonal influence, can affect an up-regulation of both the TR beta and OTC mRNAs.


Early gene interaction during prepupal expression of Drosophila arginine kinase.

Arginine kinase displays a distinctive rise and fall in specific activity and specific protein levels during the prepupal stage of Drosophila development with maximal activity occurring at morphological stage P3. This developmentally regulated peak is under the influence of ecdysone. Altered doses of the major ecdysone-inducible "early" genes at cytological regions 75B and 2B5 alter this pattern of expression while altered doses of another major "early" gene at 74EF have no effect. We hypothesize that a product of the 2B5 locus and a product of the 75B locus interact to effect this developmental pattern of expression of Drosophila arginine kinase.


[Diurnal sleep apnea in myotonic dystrophy].

We investigated diurnal sleep apnea in myotonic dystrophy with respiratory inductive plethysmography. Five of eight patients met criteria for sleep apnea syndrome and had central apnea mainly. In a case showing periodic breathing with apnea like Cheyne-Stokes type breathing, the duration of apnea and breath was even and the tidal volume went waxing and waning regularly. In the other four cases, central apneas were observed in sequence, but the duration of apnea and the tidal volume changed variously. Large breaths between apneas elevated arterial oxygen saturation rather than stable breaths without apnea. We suspected that hypoxemia, which exacerbated by involvement of respiratory muscles, supine position and sleep, initiated the hyperventilation between apneas. And then the saturation of oxygen raised by hyperventilation would cause central sleep apnea.


[Neurological and neuroimaging studies of eclampsia].

Clinical and neuroimaging studies were made in twenty-one patients during the attack of eclampsia. Most frequent neurological signs and symptoms were the impairment of consciousness, headache, seizure and visual disturbance. Mean arterial blood pressure increased by 46 mmHg (n = 21) during the attacks. Eight of 9 patients studied by CT and/or MRI showed transient abnormalities on brain images during the attack in the occipital cortex, basal ganglia, and internal and external capsule. The findings were compatible with brain edema and were seen mainly in the white matter. Cerebral blood flow measured by SPECT method in one patient during an attack with visual disturbance showed increased blood flow in the occipital cortex. Acute increase in blood pressure, cerebral hyperperfusion and edema, similar to the pathophysiology of hypertensive encephalopathy, were considered to play an important role in the pathogenesis of eclampsia.


[The correlation between vertebral artery asymmetry and pontine infarction--an MR angiography study].

The purpose of this study is to evaluate the correlation between variation of the vertebral artery (VA) and the incidence of pontine infarction. A total of 206 patients were examined using magnetic resonance imaging (MRI) and 3-dimension time-of-flight MR angiography (MRA) of the brain. Of these, 54 patients had pontine infarctions (23 symptomatic and 31 asymptomatic), and the majority of them were located in the pontine base. The sites of dominant lesion in the pons were right in 18 cases, left in 8 cases, and bilateral in 28 cases. The number of patients with VA asymmetry (the ratio of internal diameters 1:2 or more) were 89 (43.2%). Of these, 67 patients had small diametric VA of right side, and 22 of left side. Among the 117 patients with normal VA pattern, 19 (16.2%) had infarction, while among the 89 patients with VA asymmetry, 35 (39.3%) had infarction. The patients with small diametric VA of right side significantly had infarctions in the same side of the pons. The results of this study suggest that VA asymmetry is considered to be one of the risk factors of pontine infarction and that MRA can be useful in the examination of the cerebral artery as a valuable and non-invasive screening method.


[Adverse effect of antiepileptic drugs on the visual recognition--a contrast sensitivity function study].

Contrast sensitivity function (CSF) was measured in 16 patients (14-60 yr.) with epilepsy to investigate adverse effect of antiepileptic drugs on the central nervous system. Eight patients were treated with phenytoin, while 8 were given polytherapy (phenytoin in combination with phenobarbital, carbamazepine or valproic acid). Thirty-one normal controls (19-59 yr.) were also subjected to this study. Vertical sinusoidal gratings with various spatial frequencies (0.5-20.0 c/deg) were presented on a video monitor. Contrast sensitivity (reciprocal of threshold contrast) was determined at each spatial frequency. CSF of normal subjects showed an inverted U-shaped function against the spatial frequencies with a peak at 6 c/deg (medium size pattern). There was no significant difference in CSF values between normal controls and patients with epilepsy. However, 3 patients with polytherapy showed the significant reduction of contrast threshold. Since these patients did not complain of visual disturbance with normal visual acuity, CSF abnormality was considered as having subclinical visual dysfunction. These results suggest that CSF is useful for evaluating the adverse effect of antiepileptic drugs on the visual recognition, and that polytherapy is responsible for CSF abnormality. Therefore, monotherapy should be scheduled from the onset of therapy.


[A case of hemi-hyperhidrosis and non-paralytic pontine exotropia due to brainstem infarction].

A case of hemihyperhidrosis and non-paralytic pontine exotropia due to brainstem infarction is reported. A 55-year-old hypertensive man developed right hemiparesis with slight dysarthria and nausea upon awaking. The right side of his face and right upper limb and trunk to the level of the Th8-9 territory showed hyperhidrosis, which disappeared in a week. Ocular motor examination revealed that during forward gaze with the left eye fixing, the right eye deviated outward. The patient was able to adduct the right eye to midposition with the right eye fixing. Rightward gaze elicited full abduction and right-beating nystagmus of the right eye, but the left eye did not adduct. When he attempted to gaze leftward, both eyes made the full excursion, but saccades were slow in that direction. Convergence was intact. Vertical gaze was full, and he did not show Horner's sign. This ocular sign, non-paralytic pontine exotropia, disappeared three days later. T2-weighted spin echo magnetic resonance imaging disclosed a small lesion with high intensity in the inner side of the left middle pons. This hyperhidrosis was thought to be caused by destruction of inhibitory fibers thermoregulating sweating. These findings suggest that at the level of the middle pons inhibitory fibers descend along the inner side of facilitatory fibers thermoregulating sweating, which are speculated to descend the dorso-lateral part of the pontine tegmentum. These findings also suggest that lesions of non-paralytic pontine exotropia may be located in the paramedian pontine reticular formation rostral to the abducens nucleus with ipsilateral medial longitudinal fasciculus lesion, but further investigation is necessary.


[A case of pontine hemorrhage showing hemiasomatognosia].

