Craniopharyngioma of the cranial base and nasopharynx

A rare case of craniopharyngioma extending to the cranial base and nasopharynx is reported and eight other cases in the literature are reviewed. The embryology and the clinical features of these tumors are discussed. Tomograms of the skull and computed tomography are the most useful radiological tools of investigation. A nasoseptal or transpalatal approach to surgery, which has been performed in reported cases of cystic nasopharyngeal craniopharyngiomas, was not performed on our patient because of the hard consistency and the diffusely infiltrating aspect of the tumor.     

Rifampin alone or with trimethoprim for contacts of children with Haemophilus influenzae type b infections.

We carried out a nonrandomized, unblinded study to compare the efficacy of rifampin alone with that of rifampin in combination with trimethoprim in the eradication of the Haemophilus influenzae type b (HIB) carrier state among contacts of patients with invasive HIB infection. The study population comprised 17 index patients admitted to hospital with severe HIB infections and 233 contacts, 43 of whom had nasopharyngeal colonization with HIB of the same biotype as that of the index patient. Rifampin in a daily dose of 20 mg/kg (maximum 600 mg) for 4 days eradicated the carrier state in 86% of cases, as did the combination of rifampin at the same dosage and trimethoprim in a daily dose of 5 mg/kg (maximum 160 mg) for 4 days.     

Follow-up cytology in the management of urotheliomas

Ninety-one patients with operation history for urotheliomas were followed-up by urinary cytology for 17.5 months on the average. Cytologically, fresh urine was examined every month and vesical irrigation fluid every three months. Cystoscopy was also performed every three months, IVP every six months, and biopsy was performed when carcinoma or dysplasia was suspected. As a result, cases were classified into four groups. Group 1: All cytological examination were negative. Group 2: Cytology was positive for two or three months after TUR-Bt during which period vesical instillation therapy of anti-cancer drugs was performed, but was negative after this period. Group 3: Positive and negative cytology were diagnosed irregularly. Group 4: All cytological examinations were positive. The numbers of cases classified into these groups were 27 (29.7%), 7 (7.7%), 43 (47.3%) and 14 (15.4%), respectively. Tumor recurrence was seen in 1/27 (3.7%), 0/7, 12/43 (27.9%) and 4/14 (28.6%) cases, respectively. Metastasis was seen in only five cases of the group 4. Tumor recurrence and positive urinary cytology at the same time were seen in nine cases (20.9%) of group 3, and eight cases (57.1%) of group 4. Thirty four cases (79.1%) with discrepancy of cytological and endoscopic findings in group 3, in which cases 20 cases had only positive irrigation cytology and 11 cases had positive fresh urine and irrigation specimens, were more suspicious of temporary existence of in situ carcinomas or dysplastic urothelium. Of six cases with the discrepancy in group 4, three cases were in situ carcinoma diagnosed by random biopsies, and four cases had positive cytologies after TUR-Bt continuously.(ABSTRACT TRUNCATED AT 250 WORDS)     

Theoretical calculation of relative binding affinity in host-guest systems.

The relative free energy of binding the anions Cl- and Br- to the macrotricyclic receptor SC24 in water has been computed by a computer simulation technique. This result and an incidental result for the relative free energy of hydration of the anions are in excellent agreement with experimental data. The simulation approach to ligand-receptor interactions that is described here has significant potential as a predictive tool in chemistry, biochemistry, and pharmacology.     

Sarcoplasmic reticulum calcium load regulates rat arterial smooth muscle calcium sparks and transient KCa currents

