Micrometer-sized network structure of novel DNA-lipid conjugates induced by heat stimulation.

We have developed a novel lipid-bearing DNA that forms hairpin modules, including a single RNA monomer; this can be used to create micrometer-sized structures from nanometer-sized building blocks during breakage at the RNA site. In the presence of divalent metal ions and heat stimulation, we observed transition of the self-assembly, which results in the formation of a three-dimensional network structure. To our knowledge, this is also the first report of heat-induced micrometer-sized molecular self-assembly of molecules that carry biological information.

Reductions of docosahexaenoic acid-containing phosphatidylcholine levels in the anterior horn of an ALS mouse model.

In this study, we analyzed the spatiotemporal alterations of phospholipid composition in the spinal cord of an amyotrophic lateral sclerosis (ALS) mouse model (G93A-mutated human superoxide dismutase 1 transgenic mice [SOD1(G93A) mice]) using imaging mass spectrometry (IMS), a powerful method to visualize spatial distributions of various types of molecules in situ. Using this technique, we deciphered the phospholipid distribution in the pre-symptomatic stage, early stage after disease onset, and terminal stages of disease in female SOD1(G93A) mouse spinal cords. These experiments revealed a significant decrease in levels of docosahexaenoic acid (DHA)-containing phosphatidylcholines (PCs), such as PC (diacyl-16:0/22:6), PC (diacyl-18:0/22:6), and PC (diacyl-18:1/22:6) in the L5 anterior horns of terminal stage (22-week-old) SOD1(G93A) mice. The reduction in PC (diacyl-16:0/22:6) level could be reflecting the loss of motor neurons themselves in the anterior horn of the spinal cord in ALS model mice. In contrast, other PCs, such as PC (diacyl-16:0/16:0), were observed specifically in the L5 dorsal horn gray matter, and their levels did not vary between ALS model mice and controls. Thus, our study showed a significant decrease in DHA-containing PCs, but not other PCs, in the terminal stage of ALS in model mice, which is likely to be a reflection of neuronal loss in the anterior horns of the spinal cords. Given its enrichment in dorsal sensory regions, the preservation of PC (diacyl-16:0/16:0) may be the result of spinal sensory neurons being unaffected in ALS. Taken together, these findings suggest that ALS spinal cords show significant alterations in PC metabolism only at the terminal stage of the disease, and that these changes are confined to specific anatomical regions and cell types.

Superior mesenteric artery stent-graft placement in a patient with pseudoaneurysm developing from a pancreatic pseudocyst.

Pseudoaneurysm is a relatively rare but serious complication of pancreatitis which is often fatal. We report successful stent-graft placement in the superior mesenteric artery in a 45-year-old man with a pancreatic pseudocyst that grew during therapy for chronic pancreatitis and developed into a pseudoaneurysm. After a stent graft was inserted in the superior mesenteric artery, the pseudoaneurysm disappeared and no further complications developed. Stentgraft placement was considered to be a useful therapy for pseudoaneurysms in the superior mesenteric arterial region.

Embolization of collateral vessels using mechanically detachable coils in young children with congenital heart disease.

Our objective was to evaluate the usefulness of embolizing collateral vessels using mechanically detachable coils (MDCs) in children aged 3 years or younger with congenital heart disease. The subjects were 8 children with congenital heart disease featuring collateral vessels (age 18 days-3 years): 3 with a single ventricle, 2 with the tetralogy of Fallot, 2 with pulmonary atresia, and 1 with a ventricular septal defect. The embolized vessels were the major aortopulmonary collateral artery (MAPCA) in 5 patients, the persistent left superior vena cava in 2, and the coronary arteriovenous fistula in 1. A 4 or a 5 F catheter was used as the guiding device, and embolization was performed using MDCs and other conventional coils introduced through the microcatheter. One patient had growth of new MAPCAs after embolization, and these MAPCAs were also embolized with MDCs. Thus, a total of 9 embolization procedures were performed in 8 patients. Complete occlusion of the collateral vessels was achieved in 8 of 9 procedures (89%). Seven of 8 patients (88%) had uneventful courses after embolization, and MDC procedures appeared to play important roles in avoiding coil migration and achievement of safe coil embolization. One patient who underwent MAPCA embolization showed no improvement in heart function and died 2 months and 19 days later. Embolization of collateral vessels using MDCs in young children with congenital heart disease can be an effective procedure and a valuable adjunct to surgical management.