We reported a case of pontine hemorrhage showing hemiasomatognosia. A 74-year-old, right-handed man was admitted to our hospital complaining of numbness of left upper and lower extremities. Neurological examination revealed marked disturbance of superficial and deep sensation of left half of his body without hemiparesis and consciousness disturbance. Neuropsychologically, he had experience of having lost the perception of his left upper limb, which was referred to "conscious hemiasomatognosia" by Frederiks. Brain CT and MRI showed a pontine hematoma involving the right medial lemniscus, the right spinothalamic tract and the right medial longitudinal fasciculus. One week after the onset, hemiasomatognosia disappeared with improvement of sensory disturbance. These indicate that this form of hemiasomatognosia may be associated with transient blockage of somesthetic input.


[Bezafibrate myopathy in two patients with chronic renal failure].

Case 1, a 60-year-old man and case 2, a 70-year-old man had several year history of chronic renal failure with hypertension and hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 1,200 mg per day in case 1 and 400 mg per day in case 2 respectively. Three to fourteen days later, both patients noticed symmetrical muscle pain and weakness. Then the symptoms worsened and they were hospitalized. At the time of admission, both patients revealed weakness in the proximal muscles of their upper and lower limbs and the serum creatine kinase and myoglobin levels were remarkably elevated. Myoglobinuria was also noted. Routine light microscopic examination of biopsied quadriceps femoris muscles of two patients showed scattered necrotic muscle fibers, some of which were under phagocytosis. The symptoms of the patients were immediately resolved after the drug was discontinued. Serum concentration of bezafibrate was remarkably elevated during treatment. Thus the diagnosis was established as having bezafibrate induced myopathy and, as far as we know, this is the first report of bezafibrate induced myopathy in Japan. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction. Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.


[A case of hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome with spastic paraparesis and severe distal muscle atrophy of lower limbs].

A 16-year-old boy with hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome was reported. He was the second child of first-cousin consanguineous parents. Since childhood, he was mentally retarded and had frequent episodes of vomiting but no unconsciousness attack. Because of progressive gait disturbance since the age of 15, he was admitted to Kyushu University Hospital. Neurological examination revealed mental defect and spastic paraparesis with bilateral positive pathological reflexes. Moreover, severe muscle atrophy and moderate weakness were observed in the distal portion of lower extremities. The diagnosis of HHH syndrome was made by the examination of amino acids in the serum and urine and by the incorporation study of radioactive ornithine into cultured fibroblasts. EMG and nerve biopsy studies suggested that the muscle atrophy seen in this patient was caused by the degeneration of spinal anterior horn cells. Amino acid imbalance, especially elevation of glutamine and glutamic acid in the CSF, may cause dysfunction of neuronal system including anterior horn cells.


[A case of multiple sclerosis with intractable hiccups and sleep apnea syndrome].

A 48-year-old female with multiple sclerosis (MS) accompanied by intractable hiccups of over one month' duration and the sleep apnea syndrome was reported. This MS patient had been well controlled until September 16, 1991 when she experienced nausea, vomiting and hiccups. The patient was admitted to Kawasaki Medical School Hospital on October 9, 1991. A physical examination revealed intractable hiccups. T1-weighted MRI showed a low and T2-weighted image disclosed a high signal intensity area in the tegmentum of the medulla oblongata. The intractable hiccups and vomiting improved with intravenous high dose methylprednisolone injection therapy. The following day, she complained of insomnia and her family observed severe snoring and apnea during the night. These symptoms and the results of a breathing monitor were compatible with the sleep apnea syndrome. These symptoms disappeared following the administration of amitriptyline. There have been few reports of the combination of intractable hiccups and the sleep apnea syndrome in MS. The MRI findings suggest that the causative lesion of these symptoms is in the tegmentum of the medulla oblongata.


[Action myoclonus in adult Huntington's disease].

In contrast to juvenile rigid form of Huntington's disease (HD) in which myoclonus is often seen, only 5 patients with myoclonus complicating adult HD have been reported. We herein described an adult HD patient who suffered from severe action myoclonus leading to physical disability. To our knowledge, this is the first case report in Japan. The patient, a 32-year-old female with a family history of chorea, developed choreiform movements and mental changes since the age of 24. Subsequently her motor disability has been aggravated by distinctively different involuntary movements characterized by sudden, violent, continuous muscular contractions of four extremities on any attempts at movement. Examination revealed moderate dementia and chorea complicated by frequent myoclonic jerks involving upper and lower extremities in posture or during movement. A head CT scan and MRI revealed caudate atrophy. The myoclonus, as recorded by surface electromyography over the right arm consisted of 40-60 msec-synchronous semirhythmic bursts. The cortical component of SEP was enlarged and C reflex was also observed. Clonazepam (4 mg a day) was instituted with a pronounced reduction in myoclonus and a return to her previous level of daily life activity. Although myoclonic jerks are often recognized in juvenile patients with rigid form of HD, they have been considered to exert a minor influence on physical disability. By contrast, our present observation and review of literature suggest that myoclonus may lead to severe motor impairment in adult HD.


[A case of transient parkinsonism due to mesencephalic hemorrhage].

A 68-year-old man was admitted because of sudden onset gait disturbance and bradykinesia. He experienced left putaminal bleeding following mild right hemiparesis and emotional incontinence without any difficulties in his daily life since three years before admission. On neurological examination the patient was alert and oriented. He showed forced crying. Myerson's sign was positive. There were no abnormal findings in ocular movements, pupillary reflexes and other cranial nerves. Muscle tone was increased with cog-wheel phenomenon in bilateral upper extremities. Coordination was preserved. He showed severe akinesia and small steppage gait with stooped posture. Freezing phenomenon was observed in initiation of gait and turning. The deep tendon reflexes were increased in the right side with bilateral pathological reflexes. There was no definite weakness and sensory disturbance in all extremities. Brain CT revealed a small high density lesion in the medial side of right cerebral peduncle and a lens-shaped low density lesion in the left putamen. On T1 and T2 weighted images of MRI, right peduncular lesion showed low signal. It extended to the substantia nigra which was partially destructed. His parkinsonism was rapidly improved and completely disappeared within following two weeks. High density lesion of right peduncle on CT also disappeared. We discussed the mechanisms of parkinsonism following unilateral mesencephalic hemorrhage in this patient.


[A case of angiotropic lymphoma diagnosed by adrenal biopsy].

