Minimum stable structure of the receptor for advanced glycation end product possesses multi ligand binding ability.

The receptor for advanced glycation end products (RAGE) is a multi-ligand receptor involved in the development of diabetic complications. Although the soluble form of the extracellular domain maintains the ability to bind multi-ligands, it is unstable and degrades into several peptide species during storage. Proteolysis with thrombin or factor Xa revealed several protease sensitive sites. Most sensitive site is located between Arg228 and Val229, and peptide bond next to Arg216, Arg116, Arg114 and Trp271 are also cleaved. Seven truncated extracellular domains of RAGE were engineered in order to obtain a stable soluble fragment. RAGE 143 (Ala23-Thr143) is not only protease resistant but also shows the same ligand-binding ability as that of the full-length extracellular domain. The resultant minimum RAGE 143 works as a stable recognition devise to detect advanced glycation end products (AGEs).

[Emphysematous giant bulla that was difficult to differetiated from pneumothorax].

We experienced 2 patients who admitted to our hospital becaus of acute onset of dyspnea and chest pain. Chest X-ray and chest computed tomography showed severe atelectasisi of hemilateral lung. After intathoracic drainage under local anesthesia, we diagnosed a emphysematous giant bulla. We resected the giant bulla.

Recurrent small cell carcinoma of the ovary treated with docetaxel: A case report.

Multiagent chemotherapy for small cell carcinoma of the ovary (SCCO) may contribute to the prolonged survival of young women who are suffering from this disease, even in the advanced stage with remaining tumor, although the rarity of SCCO complicates the generalization of chemotherapy agents and operation methods for this disease. A 24-year-old patient with SCCO FIGO stage IIC is alive after recurrences and chemotherapy including cisplatin + etoposide after the first operation and docetaxel for the second recurrence. She is now doing well with no evidence of disease more than 4 years after the first operation and 2 years after docetaxel treatment. This may be the first report describing the use of docetaxel that may be included in multiagent chemotherapy.

[Computed tomography findings of pulmonary benign lesion in the peripheral region].

We evaluated computed tomography (CT) images in 22 cases of pulmonary granulomas less than 2 cm in diameter which preoperative diagnosis was difficult. In these lesions, air-containing type, irregular undulation of margin, pleural indentation, accompanying shadow and involvement of pulmonary artery was observed on CT images. The accompanying shadow and the absence of pulmonary vein relate to the lesion may have relevance in pulmonary benign lesion.

[Pulmonary sequestration associated with fungal infections; report of a case].

A 45-year-old female was admitted to our hospital complaining of cough and purulent sputum. Enhanced chest computer tomography(CT) showed that abnormal mass shadow in left lower lobe of the lung and an aberrant artery originated from the discending aorta and penetrated the lesion. Left lower lobectomy was performed and intralobar sequestration was diagnosed. Moreover, fungus which were suspected Aspergillus were found in the cystic lesion. The postoperative course was uneventful and she was discharged.

[Multiple lung cancer with cavity; report of a case].

A case of multiple lung cancer with cavity was reported. Chest X-ray and chest computed tomography (CT) showed two abnormal shadows with consolidation in the right S1 and S2b. The shadow in S2b had a cavity. Right upper lobectomy and right middle lobe partial resection was performed and the histopathological examination revealed adenocarcinoma. This case deserves attention of difficulty in differentially diagnosis on the chest X-ray and chest CT from pulmonary tuberculosis.

[Contralateral pneumothorax after pneumonectomy for bronchogenic carcinoma; report of a case].

A case of contralateral pneumothorax after pneumonectomy was reported. Intrathoracic drainage was performed and pneumothorax was healed. Recurrent pneumothorax was occurred in this patient and intrathoracic drainage was performed again and pneumothorax was healed. We suspected that bulla was the cause of pneumothorax and thought that contralateral pneumothorax after pneumonectomy must be carefully follow-up.

Organochlorine and organotin compounds in Caspian seals (Phoca caspica) collected during an unusual mortality event in the Caspian Sea in 2000.