Recent-onset bell palsy complicated by diabetes: comparison of steroid and lipoprostaglandin E(1) therapy.

OBJECTIVE: To compare megadose steroid therapy (n = 17; group S) and lipoprostaglandin E(1) (lipo-PGE(1)) therapy (n = 14; group L) in patients with recent-onset Bell palsy complicated by diabetes. DESIGN: A nonrandomized controlled trial was performed. The 2 groups were almost identical in age, sex distribution, and laterality, and there was no difference in the average palsy scores in the 2 groups either at the time of the first visit or when the palsy was at its worst. RESULTS: There was no statistically significant difference in the cumulative rates of improvement in the 2 groups 4 weeks, 2 months, or 6 months after the first visit, revealing no difference in the therapeutic effects of the 2 agents. During the therapy, fasting blood glucose concentrations were increased in all patients in group S, whereas they were not increased in group L. Complicated diabetes was aggravated in group S, while it was not aggravated in group L. CONCLUSIONS: Lipo-PGE(1) therapy may have improved vascular flow in the facial nerves and accelerated recovery, resulting in a rate of improvement comparable with that obtained through megadose steroid therapy. Lipo-PGE(1) is a useful treatment method for patients with Bell palsy complicated by diabetes.

Surgical treatment of chronic subdural hematoma based on intrahematomal membrane structure on MRI.

BACKGROUND: To determine the optimal surgical management of chronic subdural hematoma (CSDH), we assessed which operative procedure, burr holes or small craniotomy, was more effective on 49 consecutive patients. METHOD: We retrospectively classified all cases into two groups according to the intrahematomal membrane structure of CSDH on T2*-weighted magnetic resonance (MR) imaging. The first group, labeled type B, included hematomas which had no intrahematomal membrane and/or were monolayer multilobule. The second group, labeled type C, consisted of hematomas which were divided into multiple layers by the intrahematomal membrane. FINDINGS: The outcome of type C patients treated with burr holes was significantly inferior to that of those who underwent a small craniotomy in terms of the relative outcome of neurological grading. re-operation ratio, and postoperative hospital stay (p < 0.05). Type C hematomas treated with burr holes also had inferior outcome compared with a small craniotomy in terms of the duration of hematoma until disappearance on postoperative CT (p < 0.05). INTERPRETATION: We concluded that a considerable number of cases appeared to need craniotomy and resection of intrahematomal membrane for complete recovery in CSDH, and that T2*-weighted MR imaging could be used as a basis for selecting the operative procedure for CSDH.

Psoriasis vulgaris and acute guttate psoriasis in a family.

A 33-year-old man (Case 1) developed scaling and erythema on the extensor side of his extremities, head, and back, 3 years before his first visit to our hospital. The lesions spread out to form several plaques and became persistent (Fig. 1a). Serum antistreptolysin O (ASO) was within the normal range and a pharyngeal culture showed normal flora. Histologic findings were compatible with psoriasis vulgaris (Fig. 1b). Topical steroid therapy was effective; however, scaling and erythema persisted. The 8-year-old daughter (Case 2) of Case 1 had suffered severe tonsillitis 2 months prior to the skin eruptions. Numerous rain drop-like scaly papules appeared on her legs and generalized rapidly (Fig. 2a). Her tonsils were swollen and reddish. Streptococcus pyogenes was detected by pharyngeal smear. The ASO value was at a high level. Histologic examination showed slightly elongated rete ridges, focal lack of the granular layer, parakeratosis, mild spongiosis, and exostosis of neutrophils (Fig. 2b). She was diagnosed with acute guttate psoriasis. Administration of oral antimicrobials reduced the ASO value and led to remission of the disease. After 1 month of antimicrobial treatment, the erythematous papules disappeared. The human leukocyte antigen (HLA) typing of the father was HLA-A24, A31, B7, B39, and Cw7, and that of the daughter was HLA-A24, A31, B39, and Cw7. Both possessed HLA-A24, B39, and Cw7. The HLA typing of other family members was also studied. The mother had HLA-A11, A24, B39, B62, Cw4, and Cw7, and her son had HLA-A11, A24, B7, B62, Cw4, and Cw7. The result of HLA typing is shown in Table 1. Lymphocyte stimulating test was performed using heat-killed S. pyogenes which were boiled at 70 degrees C for 10 min and sonicated. The stimulation index was twofold higher in the daughter than in the father (Fig. 3).