We reported the first case of angiotropic lymphoma diagnosed by adrenal biopsy in Japan. Immunohistochemical study and southern blot hybridization analysis proved it to be B-lymphocyte origin. A 61-year-old man with history of mild hypertension and diabetes mellitus was admitted to our department because of recurrent minor stroke. On admission, general physical findings were normal. Laboratory investigations showed an elevated erythrocyte sedimentation rate and increased serum lactic dehydrogenase (LDH) level. The serial computed tomographic (CT) scan of the brain showed multifocal abnormal density lesions in bilateral hemispheres. Magnetic resonance imaging (MRI) of the brain demonstrated multiple lesions of increased signal intensity in the brainstem and bilateral hemispheres. A subsequent CT scan of the abdomen revealed swelling of bilateral adrenal glands. Adrenal biopsy was performed. Biopsy samples showed the intravascular proliferation of malignant lymphoma cells, non-Hodgkin, diffuse large cell type. These cells had the immunophenotype of a B cell lymphoma (reactive with the antileukocyte common antigen, anti-MB-1, anti-MB-2 and anti-MX-pan B, and unreactive with the anti-MT-1, anti-UCHL, anti-Ki, anti-kappa, anti-lambda and antifactor-VIII). Southern blot hybridization analysis showed monoclonal rearrangements of the immunoglobulin heavy-chain gene, which strongly suggested a B-lymphocyte origin. Thus, a diagnosis of angiotropic lymphoma was made. As soon as chemotherapy was begun, the patient fell into deep coma. A repeat CT scan of the brain was normal. His clinical status gradually deteriorated, and he died 18 months after his initial symptom. Autopsy, which was limited to the body, revealed characteristic systemic intravascular stagnation of lymphoma cells.(ABSTRACT TRUNCATED AT 250 WORDS)


[A case of ornithine transcarbamylase deficiency presenting severe symptoms in adulthood].

An adult female case of ornithine transcarbamylase (OTC) deficiency is presented in the following. The patient had had past episodes of drowsiness with a duration less than a few minutes several times a year during childhood. She suddenly became comatose at 25 years of age, and died after 13 months of persistent vegetative state. Blood chemistry showed hyperammonemia with no liver cirrhosis or portal-systemic shunt. Plasma amino acid analysis indicated elevated glutamate and glycine levels, and plasma levels of citrulline and arginine to be low. The urinary orotic acid level was high. OTC activity of a liver specimen was 65 percent of the normal level. This is a rare case demonstrating hyperglycinemia and an elevated level of serum OTC. The importance of ruling out defective ureagenesis in adults with disturbed consciousness should be emphasized.


[A case of Machado-Joseph disease--cerebral blood flow and cerebral metabolic rate of oxygen].

A 51-year-old woman, with progressive gait disturbance and dysarthria, had been diagnosed as Menzel-type spinocerebellar degeneration. Later, she developed dystonic posture of upper limbs and bulging eyes. She was diagnosed as Machado-Joseph disease from neurological findings, which consisted of cerebellar signs, pyramidal tract signs and extrapyramidal tract signs and peripheral neuropathy. She died suddenly of unknown origin. Her illness lasted about 13 years. Neuropathological findings showed moderate neuronal loss with gliosis in the subthalamic nucleus, globus pallidus, substantia nigra, dentate nucleus, oculomotor and hypoglossal nucleus and anterior horn. Positron emission tomography (PET) using 15O steady state inhalation technique revealed reduction of cerebral blood flow and cerebral metabolic rate of oxygen in not only cerebellum but also cerebral cortex. These findings are different from typical PET findings of spinocerebellar degeneration.


[A case of moyamoya-like disease with repetitive TIA on drinking].

We reported here a patient of moyamoya-like disease with repetitive limb-shaking TIAs on drinking. Regional cerebral blood flow (rCBF) was quantified with and without drinking by single photon emission computed tomography with intravenously injected N-isopropyl-p-(I-123) iodoamphetamine (IMP). RCBF was reduced by alcohol ingestion. We speculated that homodynamic TIAs might be caused by impaired autoregulation in the region of the left carotid artery.


[A case of neuro-Behçet's disease with hemorrhagic brain stem lesion detected by MRI].

A 45-year-old woman complained of fever, arthralgia and left hemiparesis. She had suffered from recurrent oral aphthous ulcers, genital ulcers, uveitis and erythema nodosum. Laboratory examination demonstrated pleocytosis in the cerebrospinal fluid. MRI showed foci of high signal intensity on the T2-weighted images in the right pontine base, surrounded by a rim of low signal intensity suggestive of small hemorrhages. Following steroid therapy, these symptoms diminished and abnormal findings in brain MRI improved. This MRI findings may be due to hemosiderin deposition at recent stage resulting hemorrhages in foci of acute inflammation stage. We would like to emphasize that MRI are useful to evaluate the lesion of neuro-Behçet's disease and some lesions may behave like hemorrhages.


[Divergence paralysis due to a lesion of the lateral tegmentum of the midbrain caused by thalamic hemorrhage].

A 66-year-old diabetic and hypertensive man suddenly developed right hemiplegia. Examination revealed right hemiplegia including his face, vertical gaze palsy, and divergence paralysis. The cranial CT scan disclosed a left thalamic hemorrhage as large as 40 mm in diameter, which extended to the midbrain. He was treated medically and his divergence paralysis improved. But all other symptoms remained for the next 11 months and he eventually died of acute retroperitoneal hemorrhage. The autopsy revealed spongy state and gliosis extending from the left thalamic nuclei to the left midbrain. In the tegmentum, dorsolateral part around the left oculomotor nucleus was involved. The precise location of the human divergence center of the eyes is still unknown. According to previous reports, the divergence center may locate in the tegmentum of the midbrain or pons. Recently, animal experiments detected the neurons which fire for divergent in the mesencephalic reticular formation just dorsal and lateral to the oculomotor nuclei. Our case had a lesion of gliosis and spongy state, namely the old hematoma, in the same portion. Therefore, we considered that the human divergence center of the eyes might exist in the lateral tegmentum of the midbrain, just lateral and dorsal to the oculomotor nucleus.


[Adult-onset neuronal ceroid lipofuscinosis--a case report with biological study].

