Quantitative analysis of cerebrospinal fluid flow in patients with cervical spondylosis using cine phase-contrast magnetic resonance imaging.

OBJECTIVE: To investigate changes in the cerebrospinal fluid flow in patients with cervical spondylosis using cine phase-contrast magnetic resonance (MR) imaging. METHODS: The participants included 44 healthy volunteers, 11 asymptomatic patients with evidence of degenerative changes of the cervical spine revealed by MR imaging but no neurological symptoms referable to those abnormalities, and 23 symptomatic patients with myelopathy who underwent surgery. Cervical spondylotic myelopathy was evaluated using the Japanese Orthopedic Association scores, and the percentage reduction of the transverse cord area at the level of maximum cord compression was measured on T1-weighted magnetic resonance images. A cine phase-contrast MR pulse sequence with peripheral gating was used to measure the cerebrospinal fluid flow direction and velocity in the ventral subarachnoid spaces at the C1 and T1 levels. RESULTS: The velocity waveforms produced by plotting flow velocity at 16 intervals during one cardiac cycle significantly differed among the healthy volunteers, asymptomatic patients, and preoperative symptomatic patients. However, velocity waveforms did not differ between the healthy volunteers and the postoperative patients at the C1 level. Decreases of flow velocity were significantly correlated with the severity of myelopathy and the percentage reduction of cord area. Patients with severe myelopathy (Japanese Orthopedic Association score of 0-9 points) or greater than 30% reduction of cord area showed significantly decreased flow velocity compared with those with mild myelopathy (Japanese Orthopedic Association score of 10-17 points) or less than 30% reduction of cord area. Changes in flow velocity were not correlated with multiplicity of the lesion or the level of maximum cord compression. Postoperative improvement of flow velocity was not correlated with neurological recovery. CONCLUSION: Cine phase-contrast MR imaging allows quantitative and noninvasive assessment of changes in cerebrospinal fluid flow in patients with cervical spondylosis.

Use of porous hydroxyapatite graft containing recombinant human bone morphogenetic protein-2 for cervical fusion in a caprine model.

OBJECT: The efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) for enhancing anterior cervical spine interbody fusion when added to a porous hydroxyapatite (HA) graft was investigated. METHODS: Fourteen mature goats underwent three-level anterior discectomies after induction of endotracheal anesthesia. Porous HA grafts that contained 0, 5, and 50 microg of rhBMP-2 were placed concurrently with anterior cervical spine plates to achieve interbody fusion. The fusion rate, radiological findings, biomechanical stiffness, and histological appearance were evaluated in 42 spinal units immediately and again at 4 and 12 weeks after graft and plate placement. At 12 weeks postsurgery, manual testing showed a 100% fusion rate in the spines with HA grafts containing high-dose rhBMP-2; however, only a 50% fusion rate was shown in spines with grafts that contained no or low-dose rhBMP-2. On radiographic and histological studies the process of solid fusion was seen to be more advanced in relation to the use of larger amounts of rhBMP-2. Biomechanical testing demonstrated significantly higher stiffness values for grafts that contained high-dose rhBMP-2 than those without rhBMP-2 in flexion at 4 weeks, as well as in flexion, extension, and lateral bending tests at 12 weeks. Histological analysis demonstrated that rhBMP-2 increased the amount of bone apposition on the surface of the implants and promoted bone formation in the porous structure without increasing the penetration distance. CONCLUSIONS: Through osteogenesis at the fusion site, the addition of rhBMP-2 to a porous HA ceramic graft enhances the rate of anterior cervical fusion.

High incidence of silent aspiration in elderly patients with community-acquired pneumonia.

Pneumonia is a major cause of death in the elderly. To investigate the role of silent aspiration in community-acquired pneumonia, we examined the occurrence of silent aspiration during sleep in 14 elderly patients with acute episode of pneumonia and 10 age-matched control subjects by a new technique using indium111 chloride. Scanning of the thorax demonstrated that 71% of patients aspirated, whereas aspiration was observed in only 10% of control subjects. The percentage of positive scans was significantly higher in patients with acute episode of pneumonia than in control subjects (p < 0.02). The results may indicate an important role of silent aspiration in the development of community-acquired pneumonia in the elderly.