Characteristics of acoustic noise in echo-planar imaging.

Characteristics of the acoustic noise generated by magnetic resonance imagers of different systems and performance levels were studied when operating in echo-planar imaging (EPI) sequence. Continuous equivalent A-weighted sound pressure levels (Leq) and peak impulse sound pressure levels (Lpeak) during EPI were measured in 12 clinical super-conducting MRI systems (0.5-1.5 T). Sound pressure levels and frequency spectra of EPI were compared with those of nine different pulse sequences. EPI sound pressure levels differed among institutions (Leq = 94.2 +/- 2.7 dBA. Lpeak = 109.1 +/- 3.5 dB), but these were within permissible noise exposure levels. Sound pressure levels during EPI were not significantly different from those during other pulse sequences. However, compared to other pulse sequences. EPI had a significantly greater proportion of acoustic noise in the high octave-frequency band. Single-shot EPI had relatively higher frequency noise and greater Leq than multishot EPI, but the difference in Leq decreased when the number of slices in multishot EPI was increased.

Quantitative assessment of regional myocardial blood flow using oxygen-15-labelled water and positron emission tomography: a multicentre evaluation in Japan.

Recently, a method has been proposed for the quantitative measurement of regional myocardial blood flow (MBF) using oxygen-15-labelled water and positron emission tomography (PET). A multicentre project was organized with the intention of evaluating the accuracy of this method, particularly as a multicentre clinical investigative tool. Each of seven institutions performed PET studies on more than five normal volunteers following a specified protocol. The PET study included a transmission scan, a 15O-carbon monoxide static scan and a 15O-water dynamic scan, thereby yielding MBF values which should have been independent of the spatial resolution of the PET scanner employed. Fifty-three subjects (aged 20-63 years, mean+/-SD 36+/-12 years) were studied at rest, and 31 of these subjects were also studied after dipyridamole in five institutions. Inter-institution consistency and intra-subject variation in MBF values were then evaluated. MBF averaged for all subjects was 0.93+/-0.34 ml min(-1) g(-1) at rest and 3.40+/-1.73 ml min(-1) g(-1) after the administration of dipyridamole, and the flow reserve (defined as the ratio of the two MBF values) was 3.82+/-2.12; these values are consistent with previous reports. Resting MBF values were significantly correlated with the heart rate-blood pressure product (RPP) (y=0.31+6.56E-5x, P<0.010), and RPP was in resting MBF observed in all institutions was well explained by the age-dependent RPP. No significant difference was observed in resting MBF among the institutions. Except in one institution, no significant difference was seen in dipyridamole MBF or myocardial flow reserve. No significant difference was found among the myocardial segments. Regional variation was reasonably small in five institutions, but was not acceptable in two institutions, which was attributed to the scanner performance. These observations suggest that the 15O-water PET technique is useful for a multicentre clinical study if the PET scanner can provide time-activity data with good count statistics.

Limitation of Endovascular Treatment for Ruptured Cerebral Aneurysms: Results from the Protocol "GDC as the first choice".

SUMMARY: Since October, 1997, endovascular embolization using GDC has been our primary treatment for ruptured cerebral aneurysms in the acute stage. According to our protocol, an aneurysm more than 3 mm in diameter, without a wideneck or massive intracranial hematoma is indicated for endovascular therapy. Under this protocol, we experienced 35 consecutive patients with aneurysmal subarachnoid hemorrhage, and 22 of them (62.8%) were treated endovascularly. The most common reason for the contra-indication of coil embolization was wide-necked aneurysm (9 cases). We experienced two cases with embolic stroke and one case with post-embolization hemorrhage as a complication after endovascular treatment. Morbidity rate due to the complications was 9.1%. In conclusion, a system that allows both surgical and endovascular treatments to be performed in any given case is necessary for the appropriate treatment of ruptured aneurysm. In order to avoid ischemic embolic complications, postoperative anticoagulation therapy is crucial. The safety of coil embolization for very thin-walled aneurysm is questionable.

Correlation between magnetic resonance imaging and clinical profiles of periventricular leukomalacia.

