Initial change in transient osteoporosis of the hip on magnetic resonance images: a case report

We report the case of a 29-year-old Japanese man with transient osteoporosis of the left hip (TOH) following contralateral TOH, paying special attention to the initial changes on MRI. MR images showed no abnormal findings 6 weeks before the clinical manifestation, but the images just after the onset depicted a linear abnormality equivalent to a subchondral insufficiency fracture. Both radiological findings and clinical symptoms disappeared completely without any surgical intervention within 10 months.     

Plasma levels of atrial natriuretic peptide in patients with liver cirrhosis and its relation to ascites and renal function

Plasma immunoreactive a-human atrial natriuretic polypeptide (Ir-α-hANP) was measured by radioimmunoassay in 21 cirrhotics and 10 normal subjects. Average of Ir-α-hANP level in cirrhotics was significantly higher than in normal subjects (125.8 ± 79.6 versus 28.7 ± 12.2 pg/ml, P< 0.001). In cirrhotics without ascites, Ir-α-hANP levels were positively correlated with creatinine clearance (Ccr) and urinary sodium excretion, suggesting that α-hANP was closely related to renal circulation and sodium homeostasis. One the contrary, in cirrhotics with ascites Ir-α-hANP levels were negatively correlated with Ccr. Urinary sodium excretion in cirrhotics with ascites and Ccr more than 50 ml/min was positively correlated with Ir-α-hANP levels. However, cirrhotics with ascites and Ccr less than 50 ml/min excreted little sodium in spite of high Ir-α-hANP levels. On the basis of the Ir-α-hANP before and after treatment of ascites, cirrhotics with ascites were subdivided into 2 groups. In group I Ir-α-hANP decreased from high values and in group II it was further elevated from slightly high values by treatment. The difference in renal function and plasma volume may account for the difference in Ir-α-hANP changes in the 2 groups. This study was presented in part in the 22nd meeting of the Japanese Association for the Study of the Liver, June 6,1986, Tokyo, Japan and in 22nd meeting of the European Association for the Study of the Liver, September 5, 1987, Torino, Italy.     

Helicobacter pylori induces gastritis and oxidative stress after distal gastrectomy

BACKGROUND/AIMS: Helicobacter pylori is a carcinogen for gastric cancer. There have been few reports on carcinogenesis about H. pylori infection in the gastric remnant after distal gastrectomy. The relationship between carcinogenesis and H. pylori infection was studied by means of inflammation and oxidative stress. METHODOLOGY: Ninety-seven patients who had undergone curative distal gastrectomy for gastric cancer were studied. All patients underwent endoscopic examination 3 months after surgery. The presence of H. pylori was determined using urease rapid test, hematoxylin-eosin staining, and immunohistochemical staining. Fifty-one patients were positive (group A) and 46 patients were negative (group B). The grades of remnant gastritis were scored by updated Sydney System. 8-Hydroxydeoxyguanosine (8-OHdG) as an oxidative stress marker, was analyzed immunohistochemically, and graded in 4 grades. RESULTS: Both the neutrophil infiltration score and 8-OHdG expression score was higher in group A than group B (p = 0.03 and 0.05). The correlation between the 8-OHdG expression score and the neutrophil infiltration score was significant (p = 0.02). CONCLUSIONS: As gastritis is related to oxidative stress, H. pylori infection is suspected to play an important role in carcinogenesis in the gastric remnant.     

Transumbilical laparoscopically assisted appendectomy in children: the results of a single-port,single-channel procedure

Background  

Even for pediatric patients, the use of laparoscopic appendectomy has been widely accepted, and three trocars usually are necessary to perform a laparoscopic appendectomy. However, single-port appendectomy for children represents an attractive alternative. To reduce the number of incisions and trocars, the authors have adopted a transumbilical laparoscopically assisted single-port appendectomy (TULAA) approach. This study aimed to evaluate the results of their single-channel, single-port appendectomy.     

Effect of selective inhibitor of thromboxane A2 synthetase on cerebral vasospasm after early surgery

The authors report the results of inhibition of thromboxane A2 synthetase in 49 consecutive patients with subarachnoid hemorrhage (SAH). These unselected Grade I to IV patients all had a ruptured aneurysm of the anterior circle of Willis, and were operated on within 72 hours after SAH. Twenty-seven patients were treated postoperatively by an intravenous infusion of sodium (E)-3- [4-(3-pyridylmethyl)-phenyl] -2- propenoate (OKY-1581), a selective inhibitor of thromboxane A2 synthetase, at 5 micrograms/kg/min for 10 to 14 days, and the remaining 22 patients did not receive this drug. Both groups of patients had similar age distribution and preoperative neurological conditions. A suggestive but statistically insignificant improvement was found in postoperative angiographic vasospasm, ischemic symptoms, and overall outcome in the group receiving OKY-1581. The incidence of low-density areas on the postoperative computerized tomography scans was significantly decreased in patients treated with OKY-1581 infusion.     