Calcospherites in rabbit incisor predentin.

Calcospherites from the lower incisor dentin of rabbits were investigated by scanning and transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS) and electron diffraction analyses. In the labial predentin, globular calcospherites of 8-31 microns were present at the root apex, decreasing in size toward the incisal region. The calcospherites at the intermediate region were of mulberry- as well as of spindle-shape of 1.5-4 microns diameter. The incisal pulp horn contained micro-calcospherites of 0.3-0.6 micron in diameter. In the lingual predentin, small granular calcospherites of 1.8-3 microns were present at the root apex, increasing in size toward the intermediate region. Ultrathin sections of globular calcospherites showed bundles of collagen fibrils at the root apex of the labial predentin. The diameters of individual bundles ranged from 1.2-3.4 microns. The width of the fibrils in the bundles was approximately 120-170 nm. Bundles of collagen fibrils were not found in the lingual predentin. Crystals of calcospherites were identified as apatite by electron diffraction. Those at the intermediate region showed preferred orientation of the c-axis. TEM-EDS analyses indicated that Ca and P were the major elements, with small amounts of Mg. The Mg/Ca molar ratios decreased from the root apex to the incisal pulp horn. Ca peak intensities increased from the root apex to the incisal region.

Prospective study on maternal, intrauterine, and perinatal infections with cytomegalovirus in Japan during 1976-1990.

Since 1976, sera obtained serially from 10,218 pregnant women during the first, second, and third trimesters of gestation and cord sera were tested for CMV complement-fixing (CF) and immunofluorescent (IF) antibodies. CMV IgG-IF antibody was positive in 9,735/10,218 (95%) in the first trimester, and a significant rise of CF antibodies during pregnancy was found in 70/9,206 (0.76%) of the seropositive group and in 5/438 (1.14%) of the seronegative group. IgM antibody was found in 6/9,206 (0.06%) of seropositive women during the first trimester and in 7/70 (10.0%) of seropositive mothers with CF antibody rise and in 4/5 of seroconverted mothers of the seronegative group, suggesting that the incidence of primary infection with CMV during pregnancy was approximately 1% of susceptible women. All the mothers with immune response had infants with neither viruria nor IgM antibody in the cord blood, whereas seropositive mothers without an immune response had infants with viruria (7/1,826; 0.4%) or with IgM antibody in the cord blood (6/9,136; 0.06%). None of these 13 babies, shedding CMV or with IgM IF antibody, had physical or mental retardation. CMV IgG-IF antibody was present in almost 80% of infants between 7 and 12 months of age in 1988, suggesting that perinatal or postnatal CMV infection may occur in infants born to seropositive mothers in 70-80% of pregnancies.

Collagen in the spicule organic matrix of the gorgonian Leptogorgia virgulata.

Decalcification of the calcareous spicules from the gorgonian Leptogorgia virgulata reveals an organic matrix that may be divided into water insoluble and soluble fractions. The insoluble fraction displays characteristics typical of collagen, which is an unusual component of an invertebrate calcium carbonate structure. This matrix fraction exhibits a collagenous amino acid profile and behavior upon SDS-PAGE. Furthermore, the reducible crosslink, dihydroxylysinonorleucine (DHLNL), is detected in this fraction. The composition of the matrix varies seasonally; i.e., the collagenous composition is most prevalent in the summer. These results indicate that the insoluble matrix is a dynamic structure. Potential roles of this matrix in spicule calcification are discussed.

[Two cases of abdominal bronchogenic cyst].

Two cases of abdominal bronchogenic cyst were reported. In the first case, the cyst was communicated with gastric fundus and existed as gastric abscess. In the second case, the cyst showed high CT number and chemical analysis of the contents revealed high range of Ca, Fe and Amylase levels.