Magnetic resonance imaging (MRI) findings of 70 children with periventricular leukomalacia (PVL), examined between 1 year 2 months and 8 years of age (mean: 2 years 4 months of age), were analysed. Neurological assessments were made between 1 year 3 months and 15 years (mean: 4 years 9 months). The possible correlations between MRI findings and clinical profiles of PVL were investigated using three parameters of the MRI findings. The grade of ventriculomegaly correlated well with the severity of cerebral palsy (CP) but not with the severity of mental impairment. The grade of reduction of periventricular white matter correlated well with the severity of CP and mental impairment, and is the most reliable parameter for neurological prognosis. The degree of periventricular hyperintensity on T2-weighted images did not correlate well with severity of CP, but correlated to some degree with mental impairment. There was a significantly lower degree of periventricular hyperintensity in children at less than 28 weeks of gestation than at 28 or more weeks of gestation, but no significant difference in other parameters. The periventricular hyperintensity should be evaluated in view of the gestational age.

Acoustic noise analysis in echo planar imaging: multicenter trial and comparison with other pulse sequences.

The purpose of this study was to evaluate acoustic noise in echo planar imaging (EPI) at various magnetic resonance imaging (MRI) centers and to compare EPI acoustic noise with that in other fast pulse sequences. We measured A-weighted root-mean-square sound pressure levels and peak impulse sound pressure levels for EPI, under the same conditions, in eleven clinical super-conducting MRI systems. We also compared sound pressure levels for the EPI and six different pulse sequences and analyzed the acoustic noise spectra. Sound pressure levels during the use of the EPI differed greatly among institutions. Moreover, sound pressure levels of the EPI were not significantly different from those of other fast pulse sequences and were within permissible noise exposure levels. In comparison to other fast sequences, the EPI had significantly greater acoustic noise in the high-octave band frequency.

Deterioration of ocular motor dysfunction after transvenous embolization of dural arteriovenous fistula involving the cavernous sinus.

We treated 9 patients with the dural arteriovenous fistula involving the cavernous sinus by transvenous embolization. Two patients experienced deterioration of oculo-motor dysfunction after transvenous embolization. We can speculate about two different kind of causes by which patients symptoms deteriorated according to the result of intrasinus pressure recorded during the embolization [1]: high intrasinus pressure caused by the obliteration of the drainage pathway resulted in cranial nerve palsy in one case [2]; implanted coils directly compressed the cranial nerve in another case. Fortunately our cases recovered, but some kind of preventative measures may be needed in similar cases.

Syntelencephaly associated with connected transhemispheric cleft of focal cortical dysplasia.

The authors report a female with syntelencephaly associated with a connected transhemispheric cleft of focal cortical dysplasia. Syntelencephaly is a rare anomaly characterized by fusion of the hemispheres in the posterior frontal and parietal regions and is considered a new variant of holoprosencephaly. Cranial magnetic resonance imaging of the patient revealed syntelencephaly associated with bilateral fused clefts of focal cortical dysplasia without the pial-ependymal seam, which was regarded as an incomplete type of schizencephaly. The underlying mechanism is discussed.

Conformational changes of the smooth endoplasmic reticulum are facilitated by L-glutamate and its receptors in rat Purkinje cells.

The intraventricular administrations of L-glutamate or trans-1-amino-1,3-cyclopentanedicarboxylic acid (t-ACPD), which is an agonist for the metabotropic glutamate receptor, induced conformational changes of the smooth endoplasmic reticulum (SER) to form lamellar bodies, consisting of stacks of flattened cisterns in Purkinje cell dendrites of the rat cerebellum. The formation of lamellar bodies by t-ACPD or by anoxia was blocked by pretreatment of L(+)-2-amino-3-phosphonopropionic acid (L-AP3), which is an antagonist for the metabotropic glutamate receptor. Injections of N-methyl-D-aspartic acid (NMDA) and amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)/kainate, which are categorized as acting on ionotropic receptors of glutamate, did not cause the formation of lamellar bodies, although kainate condensed the dendritic cytoplasm and produced a swelling of surrounding astrocytes. The cisterns of lamellar bodies formed by t-ACPD were long and formed regular stacks. Many intercisternal bridges were arranged with a center-to-center distance of about 25 nm between apposed cisterns. The bridges appeared as short tubes about 15 nm in diameter and in length, a clear center of which linked the lumen of their cisterns. The present results revealed that an excess release of excitatory transmitter by brief anoxia activates metabotropic glutamate receptors, which transform the networks of SER that normally release Ca2+ widely to the neuronal cytoplasm into lamellar bodies. Large Ca2+ storage pools of lamellar bodies are formed by the association of opposing molecules that belong to different cisterns and may protect excess release of Ca2+ from their reservoirs.

