Bilateral spontaneous cerebrospinal fluid otorrhea

We present a rare case of bilateral cerebrospinal fluid (CSF) otorrhea via multiple bony defects in the left tegmen and a single defect with the herniated brain tissue on the right side. Initially, the patient complained of left hearing loss and fullness and was diagnosed with serous otitis media. After myringotomy, the pulsating watery discharge suggested CSF otorrhea. Five months after surgical repair of the left side, right-side CSF leakage occurred. The right side was repaired surgically, and the patient recovered without incident. From our findings and a review of the literature, we postulate that bilateral CSF otorrhea resulted mainly from the thinness of the tegmen because of well-pneumatized mastoid air cells and the weakness of the dura after chronic inflammatory changes. In case of spontaneous CSF otorrhea, the roof of tegmen should be assessed bilaterally with care using radiologic examinations so as not to overlook a subclinical condition on the contralateral side.     

Usefulness of the percentage of plasma lymphocytes as a prognostic marker in patients with congestive heart failure

This prospective study was designed to evaluate the prognostic value of the percentage of plasma lymphocytes in patients with diastolic dysfunction as well as systolic dysfunction of the left ventricle. The subjects were 70 consecutive patients who were hospitalized in our institution from April 2001 to August 2002. Following the improvement of congestive heart failure, leukocyte differentiation and neurohumoral factors (plasma levels of atrial and brain natriuretic peptide, norepinephrine, epinephrine, and dopamine) were measured. During the follow-up period (17 +/- 9 months), 18 patients experienced a cardiac event. In the univariate analysis, the percentage of plasma lymphocytes in the cardiac event group was significantly less than that in the noncardiac event group (24.7 +/- 8.40 vs 33.3 +/- 7.64%, P = 0.0006), and brain natriuretic peptide was significantly larger in the cardiac event group (402 +/- 168 vs 153 +/- 51 pg/mL, P = 0.04). However, in patients with preserved systolic function, there was a significant difference in the percentage of plasma lymphocytes between the cardiac and noncardiac event groups (21.7 +/- 9.42 vs 34.2 +/- 8.21%, P = 0.037), although no difference was observed in brain natriuretic peptide (133 +/- 43 vs 125 +/- 50 pg/mL, P = 0.87). Multivariate analysis showed the percentage of plasma lymphocytes was an independent predictor of a cardiac event. The percentage of plasma lymphocytes may be useful for predicting the course of patients with congestive heart failure based on diastolic dysfunction as well as systolic dysfunction.     

Local exposure of phosphatidylethanolamine on the yeast plasma membrane is implicated in cell polarity

Cell surface phosphatidylethanolamine (PE) of the yeast cell was probed by biotinylated Ro09-0198 (Bio-Ro), which specifically binds to PE and was visualized with fluorescein-labelled streptavidin. In Saccharomyces cerevisiae, the signals were observed at the presumptive bud site, the emerging small bud cortex, the bud neck of the late mitotic large-budded cells and the tip of the mating projection. In Schizosaccharomyces pombe, the signals were observed at one end or both ends of mono-nucleated cells and the division plane of the late mitotic cells. These sites were polarized ends in the yeast cells, implying that PE is exposed on the cell surface at cellular polarized ends. Treatment of S. cerevisiae cells with Ro09-0198 resulted in aberrant F-actin accumulation at the above sites, implying that limited surface exposure of PE is involved in the polarized organization of the actin cytoskeleton. Furthermore, S. cerevisiae ros3, dnf1 and dnf2 null mutants, which were known to be defective in the internalization of fluorescence-labelled PE, as well as the combinatorial mutants, were stained with Bio-Ro at the enlarging bud cortex, in addition to the Bio-Ro-staining sites of wild-type cells, suggesting that Ros3p, Dnf1p and Dnf2p are involved in the retrieval of exposed PE at the bud cortex.     

Coexistence of spindle cell lipoma and ordinary lipoma

We report a patient with a spindle cell lipoma on the nape and three ordinary lipomas on the abdomen and extremities. The coexistence of spindle cell lipoma and ordinary lipoma in a single patient is rare. Abundant CD34-positive spindle cells and mast cells were found in the spindle cell lipoma, but in the ordinary lipomas, only a small number of CD34-positive spindle cells were found in the interstitial connective tissue and no mast cells were seen. Because mast cells are known to stimulate mesenchymal cell proliferation and collagen production, mast cell infiltration may be a trigger for the proliferation of CD34-positive spindle cells, leading to the conversion of ordinary lipoma into spindle cell lipoma.     

Skim soy protein enhances GFR as much as beefsteak protein in healthy human subjects

Background It has been reported that an acute load of beefsteak (200g) significantly enhanced the glomerular filtration rate (GFR; inulin clearance and creatinine clearance) in healthy human subjects compared to that in the same subjects in the fasted state. However, no comparative study of the effects of the same amount of vegetable protein on GFR has been reported to date.Methods We attempted to compare changes in the GFR (inulin clearance and creatinine clearance) in six healthy male subjects following consumption of the same amount of beefsteak or baked skim soy with soy sauce (protein, 86.9g) after fasting. The clearance study was performed by conventional methods. Inulin was measured by the anthrone method. Creatinine was measured by the Jaffe rate assay method. Amino-acid analysis of the beefsteak and baked skim soy with soy sauce was done by acid or hydroxide hydrolysis and an amino-acid analyzer.Results A significant enhancement of the GFR (both inulin clearance and creatinine clearance) was observed following acute loading with beefsteak or baked skim soy with soy sauce, compared to the GFR in the fasted state. No significant difference was observed between the results with beefsteak and the results with baked skim soy with soy sauce. Amino-acid analysis revealed that the total amount of three amino acids (glycine, alanine, and arginine; or serine, alanine, and proline) was almost identical in beefsteak (animal protein) and baked skim soy with soy sauce (vegetable protein).Conclusions The present study demonstrated that vegetable protein with the same amino-acid composition could enhance the GFR in healthy subjects as much as animal protein.