Plasma membrane structures of medulloblastoma and cerebellar sarcoma

Three medulloblastomas and 1 cerebellar sarcoma were studied on their plasma membrane structures. The average number of membrane particles per mum2 plasma membrane was 710 on face A and 70 on face B of medulloblastoma and 1280 on face A and 160 on face B of cerebellar sarcoma. The membrane particles were often aggregated in medulloblastoma and diffusely scattered in cerebellar sarcoma. Small gap junctions were occasionally found in cerebellar sarcoma and not evident in medulloblastoma. Round membrane protrusions, about 0.5-0.6 mu in diameter and provided with several small depressions on their foot, were often observed in region of narrow perinuclear cytoplasm of cerebellar sarcoma and different in structure from cytoplasmic processes. The present series is too limited in number to allow a definite conclusion, but indicates that the plasma membrane structures are different in medulloblastoma and cerebellar sarcoma.     

Possible tumor development from double positive foci for TGF-alpha and GST-P observed in early stages on rat hepatocarcinogenesis

Expression of TGF-alpha during promotion of neoplastic development from GST-P-positive foci in rat chemical hepatocarcinogenesis was investigated. One-hundred male F344 rats were given a single intraperitoneal injection of DEN (200 mg/kg bodyweight) and subjected to two-thirds partial hepatectomy at week 3. Commencing 2 weeks from the start, PB at doses of 0 or 500 p.p.m. was fed to the rats for 46 weeks. Groups of 10 rats were killed at weeks 4, 8, 16, 32, 48 and their livers were immunohistochemically examined for expression of GST-P and TGF-alpha. TGF-alpha-positive foci and single positive cells were observed from week 4, partially overlapping with GST-P-positive foci but being much fewer. Numbers of TGF-alpha-positive lesions did not increase from weeks 4-48, but their areas showed increment at weeks 32 and 48, especially with PB administration. Almost all of the tumors observed at weeks 16, 32 and 48 were positive for TGF-alpha (98%). In addition, epidermal growth factor receptor overexpression was observed in most TGF-alpha-positive lesions (foci and tumors). The proliferating cell nuclear antigen labeling index in double positive foci for GST-P and TGF-alpha was significantly higher than that in TGF-alpha-negative foci. In conclusion, TGF-alpha may be closely related with promotion from altered foci to neoplasms in rat hepatocarcinogenesis. Our data suggest that double positive foci for GST-P and TGF-alpha in the early stages of rat hepatocarcinogenesis may develop into tumors with promotion.     

Identification of antibiotic clarithromycin binding peptide displayed by T7 phage particles

Peptide libraries displayed by T7 phage, which contain random cDNA fragments insets, were screened for their ability to bind to a biotinylated derivative of clarithromycin. Phage particles bound to an immobilized derivative of the antibiotic were isolated and the inserted cDNA was amplified and sequenced. A common selected peptide sequence, composed of 19 amino acids, was obtained and a synthetic peptide with this sequence was produced. Surface plasmon resonance experiments showed that the synthetic peptide immobilized on a sensor chip bound to clarithromycin and the dissociation constant was determined to be 2.1 x 10(-3) M. The dissociation constants of other macrolide antibiotics, erythromycin, roxithromycin, azithromycin and josamycin were also determined to be 5.4 x 10(-3) M, 6.2 x 10(-5) M, 1.1 M and 3.4 x 10(-2) M, respectively. These results indicated that T7 phage display method might be useful to determine relatively weak interactions between small molecule drugs and the selected peptides which could represent a possible binding site conserved in binding proteins.     

LEPRECHAUNISM (DONOHUE'S SYNDROME) – TWO AUTOPSY CASES

Two autopsy cases of female newborns with numerous morphologic and metabolic abnormalities were reported. These were considered Identical with a disorder which has been called leprechaunism or Donohue's syndrome, and were believed to be the first and second autopsy cases reported in this country. Although it has been presumed that these might be abnormalities of endocrine system or of metabolism, the authors could not find any factors which caused the disorder in spite of minute analysis of steroid hormones In urine, investigation of laboratory data as well as autopsy findings.     

Electron-microscopic observation of the nucleus basilis of Meynert in human autopsy cases

Summary The large neurons of the nucleus basalis of Meynert (nbM) were examined with the electron microscope in 13 autopsied human adults. The neurons were characterized by a prominent Nissl substance and accumulation of lipofuscin granules. Lamellar bodies were often observed among the Nissl substance. Many of the lipofuscin granules were large and had a characteristic pronounced mosaic pattern of pale areas within gray zones. Menbranous structures within the nucleus and periodic transverse processes in the cristae of the mitochondria were regarded as postmortem alterations. Alzheimer's neurofibrillary tangles (NFT) were observed in two cases. Intranuclear fibrillary bundles were identified in four cases. Crystalloid formation in rough endoplasmic reticulum was identified in two cases. Hirano body was observed in a case of parkinsonism with dementia. Axonal swelling was seen in three cases and interpreted as axonal dystrophy, an age-related phenomenon. A basal body, which is unusual in neurons of the central nervous system (CNS), was observed in one case. Lewy bodies were observed in a case of parkinsonism.