Accumulation of L-[2-(F-18)]fluorophenylalanine in peri-infarct area in a patient with acute cerebral infarction

We studied the brain uptake of amino acid in a patient with acute cerebral infarction with L-[2-(F-18)] fluorophenylalanine and positron emission tomography. The increased accumulation of the ligand was specifically found in the peri-infarct area where oxygen metabolism was still maintained but decreased later in the 72-day follow-up period. The kinetic analysis revealed that increased accumulation was not due to increased transport from the blood to the brain but to delayed washout from the brain to the blood. Although the mechanism is still unknown, abnormally high accumulation of L-[F-18]fluorophenylalanine may predict delayed neuronal changes after ischemic insults of the brain.     

Morphometry in anatomy: image analysis on fine structure and histochemical reactions with special reference to radioautography

Anatomy now has a step to transfer from qualitative science to quantitative science. The methods of anatomical investigation employ optical instruments. Anatomy initially described qualitative features of the structure of the body, but now it turns to transfer to new fields measuring the number, size, length, area and volume of not only, structure but also the histochemical components of the structure with quantitative analysis. In order to quantify histochemical reactions in various organs, light and electron microscopic radioautograms were prepared from the liver, pancreas, intestines and kidney which were labeled with 3H-thymidine, 3H-uridine, 3H-leucine, 3H-glucosamine and 3H-glycerol, fixed in glutaraldehyde and osmium tetroxide, embedded in Epoxy resin, sectioned either thick or thin, coated with either Konica NR-M2 or -H2 radioautographic emulsions, exposed, developed, stained for either light or electron microscopic radioautographs. The radioautographs were observed with Olympus Vanox AHB-LB or Nikon Optiphot-2 light microscopes or Hitachi H-700, JEOL JEM-4000EX electron microscopes at 200 and 400 kV. The radioautograms were analysed with various image and analysed such as PPA-250, MOP, Digigramer-G, IBAS-II, Quadra 900, Luzex 300 to count the number of silver grains and to measure the size and number of structures. Some electron microscopic radioautographs were analysed in analytical electron microscopes, combined with Hitachi H-700 Horiba EMAX-1800E, JEOL JEM-200CX Kevex 7000-77, and JEOL JEM-4000EX Tracor-Northern TN-5400 to quantify silver grain contents. The results demonstrated that correct data can be obtained by controlling both full-automatic and semi-automatic image analysers by operating them manually.     

Osteoplastic laminoplasty for cervical myeloradiculopathy secondary to ossification of the posterior longitudinal ligament

Summary Forty-seven patients with cervical myeloradiculopathy due to ossification of the posterior longitudinal ligament were treated by laminoplasty. The spinal canal from C3 to C7 was opened en bloc unilaterally and a spacer bone graft inserted to separate the floating laminae. The average follow up was 7.3 years (range 5 to 11 years). Favourable results were obtained in 35 patients and even though they had serious postoperative symptoms those with advanced neurological symptoms before operation showed considerable improvement. Late results were poor in patients who had greater than 50% compromise of the spinal canal by the ossified lesion. Laminoplasty is a safer method of obtaining favourable late results in patients with involvement of more than 3 vertebrae, but in those with a more severe compromise of the spinal canal by ossification, additional anterior decompression may be necessary later.

---

Résumé Cet article présente les résultats à long terme de laminoplasties pratiquées pour myéloradiculopathie cervicale due à l'ossification du ligament vertébral commun postérieur, ainsi que les modifications observées dans les canaux rachidiens élargis. Habituellement le canal rachidien a été ouvert en bloc de C3 à C7, d'un seul côté, puis complété par une greffe osseuse afin de maintenir l'ouverture au niveau de la lame. On a utilisé la cotation de l'Association orthopédique japonaise, concernant la myélopathie cervicale, pour évaluer l'état des patients avant l'intervention chirurgicale, puis 2 ou 3 mois après la sortie et durant la période de surveillance. Les 47 patients de cette étude ont été suivis de 5 à 11 ans, soit en moyenne 7,3 ans. Les résultats finaux ont été favorables chez 35 patients et, même quand la symptomatologie postopératoire avait été assez préoccupante, les malades qui présentaient des symptômes neurologiques majeurs étaient notablement améliorés. Les résultats étaient mauvais chez les patients dont le rétrécissement du canal rachidien était supérieur à 50% (p<0.05). Il semble que la laminoplastie soit le moyen le plus sûr d'obtenir un résultat favorable mais une décompression antérieure complémentaire peut être nécessaire chez les patients atteints d'une sténose sévère due à une ossification du ligament vertébral postérieur.