A 32-year-old male was admitted to our hospital complaining of dementia, gait disturbance and blindness. These symptoms developed at the early two decade and were progressive. On admission, his clinical features included dementia (IQ = 69), spasticity, accentuated deep tendon reflexes, ataxia and hypesthesias in his distal limbs. Brain CT scans showed diffuse cerebral atrophy. On light microscopy, many abnormal lipopigments resembling ceroid and lipofuscin were found in Schwann cells of sural nerve and histiocytes of colon. Ultrastructurally, these materials showed lamellar structure like Zebra bodies. Nine lysosomal enzymes, serum very long-chain fatty acids, serum amino acids and urinary oligosaccharides were all normal. Neuronal ceroid lipofuscinosis (NCL) of adult type was diagnosed on the basis of clinical features, radiological and pathological findings, and biochemical studies. Many previous studies suggested that NCL was a disorder with lysosomal dysfunction. We examined lysosomal protein degradation, using 125I-low density lipoprotein (LDL) in cultured fibroblasts from this patient. The degradation of LDL was normal, compared to control subjects. The activities of cathepsin and lysosomal glycosidases, were also normal. The amount of urinary dolichol has been reported to be elevated in the patients with infantile and late infantile types of NCL. However, no elevation was found in the urine of our patient.


[Three-dimensional surface display with 123I-IMP in corticobasal degeneration].

A 65-year-old right-handed woman was admitted due to gait disturbance. She had suffered from progressive motor clumsiness in the left-sided limbs for four years. On admission, she was mildly demented, but not aphasic. Neurological examination disclosed constructional disability, limb-kinetic apraxia on the left side, and parkinsonism. Brain CT and MRI showed no responsible lesion. Three-dimensional surface display with 123I-IMP demonstrated decreased cerebral blood flow mainly in the right angular gyrus, and mildly in the right central region. She was clinically diagnosed as having corticobasal degeneration. Hypoperfusion in the angular gyrus and central region may account for constructional disability and limb-kinetic apraxia, respectively. Three-dimensional surface display with 123I-IMP appears to be useful for detecting the cortical region.


Oral lesions in elderly denture wearers.

A total of 298 patients in geriatric institutions were surveyed; 62.8% were edentulous. The frequency of denture hyperplasia and of flabby ridge was related to denture quality which deteriorates with irregular dental visits. Denture stomatitis and inflammatory papillary hyperplasia of the palate were related to denture age only and not to quality. All denture-related lesion frequencies increased with patient age and denture age. The total frequency of soft tissue lesions was 16.7% in edentulous non-denture patients and 58.2% in patients with poor quality dentures. The lowest frequency of soft tissue lesions was in edentulous, non-denture patients. Poor oral hygiene increased the frequency of positive cultures for Candida from the dentures.


Arizona providers' use and knowledge of fluoride supplements.

Dietary fluoride supplements are recommended for dental caries prevention in children without access to optimally fluoridated water. Previous studies have shown deficiencies in dentists' and physicians' knowledge about dietary fluoride supplementation. Data were collected from dentists, physicians and other healthcare provider groups to assess dietary fluoride supplement knowledge and practices. Pediatricians and dentists were found to be the most knowledgeable concerning the recommended prescribing protocols. Substantial proportions of all practitioner groups had insufficient knowledge about the recommended dosages of dietary fluoride supplements by age, fluoride levels in local water supplies, and the effectiveness of fluoride delivery methods. Baseline knowledge and practices were determined for healthcare provider groups within Arizona.


Clinical effects of a stannous fluoride mouthrinse on plaque.

The purpose of this 3-week, double-blind study was to determine the effect of a stannous fluoride-containing mouthrinse on existing and developing dental plaque. A total of 55 subjects (mean age = 31.42 yrs.) received a professional prophylaxis in randomly assigned contralateral quadrants and were then stratified into two balanced groups based on screening plaque scores: one group (27 subjects) used the placebo rinse, the second group (28 subjects) used the test mouthrinse (0.63% diluted to 0.1% stannous fluoride). Plaque index (PI) and stain index (SI) were scored at baseline, week 1 and week 3. Gingival inflammation (GI) was monitored as a measure of product irritancy potential. The PI for the stannous fluoride rinse was significantly lower than the placebo, (p < 0.0001), for both prophied and unprophied sites with an average reduction of 29% at week 1 and 28% at week 3. There was no statistically significant difference between the presence or absence of prophylaxis. Plaque indexes for both stannous fluoride and placebo showed significant reduction (p < 0.0001) compared to baseline in all sites. Differences in staining potential between stannous fluoride and placebo were not significant (p > 0.05) at any time during the study. The stain index for both stannous fluoride and placebo showed a non-significant increase from baseline in the prophied and unprophied sites. No irritancy was noted, although a trend towards lower GI scores was observed at 3 weeks for the stannous fluoride group.(ABSTRACT TRUNCATED AT 250 WORDS)


Remineralizing potential, antiplaque and antigingivitis effects of xylitol and sorbitol sweetened chewing gum.

The objective of this study was to investigate the effects of xylitol and sorbitol sweetened chewing gums on plaque accumulation, gingival inflammation and remineralizing potential of plaque following six weeks of use. Twenty-eight consenting individuals were randomly assigned to each of three phases (six weeks in duration) consisting of chewing xylitol gum, chewing sorbitol gum and a non-chewing phase. Subjects chewed one stick after every meal and at two other times for a total of five sticks per day. At the completion of each treatment phase, plaque and gingival indexes were performed and plaque was later collected. Calcium concentration in plaque was determined by atomic absorption spectophotometry. Reductions in plaque indexes were significant for both xylitol gum (p < 0.001) and sorbitol gum (p < 0.05) when compared to the no chewing period. The gingival indexes reflected a decrement in gingival inflammation with both xylitol and sorbitol, though only sorbitol values were statistically significant (p < 0.05). Chewing xylitol and sorbitol gums reduced plaque accumulation and gingival inflammation. In addition, both gums enhanced the remineralization potential of plaque. Xylitol gum showed a superior effect with respect to remineralization potential and plaque reduction. Sorbitol gum had a superior effect on gingival health but not significantly so.


Non-invasive 27-hour blood pressure registration including dental checkups in some dental practices.

The study involved 53 patients aged 18 to 67 (mean age 38.8, SD 13.6), 26 male and 27 female, who were monitored by means of a 27-hour non-invasive ambulant blood pressure registration, using the Oxford Monitoring System. All patients had been under dental supervision by the same dentist for more than one year, and were familiar with the procedure during checkups. This study showed a significant rise in systolic blood pressure (8.6 mmHg) and a tendency towards increased diastolic pressure (2.9 mmHg) during dental checkups in comparison with the values recorded 24 hours earlier during normal daily activity. These results were independent of the blood pressure classification (normotensive, borderline or hypertensive) of the patients and are comparable to the increases measured during a visit to the GP. Neither the sex nor the manner of the dentist had any significant influence on either the systolic or diastolic pressure values during the checkup. Nor did the phobic level of the patients significantly influence blood pressure values during the dental checkup. On the basis of the results of this study, it may be concluded that regardless of whether the patient is phobic or non-phobic, and regardless of the sex and manner of the dentist, blood pressure measurements taken during dental checkups are reliable and can be used for referral decisions.