Polychlorinated biphenyls (PCBs), organochlorine pesticides and organotin compounds were determined in the blubber and liver of Caspian seals (Phoca caspica) found stranded on the coast of the Caspian Sea during an outbreak of canine distemper virus (CDV) in 2000. Among organochlorines analyzed, DDTs were the most dominant contaminants with concentrations ranging from 6.3 to 470 microg/g on a lipid-weight basis. Caspian seals collected in 2000 during the epizootic had higher concentrations of organochlorines than healthy individuals sampled in 1998. However, the blubber layer was generally thinner in the seals collected in 2000 than those in the previous surveys. Although compositions of organochlorine pesticides in seals suggested that the contamination status in the Caspian Sea is improving, the levels found in Caspian seals in 2000 were comparable to those in other marine mammals that have suffered from epizootics. This implies that the present status of contamination found in Caspian seals poses a risk of immunosuppression. Concentrations of butyltin compounds in livers of seals ranged from 0.49 to 17 ng/g on a wet-weight basis and octyltin compounds were below limit of detection in all the samples analyzed, suggesting less contamination by organotin compounds in the Caspian Sea.

[Pulmonary surgery for pulmonary lesion with pulmonary tuberculosis or of tuberculosis].

Nine patients with pulmonary tuberculosis underwent open chest surgery for pulmonary lesions of tuberculosis or other than tubercolosis. They were 1 case of lung cancer, 4 cases of pneumothorax, 1 case of multi drug resistant pulmonary tuberculosis and 3 cases of tuberculoma. Postoperative complications developed in 3 cases including 2 of pneumothorax and 1 of lung collapse.

[Laryngeal manifestations of gastroesophageal reflux disease (GERD) in pediatric patients: the usefulness of therapeutic (proton pump inhibitor (PPI)) trials].

Gastroesophageal reflux, common in infants, usually resolves spontaneously by 12 to 18 months. Gastroesophageal reflux disease (GERD) contributes to certain respiratory symptoms, but is reported to be due to other causal diseases, such as tracheolaryngeal anomaly, congenital esophageal hiatal hernia, and cerebral palsy, in pediatric patients. We report 4 pediatric cases with unusual laryngeal disorders, especially posterior glottic lesion, induced by gastroesophageal reflux without other causal disease. Subject 1 was a 1-year-old boy showing severe laryngeal spasm, Subject 2 a 3-year-old boy with life-threatening supraglottic stenosis, Subject 3 a 5-year-old boy whose voice had reached near aphonia with multiple laryngeal granulomatous lesions, and Subject 4 an 8-year-old boy with persistent abnormal throat sensations. Their symptoms were recalcitrant to conventional therapy. Their case histories (much belching and hiccups) and findings for the posterior glottitis, etc., suggested that symptoms might be induced by GERD, but, barium esophagography and esophagoscopy provided no conclusive proof. We could not monitor their ph because of the excessive physical and psychological stress involved. After therapeutic trials with a proton pump inhibitor (lansoprazole 10-15 mg) for 8 weeks, all had recovered almost completely without side effects.

Bamboo node: primary vocal fold lesion as evidence of autoimmune disease.

Descriptions of vocal fold lesions related to autoimmune diseases are rare in the literature, and focus mainly on rheumatoid nodules. This is the first report in which autoimmune diseases were promptly suspected by the observation of a unique white transverse submucosal lesion in the vocal fold during clinical examination. This lesion, reported only in autoimmune disease, has been called the bamboo node and its features are different from those of rheumatoid nodules. We report here on two patients who did not have a diagnosis of systemic disease before investigation of their main complaint of hoarseness. At the patients' first visit, vocal fold bamboo nodes were seen in the vocal fold and the otolaryngologist suspected the presence of an autoimmune disease. We requested clinical investigation to clarify our suspicion that there was an underlying systemic disease. After the investigation, both patients were shown to have autoimmune disease, Sjögren's syndrome and systemic lupus erythematous, respectively. This paper emphasizes the important role of the otolaryngologist in the detection of these unique lesions in the vocal folds through the conventional laryngeal methods. These methods consisted of direct observation with a rigid laryngeal endoscope and investigation of the patient's distinctive vibratory pattern by means of laryngeal stroboscopy. The method of treatment we used to obtain the best outcome in terms of voice improvement is also discussed.

Transillumination laryngoscopy: a new way of evaluating vocal fold and hypopharyngeal lesions.

Conventional methods of observing the larynx and the hypopharynx use reflected light to illuminate the larynx. The aim of this study was to see whether transilluminating the larynx was possible in subjects with and without disease. The larynx and the hypopharynx were observed by means of a rigid scope with a low-light charge-coupled device camera without the light guide inserted. Illumination was provided by a second rigid scope attached to a light source that was held at the neck by an assistant. The larynx and hypopharynx were observed by transillumination using both constant lighting and stroboscopy in 3 subjects with pharyngeal or laryngeal lesions and in 4 normal controls. The tumors were translucent or nontranslucent in appearance. A translucent polyp became nontranslucent when overlapping the vocal fold, thus indicating that a lesion the size of a polyp could be evaluated with this method. Mucosal waves could be observed during stroboscopy with transillumination, thus allowing observation of waves and lesions that cannot be observed with conventional stroboscopy.

