Prenatal sonographic appearance of truncus arteriosus on wide‐band Doppler imaging

Persistent truncus arteriosus is an uncommon congenital cardiac anomaly. In most patients, this condition is not diagnosed prior to birth. We report a case in which this uncommon cardiac anomaly was diagnosed prenatally using wide‐band Doppler imaging. When diagnosing fetal truncus arteriosus, sonologists should carefully search for the origin of the main pulmonary artery and for its 2 branches. Our experience suggests that wide‐band Doppler imaging facilitates the prenatal diagnosis of truncus arteriosus. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2009     

A study of spike-density on EEG in West syndrome

To elucidate the pathophysiology of spasms in series, the distribution and density of spikes on hypsarrhythmia were studied in 13 patients with West syndrome by excluding slow waves from EEG using a digital filter. (1) Interictal spikes were mostly multifocal and dominant over the bilateral posterior head area with very few diffuse discharges. Therefore, spikes on hypsarrhythmia were demonstrated to occur actually depending on the brain regions although they appeared random. (2) The dominant region of interictal spikes did not correspond to the underlying focal cortical lesion in many patients, and was indicated to reflect the general process of cerebral maturation in infancy. (3) There were far fewer inter-spasm spikes, especially during the middle phase of a series of spasms, than interictal spikes. It was implied that the cortical activity of hypsarrhythmia was interfered with by the abnormal subcortical function, which might be related to the generation of spasms. (4) The dominant region of inter-spasm spikes tended to coincide with a focal cortical lesion shown by MRI and the focus of associated partial seizures.     

Serotonin modifies corticotropin-releasing factor-induced behaviors of chicks

Glucagon-like peptide-1 (GLP-1) decreased corticotropin-releasing factor (CRF)-induced behaviors in neonatal chicks, and serotonin is one of the possible mechanisms through which GLP-1 affects CRF-induced behaviors. The present experiments were conducted to confirm the effect of serotonin on CRF-induced behaviors. In Experiment 1, chicks were intracerebroventricularly injected with either saline, 0.1 microg of CRF, 5.0 microg of serotonin, or 0.1 microg of CRF plus 5.0 microg of serotonin. Injection of CRF caused excitation as evidenced by increased spontaneous activities and distress vocalizations (DVs) compared to the control group. The effect of CRF was attenuated by serotonin since chicks became quiet after given CRF with serotonin. Sleep-like behaviors were observed in the serotonin group. The number of defecations was increased by CRF and decreased by serotonin. Both CRF and serotonin increased plasma corticosterone, and the effect was synergistic. Serotonin dose-dependently decreased locomotor activities of chicks after central administration of 0.1 microg of CRF, 0.1 microg of CRF plus 2.5, 5.0, or 10.0 microg of serotonin in Experiment 2. CRF-induced DVs were modified by serotonin. Instead of DVs, tender and low-pitched vocalizations were observed in chicks treated with CRF plus serotonin, the voice frequencies of which were less than 10 kHz. In conclusion, serotonin attenuated the CRF-induced behaviors while stimulating corticosterone release. These results indicate that the role of serotonin is dependent on the behaviors being measured.     

Very fast rhythmic activity on scalp EEG associated with epileptic spasms

PURPOSE: Very fast activity was investigated on the ictal EEGs of epileptic spasms to elucidate the pathophysiology of West syndrome (WS) and related disorders from a novel point of view. METHODS: The traces of scalp ictal EEG of spasms temporally were expanded in 11 patients whose clinical diagnosis was symptomatic WS in six, cryptogenic WS in two, Aicardi syndrome in one, and symptomatic generalized epilepsy after WS in the remaining two. Time evolution of averaged power spectra of the ictal fast activity also was analyzed in each patient. RESULTS: Rhythmic gamma activity with frequency ranging from 50 to 100 Hz was detected in a total of 345 of 537 spasms. Fast activity was seen bilaterally in nine patients, was lateralized to one hemisphere in another, and appeared independently on each hemisphere in the remaining infant with Aicardi syndrome. Power spectra showed a clear peak corresponding to spasm-associated gamma rhythm, with frequency centering approximately 65 Hz and ranging from 51 to 98 Hz. The morphology and spectral characteristics of ictal gamma rhythm were completely different from those of muscle activity or alternating current (AC) artifacts. CONCLUSIONS: Spasm-associated gamma activity was clearly detected on the scalp. This observation may provide a clue to the pathophysiology of spasms.     

Ultrastructural changes of bile duct epithelium in primary biliary cirrhosis in relation to progression of bile duct loss

Summary Using wedge liver biopsies from patients with primary biliary cirrhosis (PBC), ultrastructural features of the intrahepatic bile ducts in livers with slight or no bile duct loss were compared with those in livers with advanced bile duct loss and in extrahepatic cholestasis (EHC).Most changes in the biliary epithelium in PBC were similar to those in EHC. Microvillous loss and bleb formation, mitochondrial damage and increase in endoplasmic reticulum and ribosomes were found in PBC irrespective of the degree of bile duct loss, and also in EHC. These changes were present almost equally at any level of the biliary tree, and are presumed to represent a variety of non-specific lesions of biliary epithelial cells. As the loss of bile ducts in PBC progressed, cytoskeletal filaments and cytophagosomes increased in number and basement membranes were more thickened and reduplicated. These changes were more or less conspicuous in smaller branches of the biliary tree, and were also prominent in EHC. They might be causally related to the bile flow disturbance in the liver. Lateral intercellular spaces were irregularly dilated and contained osmiophilic membranous and/or granular material, similar to that found in duct lumena, within and without the basement membrane, and in the cytoplasm of periductal macrophages. Furthermore, pinocytotic vesicles were increased in the biliary cytoplasm facing periphery. These findings suggest possible alteration of the permeability of biliary epithelial cells, probably in the direction from the lumena to the periductal tissue. Such changes were found in PBC livers with virtual absence of bile duct loss, and the significance of this phenomenon is discussed.     

