A CASE OF CHOLESTEROSIS OF THE COMMON BILE DUCT DIAGNOSED BY PERORAL CHOLANGIOSCOPY

We experienced a case of cholesterosis of the common bile duct in which peroral cholangioscopy (POCS) was very useful for making a diagnosis. The patient was a 66‐year‐old man. He was admitted for examination of an asymptomatic mass in the pancreas. The mass was diagnosed as a serous cystic tumor of the pancreas. While examining the tumor, endoscopic retrograde cholangiopancreatography (ERCP) incidentally revealed a 7 mm irregular filling defect in the distal common bile duct. EST was then performed, followed by POCS, which revealed a clump of yellowish‐white Ip or Isp polyps in the distal bile duct. Histological examination of biopsy specimens taken under direct vision gave a diagnosis of cholesterol polyps containing foamy cells. POCS was useful for allowing direct observation of the characteristic color of cholesterol polyps, and for obtaining biopsy specimens under direct vision.     

2-Arachidonoylglycerol increases in ischemia-reperfusion injury of the rat liver.

Several studies have implicated endocannabinoids in various forms of shock. However, the role of endocannabinoids in hepatic ischemia-reperfusion injury remains unclear. The purpose of this study was to evaluate the changes of two endocannabinoidsin hepatic ischemia-reperfusion injury: anandamide (ANA) and 2-arachidonoylglycerol (2-AG). Male Sprague-Dawley rats were divided into 2 groups: the short (15 min) ischemic group and the long (60 min)ischemic group in the segmental (70%) hepatic tissue. Blood levels of aspartate transaminase (AST), alanine transaminase (ALT), lactate dehydrogenase (LDH), ANA, and 2-AG were examined. Serum lev-els of AST, ALT, and LDH were significantly higher in the long-ischemia group than in the short-ischemia group. Plasma levels of 2-AG showed similar augmentation prior to and after reperfusion in both the short- and long-ischemia groups, although plasma 2-AG lev-els tended to be higher in the long-ischemia group than in the short-ischemia group. Plasma levels of ANA were augmented in the early phase of reperfusion in the short-ischemia group and did not differ significantly from the normal level with time after reperfusion in the long-ischemia group. These results suggest that the endocannabinoid 2-AG increases in hepatic ischemia-reperfusion injury of rats, rather than ANA.     

Virtual spatial registration of stand-alone fNIRS data to MNI space

The registration of functional brain data to common stereotaxic brain space facilitates data sharing and integration across different subjects, studies, and even imaging modalities. Thus, we previously described a method for the probabilistic registration of functional near-infrared spectroscopy (fNIRS) data onto Montreal Neurological Institute (MNI) coordinate space that can be used even when magnetic resonance images of the subjects are not available. This method, however, requires the careful measurement of scalp landmarks and fNIRS optode positions using a 3D-digitizer. Here we present a novel registration method, based on simulations in place of physical measurements for optode positioning. First, we constructed a holder deformation algorithm and examined its validity by comparing virtual and actual deformation of holders on spherical phantoms and real head surfaces. The discrepancies were negligible. Next, we registered virtual holders on synthetic heads and brains that represent size and shape variations among the population. The registered positions were normalized to MNI space. By repeating this process across synthetic heads and brains, we statistically estimated the most probable MNI coordinate values, and clarified errors, which were in the order of several millimeters across the scalp, associated with this estimation. In essence, the current method allowed the spatial registration of completely stand-alone fNIRS data onto MNI space without the use of supplementary measurements. This method will not only provide a practical solution to the spatial registration issues in fNIRS studies, but will also enhance cross-modal communications within the neuroimaging community.     

10/20, 10/10, and 10/5 systems revisited: their validity as relative head-surface-based positioning systems

With the advent of multi-channel EEG hardware systems and the concurrent development of topographic and tomographic signal source localization methods, the international 10/20 system, a standard system for electrode positioning with 21 electrodes, was extended to higher density electrode settings such as 10/10 and 10/5 systems, allowing more than 300 electrode positions. However, their effectiveness as relative head-surface-based positioning systems has not been examined. We previously developed a virtual 10/20 measurement algorithm that can analyze any structural MR head and brain image. Extending this method to the virtual 10/10 and 10/5 measurement algorithms, we analyzed the MR images of 17 healthy subjects. The acquired scalp positions of the 10/10 and 10/5 systems were normalized to the Montreal Neurological Institute (MNI) stereotactic coordinates and their spatial variability was assessed. We described and examined the effects of spatial variability due to the selection of positioning systems and landmark placement strategies. As long as a detailed rule for a particular system was provided, it yielded precise landmark positions on the scalp. Moreover, we evaluated the effective spatial resolution of 329 scalp landmark positions of the 10/5 system for multi-subject studies. As long as a detailed rule for landmark setting was provided, 241 scalp positions could be set effectively when there was no overlapping of two neighboring positions. Importantly, 10/10 positions could be well separated on a scalp without overlapping. This study presents a referential framework for establishing the effective spatial resolutions of 10/20, 10/10, and 10/5 systems as relative head-surface-based positioning systems.     

Lack of effect of aerobic physical exercise on endothelium-derived nitric oxide concentrations in healthy young subjects

Previous experimental research showed an attenuated vasoconstrictor response after acute exercise. This study aims to determine the effect of aerobic physical exercise on the endothelium-derived circulating nitric oxide (NO) concentrations among healthy young persons. A total of 10 subjects (5 men and 5 women) aged 21-28 were examined for the difference in concentrations of serum and plasma NO metabolites (NOx) before and after a single bout of aerobics, in which they performed cycling exercises at a constant workload corresponding to 90% of the subject-specific anaerobic threshold. A paired t-test resulted in no statistically significant differences between pre- and post-exercise concentrations of serum or plasma NOx. It is suggested that the acute effect of aerobic exercise on the vasoconstrictor/vasodilator response is not mediated by an increase in the endothelial NO release.     

