Hypoxia‐inducible factor 1α may be a marker for vasculitic neuropathy

Neuromuscular biopsy is still an essential method for diagnosing vasculitic neuropathy, although its diagnostic sensitivity is at most 60%. Our objective was to examine the expression of hypoxia‐inducible factor 1α (HIF‐1α) in peripheral nerves and to evaluate its usefulness in diagnosing vasculitic neuropathy, especially for discrimination from other axonal neuropathies. Forty‐one patients with vasculitic neuropathy consisting of 20 definite, 14 probable and seven possible diagnoses, 15 patients with metabolic neuropathy, five with motor neuron disease and six with chronic inflammatory demyelinating polyneuropathy were included. Nerve biopsy specimens were immunohistochemically examined for HIF‐1α and various cell markers. Distinct immunoreactivity (IR) was observed in nuclei of endoneurial cells in 54% (22/41) of vasculitic patients, while specimens from metabolic neuropathies showed less nuclear IR and the difference of mean density of HIF‐1α‐positive nuclei was significant. Two patients with possible vasculitis who showed HIF‐1α‐positive nuclei in endoneurium, were later confirmed to have vasculitis by skin biopsies. Most of the cells expressing HIF were demonstrated to be Schwann cells. There was a trend in the vasculitic patients with early phase nerve damage to display higher endoneurial HIF‐1α‐IR. HIF‐1α may be an immunohistochemical marker for vasculitic neuropathy, especially when the observed section contains no vasculitic lesions.     

A case of follicular bronchiolitis with broncho-pleural fistula in rheumatoid arthritis]

A 67-year-old male diagnosed clinically as having rheumatoid pleuritis and bronchiolitis was treated with adrenocorticosteroid. His clinical findings improved, but following the tapering of the steroid dose, exacerbation occurred. After the steroid dose was increased, serological findings improved, but chest X-ray findings revealed no improvement. To re-evaluate the etiology of the bronchiolar lesion, open lung biopsy was performed. The biopsy specimen showed lymphocytic infiltration and formation of lymphoid follicles in and around the bronchioles. The pulmonary lesion was diagnosed as follicular bronchiolitis.     

Effects of vinconate, a novel vinca alkaloid, on spatial learning deficits induced by the basal forebrain lesion in rats.

We investigated the effects of vinconate, a novel vinca alkaloid, on spatial learning deficits induced by the basal forebrain (BF) lesion in rats. Bilateral BF lesions were produced by injecting ibotenic acid (6 micrograms/0.5 microliter/side). In BF-lesioned rats, impairment of spatial learning in escaping onto the platform during training and decrease in spatial bias during the spatial probe trial in Morris's water maze task were both observed. Vinconate (5 and 10 mg/kg) treatment shortened the increase of escape latency to the platform in BF-lesioned rats and significantly reversed the decrease in spatial bias induced by the BF lesion. Vinconate (10 mg/kg) attenuated the decrease in choline acetyltransferase activity in the frontoparietal cortex caused by the BF lesion. The present study suggests that vinconate has an antiamnesic effect on the BF-lesion-induced amnesia by ameliorating the dysfunction in cholinergic neurons.     

Qualitative abnormalities of choline acetyltransferase in Alzheimer type dementia

The maximum activity of choline acetyltransferase (ChAT), the affinity for choline or acetyl-CoA and the isozyme pattern in the cerebral cortex of 5 cases of Alzheimer type dementia (ATD) and 6 age-matched control subjects were examined post-mortem. Maximum activities of ChAT were estimated in 5 cerebral cortical areas of Brodmann: 4, 7, 10, 17 and 22. A significant reduction in maximum activities of ChAT was found in all cortical areas for the cases of ATD. The affinity for choline or acetyl-CoA was measured in the frontal cortex (Brodmann's areas 4 and 6) and in the temporal cortex (Brodmann's areas 21 and 22). The affinity was significantly decreased in both cortices of demented patients. A significant correlation was observed between maximum activity of ChAT and the affinity for choline or acetyl-CoA. The isozyme pattern obtained by column chromatography on Sephadex G-200 was similar to that obtained by centrifugation on a sucrose density gradient. The isozyme pattern of ATD was different from that of the control subjects. These results suggest qualitative as well as quantitative abnormalities in the ChAT in autopsied brains of ATD.     

Behavioral pharmacological action of Ca-4-(3,5-dihydroxy-3-methylpenthylamido) butyrate (mevalonic GABA, MV-GABA)

The behavioral pharmacological effects of Ca-4-(3,5-dihydroxy-3-methylpenthylamido) butyrate (mevalonic-GABA, MV-GABA), a new GABA derivative were studied in comparison with those of Ca-hopantenate (HOPA) in mice. MV-GABA had no effect on the general behavior and electric shock-induced fighting behavior. The dosage of MV-GABA which caused locomotor hypoactivity produced an impairment of the rotarod performance. MV-GABA inhibited the hyperactivity induced by a dopamine (DA) agonist (methamphetamine) and acetylcholine (ACh) antagonists (scopolamine and atropine) at a dose which did not affect locomotor activity in normal mice. MV-GABA prolonged the pentobarbital-Na-induced sleeping time, and it prolonged the latencies until convulsion and death after administration of strychnine. MV-GABA and HOPA antagonized the electroconvulsive shock-induced amnesia in the passive avoidance response of mice. These results suggest that MV-GABA has effects on the central nervous systems, in particular, ACh and DA neural systems. The actions of MV-GABA were qualitatively similar to those of HOPA except for the effect on the DA neural system.     

Significance of the BTA Test in Bladder Cancer: A Multicenter Trial

Background :
The BTA test is a latex agglutination assay for the qualitative detection in the urine of analytes that are associated with bladder tumor. We compared the results of the BTA test with those of voided urine cytology (VUC) in patients with bladder cancer.
Methods :
A multicenter trial was performed at 6 institutions. A total of 132 patients with histologically diagnosed bladder cancer were enrolled. Urine samples were split for BTA and VUC testing.
Results :
The sensitivities of the BTA test and VUC were 57.6% and 37.9%, respectively; this difference was significant ( P < 0.001). The BTA test had much higher sensitivity for small, solitary, superficial tumors than did VUC.
Conclusion :
The BTA test is simple to perform, gives rapid results, and is far more sensitive than VUC for detection of bladder cancer. The BTA test has the potential to become an additional tool for detecting bladder cancer.     

Advantage of a smaller caliber fiberscope and learning curve on transurethral lithotripsy.

Transurethral lithotripsy was performed in 63 patients with ureteral calculi between September 1987 and March 1991. Three types of flexible nephroureteroscopes with diameters of 12.8F, 10.5F and 9.3F were used in groups 1, 2 and 3, respectively. The rate of successful stone disintegration and the stone-free rate 3 months after lithotripsy were 73% (11 of 15 patients) and 67% (10 of 15), respectively, in group 1, 93% (26 of 28) and 82% (23 of 28), respectively, in group 2, and 95% (19 of 20) and 85% (17 of 20), respectively, in group 3. Four complications were encountered in the patients treated with the 12.8F device (group 1). Our results clearly show that use of a slimmer fiberscope and the effect of learning to perform techniques with the flexible nephroureteroscope improved the success rate and decreased the complication rate in transurethral lithotripsy.