---

---

Presented in part at SICOT 93, Seoul, Korea, 28 August–3 September, 1993     

Evaluation of a screening program on reduction of gastric cancer mortality in Japan: preliminary results from a cohort study.

BACKGROUND: Systematic population-based screening for gastric cancer is widely spread in Japan. However, the case-control study method has been the main method used to evaluate the effectiveness of the screen ing to reduce gastric cancer mortality in Japan. METHODS: This article presents a population-based cohort study. A questionnaire about lifestyles and dietary habits was distributed to 36,990 residents in a city of Japan. The response rate to the questionnaire was 92.0%. After ineligible responders had been excluded, 24,134 subjects were classified into screened and un screened groups according to their self-reports of participation in the screening the previous year. We followed them up for 40 months and linked resident death records in the city. We compared mortality from gastric cancer and all other causes between the groups by us ing the Cox proportional hazard model. RESULTS: The follow-up period was 78,156.6 person-years from September 1992 to December 1995. The multivariate relative risks for gastric cancer death of the screened group in comparison with the unscreened group were 0.72 (95% CI 0.31-1.66) among males and 1.46 (95% CI 0.43-4.90) among females. CONCLUSION: Although our data are preliminary, we were unable to demonstrate a large contribution of the present screening program to decreasing gastric cancer mortality. Further follow-up is needed to in crease the precision.     

Psychogenic lower urinary tract dysfunction in women: patho-physiological investigation for psychogenic frequency-urgency syndrome and psychogenic urinary retention]

PURPOSE: Psychogenic lower urinary tract dysfunction (PLUTD) is composed of two syndromes; psychogenic frequency-urgency syndrome (PFUS) and psychogenic urinary retention (PUR). We evaluated the patho-physiology of PFUS and PUR, and explored the different pathogenesis in these syndromes. MATERIAL AND METHODS: Forty five patients with PLUTD, consisting of 23 patients with PFUS and 22 patients with PUR were investigated by using the psychological tests: CMI (Cornell Medical Index) and TEG (Todai's Egogram), a quantitative perspiration test in 45 females (23 patients with PFUS and 22 patients with PUR), and simultaneous measurements of voiding cysto-urethrography and urodynamic studies using the Life-Tech 6 channel polygraph in 35 patients (17 patients with PFUS and 18 patients with PUR). RESULTS: The prevalence in ages revealed two peaks, 20 years and 50 to 60 years. Over 25% of them had pyuria more than 10/hpf of WBC. Peak flow rate measured by uroflowmetry showed normal range in PFUS group and decreased in PUR group. The functional vesical volume was less than 100 ml in most patients with PFUS. Residual urine in PUR group was significantly greater. Capacity of the PFUS group were able to hold over 400 ml of contrast instilled through the urethral catheter, despite increased desire to void. Over 15% of the study group with PFUS showed uninhibited systolic contraction of detrusor (> 15 cm H2O) during filling phase. The measurement value of urodynamic parameters demonstrated that a periodic follow-up survey of the upper urinary tract should be performed because of the low compliance bladder in the patients with PLUTD. During voiding phase, the women with PFUS had a tendency to be divided into two groups, hypercontractile or acontractile detrusor. The voiding cysto-urethrography (VCUG) showed a tendency of bladder neck opening on patients with PFUS during filling phase. Most of PLUTD cases demonstrated a round to triangle shape on vesical configuration, which led to a spastic condition of detrusor muscle. We attempted to measure the quantitative perspiration using 3 kinds of loading tests; respiratory, arithmetic and psychological load. In the psychological loading test, we asked 98 questions about their daily lives including occupation, living condition, family relationship and sexual activities. Arithmetic loading test consisted of counting in reverse, subtraction and multiplication. The quantitative perspiration rate resulted in a "positive" in many patients with PFUS. Respiration loading test was performed to measure the respiration volume during 3 large inhales. Most patients with PUR tested within the normal range for respiration except for those patients with decreased or no perspiration during the psychiatric loading test. These results may reflect the psychological elements including suppression and subconscious defense mechanism. Neurosis which was diagnosed as having type III to type IV of the Cornell Medical Index was demonstrated in less than under 40% of patients with PFUS and more than 55% patients with PUR. There was no significant trend or difference between PFUS and PUR detected from Todai's Egogram. CONCLUSIONS: Due to the reflection of many psychological responses, it is necessary to investigate from various examinations including psychological, autonomical and classical urological studies for accurate diagnosis of PLUTD.     