Infiltrating neutrophils induce allospecific CTL in response to immunization with apoptotic cells via MCP-1 production

Our previous studies demonstrated that i.p. injection of late apoptotic P388 cells caused phagocytosis by macrophages and transient infiltration of neutrophils into the peritoneal cavity. As neutrophils are known to function as effectors as well as regulators in the immune response, we examined the roles of infiltrating neutrophils in alloantigen-specific CTL induction after immunization with late apoptotic P388 cells. The CTL induction and infiltration of CD8(+) T cells into the peritoneal cavity were inhibited by depletion of neutrophils by anti-Gr-1 mAb or inhibition of neutrophil infiltration by anti-MIP-2 antibody, suggesting that neutrophils are involved in CD8(+) T cell infiltration into the peritoneal cavity. It is known that MIP-1alpha, MIP-1beta, and MCP-1 are capable of attracting CD8(+) T cells and that they are produced by neutrophils. These chemokines were detected in the peritoneal cavity, and among them, MCP-1 production was reduced remarkably by suppression of neutrophil infiltration. Moreover, infiltration of CD8(+) T cells into the peritoneal cavity as well as CTL activity was clearly reduced by administering anti-MCP-1 antibody i.p. Furthermore, the CTL induction and infiltration of CD8(+) T cells in neutrophil-depleted mice were restored significantly by administering recombinant murine MCP-1 into the peritoneal cavity. These results indicate that MCP-1 appears to link infiltration of neutrophils with CTL induction.     

A syndactyly type IV locus maps to 7q36

Syndactyly occurs as an isolated abnormality or a part of a malformation syndrome. Syndactyly types I, II, III and V have been mapped to chromosomal regions 2q34–q36, 2q31–q32, 6q21–q23.2 and 2q31–q32, respectively, whereas syndactyly type IV (SD4) is extremely rare, and its gene localization has not yet been assigned. The SD4 manifests complete syndactyly of all fingers accompanied with polydactyly, and flexion of the fingers gives the hand a cup-shaped appearance. We performed a linkage and haplotype analysis of a Chinese pedigree with autosomal dominant, non-syndromic SD4 using a set of 406 microsatellite markers. The analysis gave the maximum two-point LOD score of 1.613 at recombination fraction of 0.00 and penetrance of 1.00. Thus, the SD4 locus in the family was likely assigned to a 17.39-cM region at a segment between markers D7S3070 and D7S559 at 7q36, although the LOD score obtained was not high enough to conclude the localization. Analysis of three candidate genes, LMBR1, SHH and ZRS, failed to identify any pathogenic mutations. Our gene mapping may give a clue to identify the putative SD4 gene and provide a better understanding of normal human limb development. Daisuke Sato and Desheng Liang equally contributed to this study.     

Congenital arhinia: molecular-genetic analysis of five patients

Congenital arhinia, complete absence of the nose, is an extremely rare anomaly with unknown cause. To our knowledge, a total of 36 cases have been reported, but there has been no molecular-genetic study on this anomaly. We encountered a sporadic case of congenital arhinia associated with a de novo chromosomal translocation, t(3;12)(q13.2;p11.2). This led us to analyze the patient by BAC-based FISH for translocation breakpoints and whole-genome array CGH for other possible deletions/duplications in the genome. We found in this patient an approximately 19 Mb deletion spanning from 3q11.2 to 3q13.31 but no disruption of any gene(s) at the other breakpoint, 12p11.2. As the deleted segment at 3q was a strong candidate region containing the putative arhinia gene, we also performed the array CGH in four other arhinia patients with normal karyotypes, as well as mutation analysis of two genes, COL8A1 and CPOX, selected among hundreds of genes located to the deleted region, because they are expressed during early stages of human craniofacial development. However, in the four patients, there were no copy number aberrations in the region examined or no mutations in the two genes. Although our study failed to identify the putative arhinia gene, the data may become a clue to unravel the underlying mechanism of arhinia.     

Macroscopic and histotopographic study of the deep transverse perineal muscle (musculus transversus perinei profundus) in elderly Japanese

Although the deep transverse perineal (DTP) muscle is welt known as the core of the urogenital diaphragm, most recent studies have denied its existence. In students' dissection classes, we cut the surfaces of 93 macroscopically identified urogenital diaphragms (59 male cadavers) and found the distinct sheet-like DTP in 24.7% (23 of 93 sides). Another 17 cadavers (mean age 81.4 years) were used for histology. In histology of 12 males, we consistently identified the DTP as a small muscle bundle immediately lateral to the bulbourethral gland. Thus, the macroscopicically unclear morphology of the DTP (19.4%, 18 of 93 sides) seemed to be overestimated. The histologically proven DTP was continuous with a "tail" or inferolateral protrusion of the external urethral sphincter or urethral rhabdospincter. However, the histology revealed that a sheet-like DTP was not usual (16.7%, two of 12 cadavers). Likewise, in histology of five females, the tail always continued to a muscle mass immediately lateral to the greater vestibular gland and far dorsal to the external urethral sphincter. Thus, the female topohistology seemed to be consistent with the male unclear DTP. Because of the limited incidence of a sheet-like DTP and the unclear fascial structure containing numerous vessels around the rather small DTP, in most elderly cadavers the urogenital diaphragm was likely to be a macroscopic entity rather than a histologic one. However, we believed that the histologically proven DTP was present in elderly men and women even if it had changed as a result of degeneration with aging.