Quantitative analysis of CSF flow dynamics using MRI in normal pressure hydrocephalus.

In order to clarify the flow dynamics of cerebrospinal fluid (CSF) in normal pressure hydrocephalus (NPH), a phase-contrast cine magnetic resonance (MR) imaging technique with retrospective cardiac gating was used to measure the quantitative flow velocity of CSF in the aqueduct in patients with NPH after subarachnoid hemorrhage (SAH-NPH group, n = 17), idiopathic NPH (1-NPH group, n = 2), asymptomatic ventricular dilatation or brain atrophy (VD group, n = 7) and healthy volunteers (control group, n = 19). Intracranial pressure (ICP) and pressure volume response (PVR) were also measured during the shunt operation in six of the SAH- NPH group. The maximum CSF flow velocity (Vmax) in the aqueduct was significantly larger in the SAH-NPH group (9.21 +/- 4.12 cm/sec, mean +/- SD) than in the control group (5.27 +/- 1.77, p < 0.001) and the VD group (4.06 +/- 1.81, p < 0.005). Vmax was not different between the control and VD groups. There was a positive correlation between the PVR and the peak CSF flow velocity in the SAH-NPH group. These findings suggest that the changes of CSF flow velocity in the SAH-NPH group might be caused by a moderate decrease of intracranial compliance. The CSF flow study using MRI is useful to differentiate NPH from brain atrophy or asymptomatic ventricular dilatation and also to estimate the intracranial compliance.

Immunocytochemical localization of chromogranin A and secretogranin II in female rat gonadotropes.

Ultrastructures of pituitary gonadotropes are known to show a prominent sex-related difference: typical male rat gonadotropes contain both large- and small-sized granules, whereas typical female rat gonadotropes appear to exhibit uniformly small-sized granules. Our preceding studies have demonstrated that two representative granins, chromogranin A (CgA) and secretogranin II (SgII), are separately localized to each type of granule in male rat gonadotropes. To clarify whether or not there is a certain relationship between granin proteins and characteristic features of secretory granules in female rat gonadotropes, we examined the expression levels and immunocytochemical localizations of CgA and SgII in the cells. Northern blot and immunoblot analyses demonstrated that both CgA and SgII were synthesized and stored in the female pituitary, although the amount of CgA was much lower in the female than that in the male pituitary. Immunocytochemical observations clarified that gonadotropes in the female pituitary possessed intermediate secretory granules containing both CgA and SgII, in addition to solely CgA-positive and SgII-positive ones. However, secretory granules containing CgA in the female gonadotropes were much smaller in size and appeared less frequently than those in the male cells, whereas no sexual difference was discerned in SgII-positive granules. Moreover, the size and appearance of CgA-positive secretory granules varied depending on stages of the estrous cycle. These findings suggest that the size and appearance of secretory granules containing CgA are closely associated with the expression and storage levels of CgA in the pituitary.

Compositional changes in glycoconjugates recognized histochemically with lectins in Purkinje cells in suckling and adult rats.

Cerebella from suckling and adult rats were examined histochemically with 19 different biotin-labeled lectins. Purkinje cells from postnatal rats had a marked ability to combine with many lectins, but minimal ability was found in adult rats except for Con-A, LEL, and MAL lectins. The cell body of Purkinje cells on postnatal day 7 was strongly labeled with 6 lectins (Con-A, LTL, MAL, SJA, UEA-I, and VVA). Only moderate staining was observed with these lectins on postnatal day 5. The dendritic tree of the cells showed a moderate labeling ability with LTL and UEA-I on postnatal days 15 and 20. The dendritic tree was strongly labeled with MAL on postnatal days 10, 15, 20 and adult. Positive reactions were observed in the cells when cerebellar sections from rats on postnatal day 7 were incubated with 3 other lectins (AAL, LEL, and SBA). The cells on postnatal day 7 were rarely labeled with BSL-II, DBA, DSL, LCA, PNA, PSA, RCA120, SSA, STL, and WGA. Purkinje cells on postnatal day 7 may be rich in N-linked oligosaccharides, with terminal sugar structures that resemble blood-group-related antigens (type H) and/or tumor-related antigens. These glycoconjugates may be present at low levels in the Purkinje cells of adult rats. Dendrites of Purkinje cells of adult rats were strongly labeled by Con-A, LEL, and MAL. The dendrites of Purkinje cells may be rich in highly branched oligosaccharides.