Biglycan is a specific marker and an autocrine angiogenic factor of tumour endothelial cells.

BACKGROUND: We isolated tumour endothelial cells (TECs), demonstrated their abnormalities, compared gene expression profiles of TECs and normal endothelial cells (NECs) by microarray analysis and identified several genes upregulated in TECs. We focused on the gene encoding biglycan, a small leucine-rich repeat proteoglycan. No report is available on biglycan expression or function in TECs. METHODS: The NEC and TEC were isolated. We investigated the biglycan expression and function in TECs. Western blotting analysis of biglycan was performed on sera from cancer patients. RESULTS: Biglycan expression levels were higher in TECs than in NECs. Biglycan knockdown inhibited cell migration and caused morphological changes in TECs. Furthermore, immunostaining revealed strong biglycan expression in vivo in human tumour vessels, as in mouse TECs. Biglycan was detected in the sera of cancer patients but was hardly detected in those of healthy volunteers. CONCLUSION: These findings suggested that biglycan is a novel TEC marker and a target for anti-angiogenic therapy.

A prevalent founder mutation and genotype-phenotype correlations of OTOF in Japanese patients with auditory neuropathy.

Auditory neuropathy is a hearing disorder characterized by normal outer hair cell function and abnormal neural conduction of the auditory pathway. Aetiology and clinical presentation of congenital or early-onset auditory neuropathy are heterogeneous, and their correlations are not well understood. Genetic backgrounds and associated phenotypes of congenital or early-onset auditory neuropathy were investigated by systematically screening a cohort of 23 patients from unrelated Japanese families. Of the 23 patients, 13 (56.5%) had biallelic mutations in OTOF, whereas little or no association was detected with GJB2 or PJVK, respectively. Nine different mutations of OTOF were detected, and seven of them were novel. p.R1939Q, which was previously reported in one family in the United States, was found in 13 of the 23 patients (56.5%), and a founder effect was determined for this mutation. p.R1939Q homozygotes and compound heterozygotes of p.R1939Q and truncating mutations or a putative splice site mutation presented with stable, and severe-to-profound hearing loss with a flat or gently sloping audiogram, whereas patients who had non-truncating mutations except for p.R1939Q presented with moderate hearing loss with a steeply sloping, gently sloping or flat audiogram, or temperature-sensitive auditory neuropathy. These results support the clinical significance of comprehensive mutation screening for auditory neuropathy.

Comparison of Electroaudiometry with cochlear implant in children with inner ear anomaly.

The promontory stimulation test (PST) using a needle electrode has been used to evaluate the sense of the auditory nerve as a preoperative examination for cochlear implant in adults. Because this is a painful test, it is not suitable for children. It has been reported that children with inner ear anomaly showed poorer outcomes of hearing after cochlear implant. Electroaudiometry developed by Med-El Corporation, which is noninvasive, is a more suitable procedure for young children. Patients were three children less than five years old with inner ear anomaly. Two patients showed common cavity, and one showed narrow IAC with hypoplastic cochlear anomaly. By using Electroaudiometry, we analyzed electro-neural hearing of these children before cochlear implant, and compared their hearing after cochlear implant. Three children seemed to have residural electro-neural hearing because the dynamic range between stimulus level (SL) and uncomfortable level (UCL) was detected by using Electroaudiometry. After cochlear implant, their pure-tone audiograms showed moderate hearing thresholds, and their hearing detection and speech perception improved. These results suggest that Electroaudiometry is available for evaluating electro-neural hearing in young children with inner ear anomaly. It can provide useful information for a successful cochlear implant and evaluation of postoperative performances.

Advancement in singing ability using The YUBA Method in patients with cochlear implants.

CONCLUSION: Although overall improvement was not so dramatic due to a lack of retention, session by session advancement of matching pitch for targeted MIDI (Musical Instrument Digital Interface) sound was predominantly obvious. It was proved that The YUBA Method worked to improve singing ability for patients with cochlear implants. OBJECTIVES: This study sought to verify whether or not the Yuba theory and method improved the singing ability of patients with cochlear implants. SUBJECTS AND METHODS: Based on diagnosis, the instructor experimented to improve matching pitch of singing for three patients with cochlear implants using The YUBA Method. The mean fundamental frequencies and standard deviation of singing were then compared with before and after instructions to patients. The instruction was given for over 40 days at the University of Tokyo Hospital. RESULTS: For each patient, the mean fundamental frequencies of their singing approached the mean MIDI specified frequencies as references for tests done in all three songs. Overall, the SD between fundamental frequencies of their singing and reference MIDI sounds became smaller.