In vivo effect of cis- and trans-diamminedichloroplatinum(II) on DNA and chromatin degradation in Ehrlich ascites tumour cells.

Ehrlich ascites tumour (EAT) cell nuclei were isolated from mice treated with cis- and trans-diamminedichloroplatinum(II) (DDP). The electrophoretic analysis of DNA extracted from corresponding nuclei revealed the high level of EAT DNA stability suggesting very low DNA endonuclease activity. The DNA degradation to high molecular weight fragments was achieved by mild treatment of nuclei with exonuclease DNase I. Cis- and trans-DDP reduced the rate of EAT DNA breakdown to high molecular weight fragments. Direct gel electrophoresis of the same nuclei confirm and extend our recent finding of rat liver chromatin breakdown to large chromatin blocks of uniform size.


Erythrocyte membrane lipid composition fluidity in patients with essential hypertension.

The lipid composition and fluidity of erythrocyte membrane in 36 patients with essential hypertension were examined. The results showed that either cholesterol/phospholipid molar ratio or lipid peroxides content was significantly increased (P < 0.01 or 0.001), and the superoxide dismutase activity, contents of four classes of phospholipids, i.e., phosphatidyl ethanolamine, phosphatidylcholine, phosphatidylserine and sphingomyelin of erythrocyte membrane, and lipid fluidity were significantly decreased (P < 0.05, < 0.01 or < 0.001) as compared with those in 35 normotensive control subjects. These results suggested that the changes of lipid composition and fluidity might associate with the decreased activities of cation transport systems in cell membranes and play an important role in the pathogenesis of essential hypertension.


Evaluation of the effect of PTCR/PTCA by 99mTc-MIBI myocardial imaging in acute and old myocardial infarction.

This study is to clarify the ability of technetium-99m-Hexakis-2-methoxyisobutyl isonitrile(MIBI) myocardial scintigraphy for assessment of the effect of PTCR/PTCA as compared with conventional thallium-201 myocardial scintigraphy (201Tl). 99mTc-MIBI (740-888MBq) was injected before emergency PTCR/PTCA, and the initial imaging was performed immediately after PTCR/PTCA in 4 patients with acute myocardial infarction (AMI). On the other hand, in 2 patients with old myocardial infarction (OMI), 201Tl and MIBI myocardial imagings were performed before and one week after rescue PTCA. The defect area on the follow-up MIBI imaging was smaller than that on the initial MIBI imaging in 2 patients with successful emergency PTCR/PTCA. But in the other 2 AMI patients with unsuccessful reperfusion, the defect area did not significantly decrease after PTCR/PTCA. Reperfusion was successful in one of the two patients with OMI. In both the two patients with OMI, the MIBI defect area did not significantly decrease after rescue PTCA. MIBI myocardial scintigraphy is a useful noninvasive method for evaluating the effect of emergency PTCR/PTCA for myocardial salvage in patients with AMI, because MIBI is a kit type agent, and it does not redistribute.


Vitamin D and calcium metabolism in children with nephrotic syndrome of normal renal function.

This study demonstrates that there are distinct abnormalities of vitamin D and calcium metabolism in children with nephrotic syndrome (NS) and normal renal function. In patients with active NS, serum calcium, ionized calcium, 25-OHD3 and CT were decreased, plasma PTH level was increased and serum ALP was elevated. These abnormalities returned to normal in remission. Serum 1,25-(OH)2D3, although normal in absolute value during both active and remission stage, may be inappropriately low for the hypocalcemia and hyperparathyroidism during the active stage. Therefore, children with active NS are at the risk of developing metabolic bone disease. The treatment with a high dose of vitamin D3 may correct the abnormalities, which suggests vitamin D3 should be used in children with protracted active NS.


Protective effect of Re-LPS antiserum on experimental multiple system organ failure.

This study examines the possible beneficial effect of Re-LPS (F515) antiserum on experimental multiple system organ failure (MSOF) in rabbits. The results showed that the plasma LPS level was significantly decreased, and it took a shorter period to clear up LPS in experimental than in control rabbits after receiving Re-LPS antiserum. Pretreatment with antiserum can markedly improve the function of the liver, lungs, kidneys, blood and gastrointestinal tract. The MSOF incidence in the group of rabbits receiving immune sera was only 11.2% and the survival rate was raised by about 40.0%. The results suggest that early passive immunotherapy may neutralize gut-derived endotoxin, inhibit endotoxin-induced mediators release and prevent development of severe complications due to sepsis. It is therefore postulated that LPS core antiserum may provide a prophylactic effect on the development of experimental MSOF.


A study on a family with high incidence of leukemia.

A family with a high incidence of leukemia was investigated and followed up for 10 years. Up to now, 7 of 48 members in this family had acute nonlymphocytic leukemia. Chromosomal aberration was found in 3 healthy members, 2 of whom were found to have 47, XX, +5, -8, +Mar, del (7) (q22-qter) and 45, XO, -Y chromosomes and developed this disease 5 and 7 years later respectively. Pedigree analysis suggested that the hereditary defect in the family should rest on the maternal lineage. It is considered that hereditary factors play an important part in the pathogenesis of leukemia in the family.


Growth promoting effect of zinc supplementation in infants of high-risk pregnancies.

This study was made to determine whether zinc deficiency is one of the factors involved in growth retardation of infants of high-risk pregnancies. The high risk factors were hypertension of pregnancy, diabetes mellitus, congenital heart disease, chronic nephritis, rheumatic heart disease and hyperthyroidism. 102 neonatal infants were divided into 3 groups: breast fed group, 37 cases; test group, 32 cases formula-fed with supplementary zinc 1.14-2.28 mg/kg/d; and control group, 33 cases formula-fed and supplemented with Vitamin B complex as placebo. The groups were divided by double-blind and randomized method. There were no differences in the 3 groups in sex ratio, growth status and serum zinc concentration at the beginning of the study. Anthropometric data were obtained at 0, 3 and 6 months.


Iliac periosteal graft with vascular pedicle in the treatment of avascular necrosis of the femoral head. Experimental study and clinical application.