[Metastatic calcifications detected by Tc-99m MDP bone scanning in patients with hypercalcemia: case report].

A 59-year-old woman with hypercalcemia due to hyperparathyroidism and 1-year-old boy with cryptogenic hypercalcemia were referred for bone scanning. There were increased accumulations of the technetium-phosphate complex in thyroid, stomach, lung, heart, and kidney. 99mTc-MDP bone scanning was useful for detecting metastatic calcification.

Effect of Streptococcus lactis preparation in diet of mice on inhibiting age-dependent loss of superoxide dismutase activity in tissues.

SL-diet was prepared using commercial pellets supplemented with 1% pulverized Streptococcus lactis (SL). SL fed group of ICR strain mice were bred from 8 weeks up to 75 weeks. End-point age for survival in these mice was approximately 75 weeks. No significant differences in survival rate were observed at 75 weeks between the commercial diet and SL-diet group. The superoxide dismutase (SOD) activities in the liver, brain and erythrocytes of 75-week-old mice significantly decreased compared with those aged 10 weeks. Cu.Zn-SOD and Mn-SOD activities in the liver and brain of SL-diet mice were maintained in similar degree in the juvenile group, however, decreased significantly in the commercial diet group. SOD in erythrocytes was slightly decreased and no significant difference was noted in either group.

Ultrastructural and histochemical aspects of zinc accumulation by fish scales.

The effect of zinc exposure on the ultrastructure of the scales and scale associated cells of the estuarine teleost, Fundulus heteroclitus was investigated in laboratory experiments. The Timm sulfide silver stain indicated that in the calcified region of the scales, Zn was colocalized with the calcium phosphate mineral crystals. X-ray diffraction analysis showed that Zn did not have an effect on crystal structure. The scale osteoblasts of Zn-exposed fish showed an increase in the number of lysosome-like structures contained by the cytoplasm. In Zn-exposed animals, X-ray microanalysis revealed that these structures contain greatly increased levels of zinc and sulfur relative to controls. In all specimens, the lysosomes contained higher levels of Zn than either the surrounding cytoplasm or adjacent scales. The findings suggest that osteoblast lysosomes may be involved in the accumulation of Zn and other metals by fish scales by the enzymatic degradation of metallothioneins or other metal-binding proteins. This could represent an important mechanism for the detoxification of excess heavy metal ions taken up from the environment and the metabolism of essential metals by calcified tissues.

[Fundamental and clinical studies of low-dose total body irradiation in tumor control].

Total body irradiation of 10 rad showed an enhancement effect on tumor cell killing when given 12 hours before local tumor irradiation. In order to clarify the mechanism of this kind of effect, some immunological studies were performed using several immunological procedures, and the results suggested that 10 rad of total body irradiation caused increasing tumor immunity in irradiated tumor bearing mice. Clinical trials in some patients with advanced tumors are now being undertaken on the basis of these experimental data, and the effect of total body irradiation tumor control appears promising although it is too early to draw conclusions.

[The effect of low-dose total body irradiation on tumor control].

Total body irradiation (TBI) is considered to bring about an immunosuppressive effect on an organism, on the basis of data obtained from sublethal doses of TBI. However, there are no data on how low-dose TBI affects an organism. Over the last five years, we have been studying the effects of low-dose TBI on normal or tumor-bearing mice and the immunological background of these effects. In experimental studies, an increase in the TD50 value (the number of cells required for a tumor incidence of 50%) in mice exposed to 10 rad was recognized and showed a remarkable increase at 6 hours to 15 hours after irradiation. TBI of 10 rad also showed an enhancement effect on tumor cell killing when given 12 hours before local tumor irradiation. In order to clarify the mechanism of this kind of effect, some immunological studies were performed using several immunological procedures, and the results suggested that 10 rad of TBI caused increasing tumor immunity in irradiated mice. Clinical trials in some patients with advanced tumors are now being undertaken on the basis of these experimental data, and the effect of TBI on tumor control appears promising, although it is too early to draw conclusions.

