Developmental brain-stem pathology in sudden infant death syndrome

The brain-stems of control and sudden infant death syndrome (SIDS) infants were examined developmentally with Golgi and immunohistochemical methods. The development of dendritic spines changed dramatically from the prenatal to postnatal period in the ventrolateral medulla as well as in the reticular formation and vagal nuclei in controls, but persisted in SIDS infants. These observations suggest a delay in maturation of the meduallary respiratory neurons and transneuronal connection between the central chemoreceptor and neural respiratory center in SIDS. In addition, substance P (SP)-positive nerve fibers were increased in the pons of SIDS infants. An increased activity in the afferent SP neurons in SIDS may be due to chronic hypoxia as in brain-stem gliosis, and may be involved in cardiorespiratory regulation.     

I.v. compared with brachial plexus infusion of butorphanol for postoperative analgesia

In a randomized, double-blind, controlled study, we have comparedtwo groups of patients receiving either continuous systemici.v. or continuous brachial plexus infusion of butorphanol foran algesia after operations on the upper extremities. Twenty-twopatients undergoing elective upper extremity surgery were allocatedrandomly to one of two groups to receive either butorphanoli.v. and saline injected into the brachial plexus sheath (i.v.group) or butorphanol injected into the brachial plexus sheathand saline i.v. (brachial plexus group). After surgery on theupper extremity under continuous axillary brachial plexus block,each patient received a continuous infusion of butor phanoleither i.v. or into the brachial plexus sheath at a dose of83.3 µg h^–1. Concurrently, a saline infusion wasgiven via the alternate route. Patients rated their pain ona 10-cm visual analogue scale (VAS). VAS scores in the two groupsdid not differ up to 6 h and 24 h after operation. From 9 huntil 24 h after operation, pain scores were significantly higherin the i.v. group than in the brachial plexus group. The VASscore 9 h after operation was 3.3 (SD 2.7) in the i.v. groupand 0.6 (0.9) in the brachial plexus group (P < 0.01); 12h after operation 2.7 (1 .8) in the i.v. group and 0.6 (0.9)in the brachial plexus group (P < 0.01); 18 h after operation1 .7 (1.0) in the i.v. group and 0.7 (1.0) in the brachial plexusgroup (P < 0.05); and 24 h after operation 3.2 (2.4) in thei.v. group and 0.7 (1.2) in the brachial plexus group (P <0.01). We conclude that continuous injection of butorphanolinto the brachial plexus sheath provided superior analgesiacompared with continuous i.v. injection.     

MALIGNANT HEMANGIOENDOTHELIOMA

Background. The administration of interleukin-2 (il-2 ) has recently been reported to be favorable for treating malignant hemangioendothelioma (mhe ). Methods. Two patients with mhe responded well to intra-lesional injections of recombinant il-2 (ril-2 ) without major side effects. The purpose of this study was to characterize cells infiltrating the regressing tumor following ril-2 treatment. Immunohistochemical studies were performed on biopsy specimens taken from ril-2 -injected lesional skin. Results. It was shown that CD8⁺ lymphocytes and CD56⁺ natural killer (nk ) cells infiltrated at the ril-2 -injection sites, suggesting that these cells contributed to the tumor regression. In addition, MHE cells bore intercellular adhesion mole-cule-1 (icam -1) whose expression was augmented by rn-2 injections. Conclusions. These findings suggested, that ril-2 not only induces lymphokine-activated killer (lak ) cells and nk cells, but also facilitates these cytotoxic cells to adhere to MHE cells by enhancing icam -1 expression of tumor cells.     

Effect of Kil769, a Novel K+-channel Opener,on Sensitivity to Ca2+ of Contractile Elements and Inositol Phosphate Formation in Porcine Coronary Artery

To determine whether Kil769, a novel K⁺-channel opener, acts intracellularly in vasorelaxation, we compared the effects of Kil 769 on force of contraction, intracellular Ca²⁺ concentration ([Ca²⁺]_i) and inositol phosphate (IP₁) formation with those of Ca²⁺-channel blockers in isolated porcine coronary artery. Kil 769 (10 μm) and verapamil (1 μm), which produced submaximal relaxation, reduced the increase in [Ca²⁺]_i and force of contraction induced by 25 mM KC1. Verapamil reduced [Ca²⁺]_i and the force of contraction to a similar extent but Kil 769 reduced force of contraction more strongly than it did [Ca²⁺]_i. Kil 769 also inhibited U46619 (9,11-dideoxy-9α, 11α-methano-epoxy-PGF_2a)-induced IP₁ formation and glibenclamide blocked its inhibitory effect. These results suggest that the opening of K⁺ channels induced by Kil 769 reduces the Ca²⁺ sensitivity of contractile elements and inositol phospholipid hydrolysis which is related to the Ca²⁺ release from intracellular storage.     

Preschool sarcoidosis manifesting as juvenile rheumatoid arthritis: A case report and a review of the literature of Japanese cases

Nine Japanese cases of sarcoidosis in children of 4 years of age or younger have been reported in the literature, including the case presented here. Clinically, preschool sarcoidosis is distinctly different from that of older children; it is characterized by a triad of skin, joint and eye lesions without pulmonary involvement. It is easily confused with juvenile rheumatoid arthritis which also presents the symptoms of arthritis and uveitis. We report on a patient with preschool sarcoidosis who was initially diagnosed as having juvenile rheumatoid arthritis. We recommend prompt skin biopsy to differentiate between these conditions.     

Choriocarcinoma of Stomach: A case Report

A case of primary choriocarcinoma of the stomach in an adultmale has been reported. The diagnosis was authenticated by morphological,biological and immunological examinations. In spite of the radicaloperation for the primary gastric lesion and anti-cancer chemotherapyusing Mitomycin-C and Endoxan, early death resulted from bleedingfrom a metastatic focus in the liver. Histologically, the choriocarcinomawas associated with adenocarcinoma in this case, similar tocases reported in the literature. Metastatic foci in the liver,lungs and lymph node possessed features of choriocarcinoma.At autopsy meticulous search failed to reveal any other possibleprimary foci than the stomach. Five cases of primary gastric choriocarcinoma verified histologicallyand biologically have been found in English and German literatures,which were reviewed, and histogenesis of gastric choriocarcinomawas discussed. ^*The case was presented at the 25th Annual Meeting of the JapaneseCancer Association (1966).     

Unfolding of tertiary structures of proteins

The unfolding pathway of lysozyme was investigated by carrying out the computer simulation. Taking into account the simultaneous change of both the dihedral angles ø and of a residue, we explore the detailed features of the conformational energy profiles. The triangle distance map shows that the lysozyme molecule is divided into three domains, 1–40, 41–101 and 102–129 in amino acid residue numbers (referred to as the domains I, II and III, respectively). The calculated unfolding process indicates that in the early stage of unfolding domain III located at the C-terminal begins to be detached from the other two, and then domain I can be unfolded. The long-range interactions between domains I and III stabilize the whole molecule and give the cooperative nature of the folding. The calculated unfolding pathway of lysozyme is consistent with the folding pathway proposed by Anderson & Wetlaufer [J. Biol. Chem. (1976). 251 , 3147–3153] who identified the disulfide bondings in the early stage of the glutathione regeneration. A simplified treatment of unfolding for myoglobin is also discussed in the Appendix.