Clinical aspects of the "third rhythm" of the temporal lobe.

We studied clinical aspects of the "third rhythm," which was first described by Niedermeyer as alpha-like activity of the temporal lobe. By scalp EEG, temporal alpha-like activity was recorded in 15 (0.30%) of 4929 patients over 20 years of age. The temporal alpha-like activity was observed in 5 patients who had clinical and brain imaging findings indicating the presence of a cerebrovascular disorder. The alpha-like rhythm of these patients was left-sided, and wicket spikes appeared in the same region as the alpha-like rhythms in 4 of the 5 patients. In 8 of the 15, the temporal alpha-like rhythm was recorded over the defective bone or replacement bone after intracranial surgery. The alpha-like rhythm of these patients was similar to breach rhythm in the temporal region. The remaining 2 patients had not undergone intracranial surgery nor did they show symptoms of cerebrovascular disorders. The temporal alpha-like rhythms in one of these 2 might be a physiological third rhythm detected by scalp EEG through congenital bone thinning. Our observation supports the existence of intrinsic activity of the temporal lobe (the third rhythm). The third rhythm can be recorded by routine scalp EEG in some clinical conditions, and it is important to recognize this rhythm when one encounters temporal rhythmic activity independent of alpha rhythm of the occipital lobe.     

Knowledge, risk perception of AIDS and reported sexual behaviour among students in secondary schools and colleges in Tanzania.

A questionnaire survey was carried out among 1041 students in secondary schools and colleges in Dar-es-Salaam, Tanzania to evaluate the relationship between HIV-risky sexual behaviour and anti-condom bias, as well as with AIDS-related information, knowledge, perceptions and attitudes. Self-reportedly, 54% of students (75% of the boys and 40% of the girls) were sexually active, 39% had a regular sexual partner and 13% had multiple partners in the previous year. The condom use rate was higher than previous reports. However, 30% of sexually active respondents did not always use condoms (Risk-1 behaviour) and 35% of those with multiple partners in the previous year did not always use condoms (Risk-2 behaviour). Multiple logistic regression analyses indicated that 'sex partner hates condom' had association with both Risk-1 behaviour (OR 2.47; 95% CI 1.58-3.85) and Risk-2 behaviour (OR 2.47; 95% CI 1.10-5.48). 'Use of condom prevents HIV infection' also had association with both Risk-1 behaviour (OR 2.09; 95% CI 1.19-3.67) and Risk-2 behaviour (OR 3.73; 95% CI 1.28-11.03). Students engaging in risky behaviour were aware of the risk, even though they failed to change their behaviour. Reasons for the AIDS epidemic among Tanzanian students and the importance of more effective AIDS education are also discussed.     

Anisatin modulation of the gamma-aminobutyric acid receptor-channel in rat dorsal root ganglion neurons.

1. Anisatin, a toxic, insecticidally active component of Sikimi plant, is known to act on the GABA system. In order to elucidate the mechanism of anisatin interaction with the GABA system, whole-cell and single-channel patch clamp experiments were performed with rat dorsal root ganglion neurons in primary culture. 2. Repeated co-applications of GABA and anisatin suppressed GABA-induced whole-cell currents with an EC50 of 1.10 microM. No recovery of currents was observed after washout with anisatin-free solution. 3. However, pre-application of anisatin through the bath had no effect on GABA-induced currents. The decay phase of currents was accelerated by anisatin. These results indicate that anisatin suppression of GABA-induced currents requires opening of the channels and is use-dependent. 4. Anisatin suppression of GABA-induced currents was not voltage dependent. 5. Picrotoxinin attenuated anisatin suppression of GABA-induced currents. [3H]-EBOB binding to rat brain membranes was competitively inhibited by anisatin. These data indicated that anisatin bound to the picrotoxinin site. 6. At the single-channel level, anisatin did not alter the open time but prolonged the closed time. The burst duration was reduced and channel openings per burst were decreased indicating that anisatin decreased the probability of openings.