Distribution pattern of liver matrix proteins, fibronectin and type I collagen, in DAB-induced hepatoma of rat.

Specific antibodies to fibronectin and type I collagen in rat livers were used to demonstrate these matrix proteins with direct immunoperoxidase method in paraffin sections of normal liver, DAB-induced hepatoma and CCl4-induced fibrotic liver. In normal livers, the immunoreactive products of both matrix proteins were found in the periportal regions, while the hepatocytes and most of the interstitial matrix remained unstained. The specimens obtained from DAB-treated liver showed a more intense reaction with fibronectin antibody in the perisinusoidal space including proliferated cholangiolar cells, as compared to no reaction with type I collagen antibody. In CCl4-fibrotic liver, apparent reactions were also found for both matrix proteins in the periportal interstitium and in progressing fibrotic area with severe fatty metamorphosis. These findings suggest that these matrix proteins have an advantage in the attempt to distinguish different patterns of neoplastic alteration in experimental rat livers.

A simple and rapid microdiffusion method for blood ammonia using a reflectance meter and a reagent plate, and its clinical evaluation for liver diseases.

A simple and rapid procedure using 20 microliters of whole blood is described for estimating blood ammonia by means of a reflectance meter using a reagent plate, which operates by the principle of microdiffusion. The most suitable condition for microdiffusion was at 37 degrees C for 15 min, in which the standard curve was linear, and reproducibility and recovery were sastisfactory. Blood ammonia levels by this method correlate significantly with the values by an ion exchange method in 72 patients with liver disease (r = + 0.970, y = 1.13x - 11). The method has a distinct advantage in sensitivity, simplicity, and rapidity for blood ammonia determination.

Synthesis and transport of the organic matrix of the spicules in the gorgonian Leptogorgia virgulata (Lamarck) (Coelenterata: Gorgonacea). An autoradiographic investigation.

The sequence of the synthesis and transport of the organic matrix of spicules has been elucidated in the gorgonian Leptogorgia virgulata by use of 3H-aspartic acid as the tracer in electron-microscopic autoradiography. The entire process of matrix synthesis and transport takes approximately 2 h. It seems that the protein moiety of the organic matrix is synthesized in the RER prior to 5 min following the initial 10 min incubation in the tracer. At the 5 min chase the label is moving from the RER to the Golgi complexes where the carbohydrate moiety of the matrix is presumed to be synthesized. At the 5 to 15 min chases the label is transported out of the Golgi complexes via Golgi vesicles. This phase continues for 30 min. From 60 to 120 min the 3H-aspartic acid moves to the spicules. After 120 min the majority of the label has moved into the spicules. Silver grain counts over both multivesicular and electron-dense bodies remain at relatively low and constant levels over 4 h indicating that neither organelle is involved in the synthesis and transport of the organic matrix.

Inhibition of aging changes by lyophilized Streptococcus faecalis in diet.

Effects of dietary Streptococcus faecalis (SF) on aging were evaluated using 1-week, 6-month, and 27-month-old Wistar and SHR rats. SF was lyophilized and added to commercial pellets at 1%. SF inhibited hypertension in aging SHR. SF inhibited aging-related changes in a wide variety of tissues. These changes were a disarray of hepatic cords, portal fibrosis; calcification of cartilage matrix, dominance of chondroitin sulfate B, and keratosulfate over chondroitin sulfates A and C; aortic endothelial damage, segmental thickening, calcification, and chondroid cells in the intima; atrophy of epidermis and appendages, and increase in amorphous dermal matrix; waxy degeneration and atrophy of psoas muscles; increase in lipoperoxides in the serum, liver, and brain; and reduction of cyclic AMP and GMP in the serum. Histological changes of the xyphoid cartilage, aorta, mesenteric artery, liver, dorsal skin, and psoas muscles in 27-month-old SF rats were much less severe than those in controls.