Voltage-gated Na⁺ current is reduced by acid solution. Protons reduce peak Na⁺ conductance by lowering single channel conductance and shift the voltage range of gating by neutralizing surface charges. Structure-function studies identify six carboxyls and a lysine in the channel's outer vestibule. We examined the roles of the superficial ring of carboxyls in acid block of Na_v1.4 (the rat skeletal muscle Na⁺ channel isoform) by measuring the effects of their neutralization or their substitution by lysine on sensitivity to acid solutions, using the two-micropipette voltage clamp in Xenopus oocytes. Alteration of the outer ring of carboxylates had little effect on the voltage for half-activation of Na⁺ current, as if they are distant from the channels' voltage sensors. The mutations did not abolish proton block; rather, they all shifted the p K _a (-log of the dissociation constant) in the acid direction. Effects of neutralization on p K _a were not identical for different mutations, with E758Q > D1241A > D1532N > E403Q. E758K showed double the effect of E758Q, and the other lysine mutations all produced larger effects than the neutralizing mutations. Calculation of the electrostatic potential produced by these carboxylates using a pore model showed that the p K _a values of carboxylates of Glu-403, Glu-758, and Asp-1532 are shifted to values similar to the experimentally measured p K _a. Calculations also predict the experimentally observed changes in p K _a that result from mutational neutralization or introduction of a positive charge. We propose that proton block results from partial protonation of these outer ring carboxylates and that all of the carboxylates contribute to a composite Na⁺ site.     

Brain N-acetylaspartate is elevated in Pelizaeus-Merzbacher disease with PLP1 duplication.

OBJECTIVE: To assess alterations in brain metabolites of patients with Pelizaeus-Merzbacher disease (PMD) with the proteolipid protein gene 1 (PLP1) duplications using quantitative proton MRS. METHODS: Five unrelated male Japanese patients with PMD with PLP1 duplications were analyzed using automated proton brain examination with the point resolved spectroscopy technique (repetition and echo time of 5,000 and 30 msec). Localized spectra in the posterior portion of the centrum semiovale were acquired, and absolute metabolite concentrations were calculated using the LCModel. RESULTS: Absolute concentrations of N-acetylaspartate (NAA), creatine (Cr), and myoinositol (MI) were increased by 16% (p < 0.01), 43% (p < 0.001), and 31% (p < 0.01) in patients with PMD as compared with age-matched controls. There was no statistical difference in choline concentration. CONCLUSION: The increased concentration of NAA, which could not be detected by previous relative quantitation methods, suggests two possibilities: axonal involvement secondary to dysmyelination, or increased cell population of oligodendrocyte progenitors. Elevated Cr and MI concentrations may reflect the reactive astrocytic gliosis. Our study thus emphasizes the importance of absolute quantitation of metabolites to investigate the disease mechanism of the dysmyelinating disorders of the CNS.     

Nuclear estrogen receptor beta in lung cancer: expression and survival differences by sex.

PURPOSE: A role for estrogens in determining lung cancer risk and prognosis is suggested by reported sex differences in susceptibility and survival. Archival lung tissue was evaluated for the presence of nuclear estrogen receptor (ER)-alpha and ER-beta and the relationship between ER status, subject characteristics, and survival. EXPERIMENTAL DESIGN: Paraffin-embedded lung tumor samples were obtained from 214 women and 64 men from two population-based, case-control studies as were 10 normal lung autopsy samples from patients without cancer. Nuclear ER-alpha and ER-beta expression was determined by immunohistochemistry. Logistic regression was used to identify factors associated with ER positivity and Cox proportional hazards models were used to measure survival differences by ER status. RESULTS: Neither tumor (0 of 94) nor normal (0 of 10) lung tissue stained positive for ER-alpha. Nuclear ER-beta positivity was present in 61% of tumor tissue samples (170 of 278; 70.3% in men and 58.3% in women) and 20% of normal tissue samples (2 of 10; P = 0.01). In multivariate analyses, females were 46% less likely to have ER-beta-positive tumors than males (odds ratio, 0.54; 95% confidence interval, 0.27-1.08). This relationship was stronger and statistically significant in adenocarcinomas (odds ratio, 0.40; 95% confidence interval, 0.18-0.89). Women with ER-beta-positive tumors had a nonsignificant 73% (P = 0.1) increase in mortality, whereas men with ER-beta-positive tumors had a significant 55% (P = 0.04) reduction in mortality compared with those with ER-beta-negative tumors. CONCLUSIONS: This study suggests differential expression by sex and influence on survival in men of nuclear ER-beta in lung cancer, particularly in adenocarcinomas.