From March 1983 to June 1987, 6 patients with avascular necrosis of the femoral head were treated with vascular pedicled iliac periosteum graft. Follow-up for 3 to 7.5 years showed satisfactory results. The patients experienced no hip pain, could walk freely, and resumed work after the treatment. X-ray films showed that the original defect of the femoral head was filled up and its outline was clear and smooth. The bone density of the femoral head and neck normalized. The experimental study indicated that the vascularized periosteum improves the blood supply and initiates the revascularization and osteogenesis of the femoral head. The authors conclude that the technique is suitable for the treatment of avascular necrosis of the femoral head of Stage II and III.


DNA-malignancy-grading of bladder tumor and its clinical significance.

The DNA-Malignancy-Grade(DNA-MG) of paraffin-embedded tumor specimens from 38 patients with bladder tumor was determined by image cytometry. A good correlation was found of DNA-MG with clinical staging and histopathological grading. The DNA-MG of T1 and G1 bladder tumor was less than 3.00, while that of T3-4 and G3 bladder tumor was greater than 3.00. The 5-year survival of patients with DNA-MG < 3.00 and > 3.00 was 100% and 36.9%, respectively. The data indicate that DNA-MG plays an important role in the assessment of the prognosis and the planning of treatment.


Neuroarthropathy. Clinico-radiologic analysis of 115 cases.

115 patients (163 joints) with neuroarthropathy (Charcot joint) were observed clinically and radiologically. In Charcot joint of the shoulder, the entire scapula was disintegrated. After debridement and arthrodesis, fragmentation of bone reappeared at both ends of the affected long bone and even on the lateral surface of diaphysis. Fragmentation of the articular surface and the subchondral bone was seen in the non-weight-bearing surface. 32 patients in this series sustained spontaneous fractures without a history of trauma or undue strain. Follow-up for short periods (2 to 6 weeks) showed rapid progressive destruction. These results indicated that neurotrophic theory seems to furnish an explanation for the pathogenesis of the Charcot joint, and that bone resorption should be the primary change while bone hypertrophy and proliferation, the secondary.


Imaging study of lumbar posterior marginal intraosseous node. An analysis of 36 cases.

Clinical, radiological and CT manifestations of 36 patients with lumbar posterior marginal intraosseous cartilaginous node (LPMN) were analysed. Of the 36 patients, 27 were male and 9 female, most of them were young adults. The posteroinferior margin of L4 was the commonest site and the posterosuperior margin might also be involved. Two patients had multiple lesions. Typical radiological findings included a defect in the posteroinferior (or posterosuperior) margin of the affected vertebral body and behind the defect a bony ridge protruding into the spinal canal. CT scan showed a cartilaginous node in the posterior zone of the vertebral plate. It is suggested that LPMN was the result of disc material herniating into the posterior aspect of vertebral body through ruptured cartilaginous end-plate during the adolescence, similar to that of the limbus vertebra. Hyperflexion and hyperextension of the spine probably play an important role in the pathogenesis. The existence of LPMN favours posterior disc herniation in the same disco-vertebral junction.


Ischemic stroke treated with Ligusticum chuanxiong.

Ligusticum Chuanxiong and its effective components were studied in the treatment of ischemic stroke, a common emergent disease in China. Some injections of the medicines, including Ligusticum, Ligustrazine, Ligustylid and ferulic acid, were tested clinically and experimentally. The results showed that the effects of the drugs were the same as or even better than those of the controls, such as papaverine, dextran and aspirin-persantin. They could improve brain microcirculation through inhibiting thrombus formation and platelet aggregation as well as blood viscosity.


[Delivered by direct intrauterine transfer of gametes].

A nurse, 27, primary sterility for 5 years with normal pelvic findings. Hysterosalpingogram showed right tube not visualized, and impatent, left tube with slight enlargement at ampulla. Her last menstrual period was September 5, 1991. Ovaries hyperstimulated by clomiphene, HMG and hCG, and 8 ova taken through vaginal aspiration under B scanning on September 19, 1991. Ova and washed sperms were directly introduced into uterine cavity simultaneously. It turned out to be a successful clinical pregnancy, carried on smoothly up to 36(+1) weeks. She spontaneously delivered a healthy male infant weight 2250 grams on May 15, 1992.


[Transcervical resection of endometrium in women with dysfunctional uterine bleeding].

Transcervical resection of endometrium was performed in 65 cases by endoscopic continuous flow resectoscope under epidural anesthesia and B ultrasonic monitoring to treat dysfunctional uterine bleeding which had been treated by conservative measures no avail. Resected tissue included functional and basal layers of endometrium as well as underlying 1-2 mm myometrium. Bleeding immediately after the operation was rare serious followed by watery discharge usually persisted for about 4 weeks. Follow-up examination for 5-20 months showed that 19 cases had amenorrhea, 12 cases spotting, 31 cases had obvious reduced menstrual flow and 3 cases no improvement. Hysteroscopic examination and hysterography in all 24 cases showed no adhesions. This operation involves no abdominal incision and is therefore less traumatic. It is associated with very little bleeding and minimal morbidity. No long term effects on ovarian function was noticed. Endoscopic surgery will probably replace most conventional hysterectomies done for dysfunctional uterine bleeding.


[Prognosis of dysfunctional uterine bleeding at puberty].

The factors related to the prognosis of dysfunctional uterine bleeding (DUB) at puberty were analysed according to the 2 to 15 years' follow-up examination in 44 cases of pubescent DUB. It was found that the establishment of a regular menstrual cycle depends on the duration of disease. Among 19 cases who established a regular cycle, 12 cases (63.2%), 6 cases (31.2%), 1 case (5.3%) with the duration of disease < or = 4 years, 5 to 10 years, and > or = 11 years respectively. The incidence of gynecologic morbidity of pubescent DUB as referred to transfusion, dilatation and curettage, hysterectomy and polycystic ovarian disease was 19/44, 12/44, 1/44 and 5/44 respectively. Of 30 married patients 28 desired children and four of them conceived spontaneously. 9 cases (37.5%) conceived after ovulation induction. It is suggested that the pubescent DUB should be defined as the onset of DUB occurs within 2 years after menarche. Close following up and timely treatment contribute much to the control of the disease and decrease of gynecologic/morbidity.


[Diagnostic errors in dysfunctional uterine bleeding. Analysis of 24 cases].

