Acceleration of surgical angiogenesis in necrotic bone with a single injection of fibroblast growth factor-2 (FGF-2).

The aim of this study was to accelerate angiogenesis in necrotic bone by combining vascular bundle implantation and fibroblast growth factor-2 (FGF-2) administration. Twenty-four Japanese white rabbits were evaluated in this study. A portion of a rabbit iliac crest bone was removed as a free bone graft and frozen in liquid nitrogen to ensure complete cellular necrosis. A narrow hole was created in the bone and the graft was placed in the proximal thigh. In group 1, FGF-2 was injected into the hole at a single dose of 100 microg, and the saphenous artery and its venae comitantes were passed through the hole of the bone. In group 2, injection of saline into the hole and the vascular bundle implantation was used as a control. Neovascularization around the vessel was evaluated at weeks 1 and 2 after surgery. Neovascularization was observed along the implanted vascular bundle in both groups. At both 1 and 2 weeks after surgery, the vessel density of group 1 was significantly higher than that of group 2. The average length of newly formed vessels of group 1 was also significantly longer than that of group 2 at both 1 and 2 weeks after surgery. Both the vessel density and length were greater in week 2 animals than week 1. A local single injection of FGF-2 improved surgical angiogenesis in necrotic bone in this study. As FGF-2 is recognized as a potent mitogen for a variety of mesenchymal cells, the combination of vascular bundle implantation and FGF-2 administration may contribute to the treatment of ischemic osteonecrosis.     

Clinical significance of natriuretic peptides in patients with aneurysmal subarachnoid hemorrhage]

Hyponatremia and hypovolemia following aneurysmal subarachnoid hemorrhage (SAH) might be speculated by exaggerated secretion of natriuretic peptides and resulted ischemic sequela caused by cerebral vasospasm. We measured serum concentration of natriuretic peptides and investigated their influence on post-SAH hyponatremia. Among 49 patients of SAH, their plasma concentration of the natriuretic peptides (atrial natriuretic peptide: ANP and brain natriuretic peptide: BNP) were measured at the day of ictus and 7th day of SAH. The correlation between concentration of natriuretic peptides and location of aneurysm, severity of SAH, incidence of hyponatremia and symptomatic vasospasm were elucidated. The plasma concentration of ANP did not alter on admission and 7th day post SAH, whereas that of BNP increased in the patients with moribund SAH and those with ruptured A-com aneurysm. The initial increase of BNP following SAH could be attributed to direct damage of SAH on the hypothalamus. Hyponatremia and symptomatic vasospasm tended to occur in the patients who had persistent increase of plasma BNP concentration during one week post SAH. Therapeutic intervention to maintain normonatremia by fluid-management decreased occurrence of symptomatic vasospasm, even though patients with increased plasma BNP concentration. It might be concluded that increased secretion of BNP following SAH is caused by direct effect to the hypothalamus and prolonged hyper secretion of BNP resulted hyponatremia, hypovolemia and exaggerated symptomatic vasospasm.     

Predictive factors for vascularized iliac bone graft for nontraumatic osteonecrosis of the femoral head

We reviewed the results of 35 operations performed on 29 patients with osteonecrosis of the femoral head in which a pedicle iliac bone was utilized. The average age was 35 years (17–62). There were 28 patients of stage 2 and 7 of stage 3; there were 17 type C-1 hips and 18 type C-2 hips. The pedicle bone was inserted in the anterolateral direction of the femoral head. The average follow-up period was 8 years and 7 months. Collapse of the femoral head occurred in 19 hip joints. Although 16 of 28 stage 2 hips showed collapse, all 7 stage 3 hips resulted in collapse. Thirteen of 17 hips did not show collapse in patients with type C-1 necrosis, whereas 15 of 18 hips developed collapse in patients with type C-2 necrosis. When the bone graft was inserted in the anterolateral direction of the femoral head, incidence of collapse was reduced. These results indicate that deep circumflex iliac pedicle bone graft may be indicated for stage 2 type C-1 necrosis, and that the penetration of the graft into the anterolateral aspect of the lesion is essential for the procedure to succeed.     

Akinetic mutism from recurrent hydrocephalus: successful treatment with levodopa, bromocriptine and trihexyphenidyl

A case of akinetic mutism was reported with reference to a marked improvement by levodopa, bromocriptine and trihexyphenidyl. A 39-year-old male, first seen on February 2, 1981, had an occipitalgia, accompanied by nausea and vomiting. For several months before this consultation, the patient had suffered from asthenopia. Brain CT scan and cerebral angiogram demonstrated internal hydrocephalus due to aqueduct stenosis of unknown etiology. After a ventriculoperitoneal shunt operation on February 20, 1981, he completely recovered. Two years and a half after the shunt insertion he had no difficulty in his daily life. He reentered the hospital on December 21, 1983, because of personality change, mental deterioration and bradykinesia. Brain CT scan showed recurrent hydrocephalus resulting from shunt blockage. Following the shunt revision, hydrocephalus was resolved. Nevertheless, the patient did not return to his previous state. And he became bed-ridden, incontinent of urine, and unable to take fluids or foods, following which he went into a state of akinetic mutism. Other neurological findings were as follows: upward gaze palsy, impaired convergence, convergence nystagmus, plastic rigidity of neck and all four limbs, and diffuse hyperreflexia with right Babinski's sign. Abnormal involuntary movement was not seen. On March 27, 1984, levodopa therapy was instituted and on April 2, trihexyphenidyl was combined with levodopa. Shortly after administration of levodopa and trihexyphenidyl, akinetic mutism began to improve, but upward gaze palsy was not affected. He began to speak and could walk unassisted by the end of July.(ABSTRACT TRUNCATED AT 250 WORDS)     