Hypertonicity regulates the aquaporin-2 promoter independently of arginine vasopressin.

BACKGROUND: Aquaporin-2 (AQP-2) is an arginine vasopressin (AVP)-regulated water channel in kidney collecting duct cells. The present study was undertaken to determine whether a change in tonicity could directly regulate the AQP-2 gene in an in vitro experiment. METHODS: Various fragments of the 5'-flanking region of the murine AQP-2 gene up to -9.5 kb were cloned into a luciferase (Luc) reporter plasmid, and they were transiently transfected into Madin-Darby canine kidney cells. RESULTS: Hypertonicity significantly increased the Luc activity of the constructs containing >6.1 kb of the 5'-flanking region of the AQP-2 gene (-6.1AQP2). However, promoter regions <4.3 kb in length containing the tonicity-responsive enhancer (TonE) at bp -570 to -560 were not stimulated by hypertonicity. The TonE-deleted construct which contains -9.5 to -1.1 kb of the 5' side of the AQP-2 gene, 8.4AQP2, was also stimulated by hypertonicity. Mitogen-activated protein (MAP) kinase inhibitors SB203580 and U0126 did not affect the Luc activity of -6.1AQP2 induced by hypertonicity. In addition, the vector expressing dominant-negative TonE-binding protein (TonEBP) did not affect the hypertonicity-induced Luc activity of -6.1AQP2. The Luc activity of -6.1AQP2 was stimulated by the overexpression of TonEBP. Hypertonicity further increased the Luc activity of -6.1AQP2 under the overexpression of TonEBP. CONCLUSION: These findings indicate that hypertonicity regulates AQP-2 promoter activity via an AVP-independent mechanism, and that the tonicity-responsive element resides between the -6.1 and -4.3 kb 5'-flanking region of the AQP-2 gene, in which the structure and mechanism of response to hypertonicity could be distinct from those of TonE.     

Establishment and partial characterization of five malignant glioma cell lines

Five malignant glioma cell lines (YMG1, 2, 3, 4, and 5) were established from surgical specimens obtained from patients with glioblastoma or anaplastic astrocytoma, and these lines were partially characterized. Three glioma cell lines (YMG1, 3, and 5) were weakly positive for GFAP by Western blot analysis and two cell lines were negative. S‐100 protein was positive in all glioma cell lines. The expression of p53, p16, p15, cyclin‐dependent kinase 4 (CDK4), and EGF receptor (EGFR) proteins was examined by Western blotting. YMG1 and 2 cell lines showed accumulation of p53 protein and loss of p16 and p15 expression. YMG3 and 4 showed accumulation of p53 protein and expression of p16 and p15 proteins. YMG5 revealed weak expression of p53 protein, suggesting wild‐type p53, and loss of p16 and p15 expression. All cell lines expressed various levels of CDK4 protein. YMG1, 2, and 3 showed higher EGFR protein expression and YMG4 and 5 showed lower EGFR expression compared to U251 glioblastoma cells, which express high levels of EGFR. Fluorescence in situ hybridization analysis for EGFR gene expression did not show any amplification in the glioma cell lines. Immunohistochemical studies revealed that the patterns of p53 and EGFR expressions in the original tumor tissues were mostly correlated with those in the malignant glioma cell lines. These results suggest that the characteristics of p53 and EGFR expression in the malignant glioma cell lines were passed over from the original tumor tissues. These newly established malignant glioma cell lines can be used for further analysis of the mechanisms of tumor growth and progression.     

Effect of low-intensity aerobic exercise training on arterial compliance in postmenopausal women.

Regular aerobic exercise training attenuates age-related reduction in central arterial compliance, an independent risk factor of cardiovascular diseases. We tested the hypothesis that even low-intensity exercise training could increase central arterial compliance in postmenopausal women. Using B-mode ultrasound, we studied the central arterial compliance of 15 postmenopausal females (age: 52-66 years) before and after a 12-week aerobic exercise intervention. Subjects performed aerobic exercise training of the same energy expenditure (cycle exercise, total 900 kcal/week, 3-5 sessions/week) at two different exercise intensities: 7 trained at low intensity (40% heart rate reserve: L-TR) and 8 trained at moderate intensity (70% heart rate reserve: M-TR). Arterial compliance increased after exercise training in the L-TR group (0.70+/-0.32 vs. 1.06+/-0.55 mm2/mmHgX10(-1), p <0.05) and in the M-TR group (0.82+/-0.37 vs. 1.14+/-0.39 mm2/mmHgX10(-1), p <0.05). There was no significant difference in increases of arterial compliance in either group (L-TR: 0.35+/-0.38 vs. M-TR: 0.32+/-0.33 mm2/mmHgX10(-1)). These results suggest that the improvement of central arterial compliance by aerobic exercise training might not be influenced by the intensity of exercise training if the energy expenditure of the training is the same. Accordingly, even low-intensity exercise training may have the effect of improving central arterial compliance.