Morphological and histochemical studies of the genioglossus muscle.

The purpose of this preliminary study was to assess the histo-anatomic composition of the genioglossus muscle fibers. The genioglossus muscles were obtained from 4 cadavers and 1 autopsy specimen. On morphological study, the average diameters of the muscle fibers were seen to gradually increase, from the fibers that ran anteriorly to the dorsum of the tongue, to the fibers that ran posteriorly to the root of the tongue. Histochemical study revealed that type II fibers were significantly predominant in the anterior portion; there was no dominant fiber type in the posterior portion. Gradual changes in diameter were independent of fiber type. These findings may suggest that the fibers of the anterior portion are suitable for phasic action, and that the posterior is relatively tonic; and the posterior has larger absolute muscle strength than the anterior. It is thought that the fibers of the posterior portion might contribute to the maintenance of the mesopharyngeal airway and to vowel production, and that the anterior fibers might contribute to some fine movements and to consonant production.

Elicitation of N400m in sentence comprehension due to lexical prosody incongruity.

The role of lexical prosody in the semantic integration of spoken sentences consisting of a quiz stem and an answer word was investigated analyzing the event-related magnetic response, N400m. Three conditions regarding the relations between the quiz and the answer word were prepared: pitch-accent violation, phonemic violation and no violation. Both the pitch-accent and phonemic violations elicited significant N400m without any significant differences in the peak latency and magnitude of the equivalent current dipoles, suggesting that the role of pitch-accent in semantic integration is equivalent to that of phonemes. However, the rate of violation detection and the successful N400m source estimation were lower for the pitch-accent violation than for the phonemic violation, suggesting differential neural processes for the phonemic and prosodic cues.

Characterization of residues and sequences of the carbohydrate recognition domain required for cell surface localization and ligand binding of human lectin-like oxidized LDL receptor.

Lectin-like oxidized low-density lipoprotein receptor (LOX-1) has been cloned from human aortic endothelial cells, and has a sequence identical to that from human lung. Previous studies showed that human LOX-1 can recognize modified LDL, apoptotic cells and bacteria. To further explore the relationship between the structure and function of LOX-1, a mutagenesis study was carried out. Our results showed that the carbohydrate recognition domain (CRD) was the ligand-binding domain of human LOX-1. We also investigated the sequences and residues in CRD that were essential for protein cell surface localization and ligand binding. LOX-1s carrying a mutation on each of six Cys in CRD resulted in a variety of N-glycosylation and failed to be transported to the cell surface. This was strong evidence for the involvement of all six Cys in the intrachain disulfide bonds required for proper folding, processing and transport of LOX-1. The C-terminal sequence (KANLRAQ) was also essential for protein folding and transport, while the four final residues (LRAQ) were involved in maintaining receptor function. Both positive charged (R208, R209, H226, R229 and R231) and non-charged hydrophilic (Q193, S198, S199 and N210) residues were involved in ligand binding, suggesting that ligand recognition of LOX-1 is not merely dependent on the interaction of positively charged residues with negatively charged ligands.

Autologous transplantation of fascia into the vocal fold: long-term results of a new phonosurgical technique for glottal incompetence.

OBJECTIVES: To study the long-term results of autologous transplantation of fascia into the vocal fold, and to evaluate our use of autologous transplantation instead of bovine collagen injection in cases of glottal incompetence. STUDY DESIGN: Retrospective study of the patients who have undergone autologous fascia transplantation using our new technique. METHODS: Follow-up studies were performed for at least 1 year (up to 3 y) on 9 autologous fascia transplant patients (6 cases with type 1 procedures and 3 cases with type 2 procedures). Clinical observations, including laryngeal stroboscopy, and measurement of maximum phonation time (MPT) were carried out. RESULTS: During 3 months after autologous fascia transplantation, MPT gradually increased and stroboscopy showed improved glottal closure. These improvements continued beyond 1 year in all cases of type 1 surgery and 2 of 3 cases of type 2 surgery. CONCLUSIONS: Autologous transplantation of fascia into the vocal folds as a phonosurgical treatment for glottal incompetence yields excellent long-term results. Temporal fascia appears to be a highly suitable tissue for transplantation in Reinke's space. However, the fascia is less suitable for transplantation in the muscle. We speculate that transplantation of temporal fascia leads to regeneration of vocal fold tissue, perhaps using a mechanism similar to stem cell transplantation in other organs.