Synthesis of vinyl-terminated isotactic poly(propylene) using the coupling reaction between Zn-terminated polymer and allyl halides

Propene was polymerized with the TiCl₃/Al(C₂H₅)₂Cl catalyst system using Zn(C₂H₅)₂ as a chain transfer reagent. The resulting Zn-terminated poly(propylene) (PP) was then brought into contact with allyl halides (chloride, bromide and iodide) in the presence of N-methylimidazole to obtain vinyl-terminated PP. Allyl bromide gave the highest conversion among these allyl halides. When the coupling reaction was conducted with allyl bromide at 40°C for 24 h, the conversion to the terminal vinyl groups was over 90% for atactic PP and approximately 60% for isotactic PP. The Zn-polymer bonds of both atactic and isotactic PP were almost quantitatively converted into terminal vinyl groups at 130°C for 3 h.     

Bioaerosol concentrations and the identification of aerosolized bacteria by 16S rDNA analysis in work environments]

Bioaerosols cause sick building syndrome (SBS) and allergy. Many kinds of bioaerosol impactors are used for measurement of airborne microorganism concentrations in Japan. However, because the impactors are set on agar plates, some microorganisms cannot make colonies on the plates because of their lower viability or demands of nutrition. On the other hand, by double staining using ethidium bromide (EtBr) and carboxyfluorescein diacetate (CFDA), both total cells and cells with esterase activities can be detected without incubation. In this study, we calculated total cell concentrations and percentages of cells with esterase activities by the combination of filter sampling and double staining (EtBr and CFDA) from air of a laboratory, a conference room and outdoors. Temperature and humidity in the laboratory were constantly kept by an air conditioner, but in the conference room, an air conditioner was only operated sometimes because of its low frequency of use. There were no significant differences between total cell concentrations and humidity in both rooms, but increase of the percentages of cells with esterase activities depended on rainfall before the samplings (n=15, p<0.05 by Mann-Whitney test). The increase of active microorganisms by rainfall should be considered when we evaluate the risk of bioaerosols in the workplace. There were few differences in classifications of aerosolized bacteria by 16S rDNA sequence-based homology between the laboratory and the conference room. In both rooms, few pathogenic bacteria were observed.     

Alteration of Annexin IV Expression in Alcoholics

Western blot analysis was performed by using a specific antibody to measure annexin IV in human postmortem brain samples from alcoholic subjects. The analysis showed a significantly augmented expression in the hippocampus compared with controls, whereas the expression in the frontal cortex was equivalent in both groups. Annexin IV expression in the occipital cortex tended to increase in alcoholics. It was shown further that autoantibodies to annexin IV were increased significantly in alcoholic patients compared with controls. Thus, annexin IV may become a novel biological marker for alcoholics.     

A case of CA19‐9‐producing adenocarcinoma of the remnant stomach resembling gastritis cystica polyposa

Gastritis cystica polyposa (GCP) is a well‐known precancerous lesion of the remnant stomach. We report a case of carbohydrate antigen (CA) 19–9‐producing well‐differentiated adenocarcinoma of the remnant stomach that resembled GCP. The patient was a 66‐year‐old Japanese man who had undergone subtotal gastrectomy 20 years previously. The tumor developed in the remnant stomach at the anastomotic line. Histologically, the lesion completely encircled the gastroenterostomy stoma. There was florid growth of glands with cystic dilatation and minimal atypia extending through the thickened muscularis propria into the subserosa. Small foci of less well‐differentiated adenocarcinoma were also detected, including irregular glands or small clusters of mucus‐producing cells with moderate atypia. Immunostaining revealed that numerous tumor cells were positive for carcinoembryonic antigen and CA19‐9, whereas only a few cells were positive for p53. The macroscopic, histopathological and immunohistochemical findings indicated a diagnosis of CA19‐9‐producing well‐differentiated adenocarcinoma of the remnant stomach. To avoid underdiagnosis, careful attention should be paid to the above‐mentioned morphological features and immunohistochemical findings, in addition to the endoscopic findings.     

Axonal projections of auditory cells with short and long response latencies in the medial geniculate nucleus: distinct topographies in the connection with the thalamic reticular nucleus

The thalamic reticular nucleus (TRN) is a crucial anatomical node of thalamocortical connectivity for sensory processing. In the rat auditory system, we determined features of thalamic projections to the TRN, using juxtacellular recording and labeling techniques. Two types of auditory cells (short latency, SL, and long latency, LL), exhibiting unit discharges to noise burst stimuli (duration, 100 ms) with short (< 50 ms) and long (> 100 ms) response latencies, were obtained from the ventral division of the medial geniculate nucleus (MGV). Both SL and LL cells had a propensity to exhibit reverberatory discharges in response to sound stimuli. The primary discharges of SL cells were mostly single spikes while the non-primary discharges of SL cells and the whole discharges of LL cells were mostly burst spikes. SL cells sent topographic projections to the TRN along the dorsoventral and rostrocaudal neural axes while LL cells only along the rostrocaudal axis. As tonotopy-related cortical projections to the TRN are topographic primarily along the dorsoventral extent of the TRN and the MGV is tonotopically organized along the dorsoventral axis, SL cells, directly activated by ascending auditory inputs, may be closely involved in tonotopic thalamocortical connectivity. On the other hand, LL cells, which are suppressed by ascending inputs and could be driven to discharge by corticofugal inputs, are assumed to activate the TRN in a manner less related to tonotopic organization. There may exist heterogeneous projections from the MGV to the TRN, which, in conjunction with corticofugal connections, could constitute distinct channels of auditory processing.