This paper reports 24 cases of genital organic diseases which were misdiagnosed as dysfunctional uterine bleeding during 1984-1990. These include small submucous uterine myoma 5 cases, Granulosa cell tumor of ovary 2 cases, leiomyosarcoma of uterus 1 case, ectopic pregnancy 7 cases, carcinoma of endometrium 4 cases, abortion 3 cases, choriocarcinoma 2 cases, altogether there were 9 patients with malignant tumors in the series. The author point out that it is possible to reduce the misdiagnosis rate by emphasizing history, diagnostic curettage, ultrasonography, hysteroscopy and blood hCG determination.


[Immunopathological study on the uterine spiral arteries in pregnancy-induced hypertension].

The uterine spiral arteries were studied by the immunohistochemical ABC method in 30 cases of Pregnancy Induced Hypertension (PIH) and 10 cases of normal pregnant women. Depositions of IgM and/or C3 on the vessel wall were significantly observed only in PIH cases (15 cases, 50.0%; P < 0.05). Depositions of IgG were seen in 5 cases of PIH 16.7% showing significantly decrease. (P < 0.001), as compared with the normal pregnant women (9 cases, 90.0%). The results suggest that PIH is related to chronic rejection reaction resulting possibly from the decrease of local immunosuppression in pregnancy. Meanwhile the positive stain of IgG, IgM and C3 seen in the nuclei of decidual cells in some of PIH cases were discussed.


[Pathological and clinical study on 80 cases of liver disease in pregnancy].

Ninety-seven cases of liver disease in pregnancy confirmed by pathological examination were studied. The results showed that in addition to virus hepatitis (58.8%), which was the leading cause, there were quite a proportion of other liver diseases. Among these acute fatty liver of pregnancy accounted for 18.6%, intrahepatic cholestasis of pregnancy were 16.5%. The causes of misdiagnosis and the bases for differential diagnosis were discussed. It was considered that early pathological examination of liver and other morphological study were important in diagnosis of liver diseases in pregnancy.


[The significance of pathological examination of the placenta in exploring the causes of intrauterine fetal death].

The results of pathological examination of 68 placental from intrauterine fetal death during 1982. 4-1989.12 is presented. The shortest time interval between the death of the fetus and the expulsion of the placenta was 14 hours, and the longest was 1 month. The pathological findings may be divided into 5 classes: trophoblastic; stromal; villous net; cord and others. Causes of fetal death could be identified in 65 cases (96%), in which 36 cases (53%) were due to the factors of placenta and its appendix. It was suggested that the pathological examination of placenta might give the clue to the cause of fetal demise.


[Relation between placental morphometry and fetal growth].

Forty-eight placentae of full term infants, 21 placentae from appropriate for gestational age infants (AGA) and 27 placentae from small for gestational age infants (SGA) were measured by morphometric technic using the automatic image analyzer, in order to find out the extent of fetomaternal exchange which determines the transfer of oxygen and nutrition from mother to fetus and fetal growth. The results of measurement correlated well both with infant birth weight and placental weight. They demonstrated striking quantitative differences when the placentae of SGA were compared with those of AGA. The placenta weights in the group of SGA were notably less than those in the group of AGA. It seems that low birth weight relates to low functional tissue mass of placenta. This reduction of functional tissue is accompanied by diminution of the area for exchange between mother and fetus, both at the villous surface area and at fetal capillary surface area. Thus, the ability of transferring oxygen and nutrition from mother to fetus is curtailed. The results show that the rate of fetal growth is limited by placental function as well as its weight.


[Mechanism and effect of anisodamine on uteroplacental circulation in pregnancy-induced hypertension].

The short term effect of anisodamine, an alkaloid isolated from the chinese herb anisodas tonguticus, on blood flow of uterine and umbilical arteries in 16 pregnant women with pregnancy-induced hypertension (PIH) was investigated by means of pulsed doppler ultrasound technique Results have shown that anisodamine could decrease the A/B ratio, resistant index (RI), and pulsative index (PI) of blood velocity in these arteries with statistical significant difference. Its mechanism of action might be the improving of the rheology in PIH and adjusting the imbalance of TXA2/PGI2. It was suggested that the resistance in uteroplacental circulation was decreased and its perfusion improved, so that favors the fetal growth and development.


[Clinical analysis of 60 cases of pregnancy with thrombocytopenia].

Sixty cases of pregnancy with thrombocytopenia were analyzed. Bleeding syndrome was found in 36 patients during pregnancy, with 7 cases suffering from massive hemorrhage during delivery and a postpartum hemorrhage rate of 11.7%. There was a negative correlation between the platelet level and the amount of bleeding during gestation and delivery. We suggest that cortico steroid is necessary with a platelet count less than 50 x 10(9)/L in the middle or late trimester of pregnancy to reduce the bleeding tendency during delivery, as well as the incidence of thrombocytopenia in the newborn infant use of excessive platelet transfusion is not encouraged, since it implicates an increase in antibody-induction (PAIG) and probability of C type hepatitis in the recipient. Platelet transfusion should be reserved only for the treatment of serious hemorrhage. There were 53 newborn infants, 7 of whom (13.2%) suffered from thrombocytopenia, with a mortality of 1.9% (7/53) during the perinatal.


[Carcinoma of the cervical stump. Clinic analysis of 10 cases].

Ten cases of carcinoma of the cervical stumps from Jan. 1965 to Dec. 1990 were analysed. All of the patients received subtotal hysterectomy because majority of patients suffered from benign uterine tumors except one case of ovarian cystadenocarcinoma. The age range of the patients was 40-65 years old. The stump carcinoma was discovered 2-18 years later after primary operations. The average duration was 10.3 years. Only one patient died of 2 years after treatment, remaining patients have good health by surgical and radiotherapy. The authors emphasize that the key to prevent the cervical stump carcinoma is to avoid missing diagnoses of the precancerous lesion and cancer of the cervix, and to closely follow-up the patients with the stumps.


[Radionuclide 13m in scanning pelvic congestion syndrome after tubal ligation].

Here are reported 83 cases with pelvic congestion syndrome after tubal ligation. Radionuclide 113m in blood-pool scanning was found to be a valuable method in detecting this syndrome in 72 cases who were proved by operation with a correct diagnosis rate of 98.6%. The mild cases received non-operative treatment. The relationship between the modalities of tubal ligation and this syndrome was discussed and preventive measures suggested.


Meiotic chromosome distribution in Drosophila oocytes: roles of two kinesin-related proteins.