The syllable method: proportion of impaired syllables as an indicator of spasmodic dysphonia severity.

We have previously proposed the 'mora method' to evaluate the degree of impairment in spasmodic dysphonia (SD) in Japanese-speaking patients. With this method, impairment is judged as the proportion of impaired morae in a 25-mora sentence in a longer passage read aloud. As the mora is the phonologically isochronic unit in Japanese, the proportion of impaired morae in speech can be used to represent the temporal proportion of impaired Japanese speech. This proportional measure of impairment reflects the perceived severity of the impairment, and is a more reliable measure than a 4-point perceptual rating scale completed either by patients or by voice professionals. In this paper, we propose a 'syllable method' to characterize the severity of impairment in English-speaking SD patients. Instead of morae, the severity of SD was represented by the proportion of impaired syllables. It should be possible to characterize SD impairments more reliably and precisely with this method than using a 4-point rating scale completed by voice professionals. Ultimately, the syllable method should become a simple and effective method for evaluating the severity of SD. Furthermore, such methods can be applied to other languages, using the appropriate phonological unit (either mora or syllable).

[Effect of arytenoid adduction operation for vocal function of laryngeal palsy patients].

OBJECTIVE: To evaluate the curative efficiency on vocal function of 56 laryngeal palsy patients underwent arytenoid adduction operation. METHOD: Voice analysis and laryngeal aerodynamical measurement were performed for the 56 laryngeal palsy patients to compare maximum phonation time (MPT), mean flow rate (MFR), voice intensity(SPL), and expiratory pressure(EP) before and after operation. Perceptual evaluation was also performed for comparison by using GRBAS system(G). RESULT: The postoperative average MPT increased by 3.1 times in males and 2.7 times in females. The average MFR decreased apparently from 827.3 ml/s in males and 477.1 ml/s in females before operation to 340.3 ml/s and 158 ml/s after operation, which was statistically significant (P < 0.01). The average SPL increased and the average EP decreased after operation. After operation the average G decreased from 2.8 to 1.7 (P < 0.01) and the percentage of improvement over one grade was 71%. CONCLUSION: From these results mentioned above, it can be concluded that the arytenoid adduction operation might be one of the most effective operative methods to improve glottal incompetence caused by laryngeal nerve paralysis.

Expression of the cytoplasmic domain of NodC as an active form in Drosophila S2 cells.

NodC, a membrane protein that catalyzes the synthesis of the chitin oligosaccharide chain, was successfully produced in a soluble form. The truncated NodC gene encoding only the cytoplasmic domain that deletes the hydrophobic N-terminus expressed both cytoplasmic and secreted proteins in Drosophila Schneider 2 cells. The expressed protein maintained the ability to synthesize chitin oligosaccharides, primarily (GlcNAc)4, similar to the native membrane-bound NodC. This evidence suggests that only the large hydrophilic loop of NodC is efficient for enzymatic activity. Moreover, immobilizing the soluble NodC to a solid phase has no effect on the enzymatic activity. This, anchoring NodC is not necessary for its activity.

Abnormal elevation of resting pressure at the upper esophageal sphincter of Parkinson's disease patients.

We investigated the oral and pharyngeal swallowing function in seven Parkinson's disease (PD) patients, using videomanofluorometry, which is videofluorographic and manometric evaluation conducted simultaneously. Abnormal elevations of resting pressure were found at the upper esophageal sphincter (UES) in three of the seven cases, when they were asked to hold a bolus in the mouth and initiate swallowing. One of these three cases showed an abnormal elevation of resting pressure, intermingled with a normal pressure pattern. Since the UES showed complete relaxation in these three cases, it is inappropriate to suppose that irreversible pathophysiological changes at the level of peripheral nerves had occurred. Our results suggested that altered resting pressure resulted from dysfunction at a more central level, such as a lack of dopaminergic stimulation at the supramedullary level causing skeletal muscle rigidity. Since a tonic abnormality of the UES cannot be measured by only videofluorography, both videofluorographic and manometric evaluation will be necessary to assess the pharyngeal phase of swallowing in PD patients.