Recent new information regarding the proteins required for proper distribution of chromosomes in meiosis has come from studies of Drosophila mutants. These studies reveal that proteins related to the microtubule motor protein, kinesin, function in meiotic chromosome segregation in Drosophila females. The two proteins identified thus far are likely to play very different roles in the process. The ncd protein is a spindle motor in meiosis but may perform a different role in the early mitotic divisions of the embryo. nod functions earlier in meiosis than ncd, prior to the meiotic divisions, and may be either chromosome or spindle associated. The identification of nod as a kinesin protein raises new questions regarding the distributive model of meiotic chromosome segregation.


Replication forks are not found in a Drosophila minichromosome demonstrating a gradient of polytenization.

Differential DNA replication is widely held to influence polytene chromosome structure by causing the dramatic reductions in heterochromatic DNA content that are characteristic of most endopolyploid cells. The "underreplication model" of heterochromatic sequence underrepresentation predicts that replication intermediates should populate regions of DNA between fully polytenized euchromatic sequences and underpolytenized heterochromatic sequences. We directly tested this prediction using Dp1187, a 1300 kb Drosophila minichromosome containing well-defined heterochromatic regions. DNA from a euchromatic/heterochromatic junction region of Dp1187, demonstrating a significant gradient of underrepresentation in larval salivary glands, lacked the stalled replication forks predicted by the underreplication model. We consider an alternative mechanism leading to heterochromatic sequence underrepresentation involving a process of DNA elimination.


Effects of deletions on mitotic stability of the paternal-sex-ratio (PSR) chromosome from Nasonia.

Paternal-Sex-Ratio (PSR) is a B chromosome that causes all-male offspring in the parasitoid wasp Nasonia vitripennis. It is only transmitted via sperm of carrier males and destroys the other paternal chromosomes during the first mitotic division of the fertilized egg. Because of haplodiploidy, the effect of PSR is to convert diploid (female) eggs into haploid eggs that develop into PSR-bearing males. The PSR chromosome was previously found to contain several families of repetitive DNA, which appear to be present in local blocks. PSR chromosomes with irradiation-induced deletions have decreased rates of transmission and increased variation in transmission. This study investigates whether these differences in transmission of deletion chromosomes are due to mitotic instability. Two deletion chromosomes (E306 and F316) and the wild-type PSR chromosome were examined. A cytogenetic assay of testes revealed that wild-type PSR males contained the chromosome in 98%-100% of their spermatocytes. Similar counts from carriers of two deletion chromosomes were lower and varied between individuals from 50%-100%. One F316 male did not contain the chromosome in any of its spermatocytes although the chromosome was present in somatic tissues based on hybridization to PSR-specific repetitive DNA. A molecular analysis of males found the wild-type PSR chromosome to be present in all somatic tissues. Tissue specific differences in the presence of PSR were found in several males from the two deletion lines. The results show that deletions can result in mosaicism due to increased mitotic instability of PSR. Such individuals sometimes partially or completely fail to transmit the chromosome.(ABSTRACT TRUNCATED AT 250 WORDS)


A repetitive DNA element, associated with telomeric sequences in Drosophila melanogaster, contains open reading frames.

He-T sequences are a complex repetitive family of DNA sequences in Drosophila that are associated with telomeric regions, pericentromeric heterochromatin, and the Y chromosome. A component of the He-T family containing open reading frames (ORFs) is described. These ORF-containing elements within the He-T family are designated T-elements, since hybridization in situ with the polytene salivary gland chromosomes results in detectable signal exclusively at the chromosome tips. One T-element that has been sequenced includes ORFs of 1,428 and 1,614 bp. The ORFs are overlapping but one nucleotide out of frame with respect to each other. The longer ORF contains cysteine-histidine motifs strongly resembling nucleic acid binding domains of gag-like proteins, and the overall organization of the T-element ORFs is reminiscent of LINE elements. The T-elements are transcribed and appear to be conserved in Drosophila species related to D. melanogaster. The results suggest that T-elements may play a role in the structure and/or function of telomeres.


Sensitive period for the induction of endoreduplication by rotenone in cultured Chinese hamster cells.

Rotenone-induced endoreduplication was investigated in Chinese hamster CHL cells. Cell cycle analyses, using 5-bromo-2'-deoxyuridine (BrdU) labeling, revealed that endoreduplication was induced between the G2-phase and mitotic metaphase. Morphological studies indicated that the chromosomes of cells in metaphase at the time of rotenone exposure immediately aggregated. Within 1 h, however, the aggregated chromosomes began to decondense forming telophase nuclei. Cells with aggregated chromosomes were collected by mitotic selection using the mitotic arrestant TN-16 and then cultured for 30 h following rotenone administration. This population of cells demonstrated an extremely high frequency of endoreduplicated metaphases. Further analysis by BrdU labeling indicated that the aggregated metaphases underwent only one round of DNA replication before endoreduplicated metaphases were formed. The most sensitive period for the induction of endoreduplication by rotenone occurs during mitotic metaphase.


Characterization of a new repetitive sequence that is enriched on microchromosomes of turkey.

We cloned and characterized a new highly repetitive, species-specific DNA sequence from turkey (Meleagris gallopavo). This repeat family, which accounts for approximately 5% of the turkey genome, consists of a 41 bp repeated element that is present in tandem arrays longer than 23 kb. In situ hybridization to turkey metaphase chromosomes (2n = 80) demonstrated that this sequence was located primarily on certain microchromosomes: approximately one-third of the 66 microchromosomes showed a positive signal. With respect to the macrochromosomes, hybridization was seen only in a pericentric position on nos. 2 and 3. The turkey microchromosome (TM) sequence shares motifs (alternating A3-5 and T3-5 clusters separated by 6-8 bp) that have been found previously in other avian tandemly repeated elements, e.g. a chicken microchromosomes sequence, and W (female) chromosome-specific sequences of chicken and turkey. However, the TM sequence does not cross-hybridize under moderately stringent conditions with these other sequences. The spread and amplification of related repetitive sequence elements on microchromosomes and W chromosomes is discussed.


The complex for replication initiation of Escherichia coli.

We probed the complex between oriC and DnaA protein using two types of mutants in oriC. Base changes in the DnaA binding sites, DnaA boxes, had little effect on origin function. Mutations which change the distance between DnaA boxes R3 and R4, on the other hand, inactivated oriC unless the mutation deleted or inserted one complete helical turn. Origins with other 10 base pair insertions in the interval between DnaA boxes R2 and R3 were functional, but not insertions in the R1-R2 interval. FIS protein binds to a bipartite site in oriC between DnaA boxes R2 and R3. A model for the oriC/DnaA complex based on these results suggests an array of DnaA monomers with a 34 A spacing upon which oriC is arranged.