Multiple neural origins of early auditory evoked potential of rat.

The multiple-origin hypothesis has been often considered for an unclear neurogenesis of a characteristic wave in various evoked potentials, none of which has been verified so far. Auditory evoked potential (AEP) in the temporal cortex of rodents has typical slow positive/negative (P1/N1) biphasic waves, which are occasionally associated with an additional 2-4-ms earlier small deflection (P0/N0). Despite previous extensive efforts, P0/N0 deflection is still discussed within the multiple-origin hypothesis. In this historical perspective, we hypothesized that observable AEP is an additive mixture of mutually temporally independent signals from different origins, and that the balance of the mixture impacts on the waveform of AEP. We attempted to verify this hypothesis for the first time by independent component analysis (ICA) of epidurally densely mapped AEPs in the primary auditory cortex of rats. The mapping showed that low amplitude AEPs tended to have more P0/N0 deflections in both pentobarbital- and ketamine/xylazine-anesthesia preparations. ICA of these AEP maps suggested that AEP consisted of at least three independent components and that the deflection appeared when subcortical contribution to AEP was equal to or larger than cortical contribution. In epicranially measured evoked potentials, subcortical and cortical contributions are mixed together because distances from electrodes to cortical sources approximate distances to subcortical sources. In such conditions, e.g. in human scalp-recording experiments or routine clinical screenings, our idea is specifically worth considering for the interpretation of signals.

Safe and effective topical application dose of lidocaine for surgery with laryngomicroscopy.

A clinical case of a patient in whom seizure developed after topical application of lidocaine to the oropharyngeal region was described. The exploratory studies on the optimal dosage of lidocaine in the surgery under laryngomicroscope was performed in 22 patients. During the application of 2% lidocaine viscous and 4% lidocaine solution to the oropharyngeal region, the patient was instructed to expectorate the excess intermittently to avoid absorption. In addition, the oropharyngeal region was swabbed with gauze. The serum lidocaine concentrations after application were less than 1.8 micrograms/ml. The total application dose of the drug was within the range of 324 to 640 mg, and the total recovery rate from the saliva and gauze was 52% to 81%. We found a good correlation between net application dose (total application dose minus excessive lidocaine dose) and serum lidocaine concentration. In this study, it was shown that the safe and effective net application dose of lidocaine for the surgery may be within the range of 127 to 260 mg.

Cochlear histopathology associated with mitochondrial transfer RNA(Leu(UUR)) gene mutation.

Using dot-blot hybridization and Southern blotting, the authors detected a point mutation at nucleotide pair (np) 3243 in mitochondrial DNA from temporal bone sections of a woman with diabetes and deafness. The mutation could not be detected with agarose gel electrophoresis, suggesting that the degree of heteroplasmy is low. Histologically, there was marked degeneration of the stria vascularis and outer hair cells throughout the cochlea, as well as a reduction of spiral ganglion cells in the base. These findings suggest that the mutation affects these inner ear structures preferentially and that deafness can occur even when the proportion of np 3243 mutation is low.

Expression of epidermal growth factor family proteins and epidermal growth factor receptor in human endometrium.

The biological significance of epidermal growth factor (EGF)-related proteins in the development and progression of endometrioid endometrial carcinoma was studied. Expression of EGF-related proteins including EGF, transforming growth factor-alpha (TGF-alpha), cripto (CR), amphiregulin (AR), and EGF receptor (EGFR) were immunohistochemically examined. Results were then correlated with clinicopathologic findings and steroid receptor status in 12 specimens with normal endometrium, 13 with endometrial hyperplasia, and 40 with endometrioid endometrial carcinoma. EGFR, EGF, TGF-alpha, and CR immunoreactivities were observed in 58.3%, 66.7%, 91.6%, and 66.7% of normal endometrial specimens; 100%, 15.4%, 100%, and 30.8% of endometrial hyperplasia specimens; and 67.5%, 32.5%, 65.0%, and 65.0% of endometrial carcinoma specimens, respectively. AR immunoreactivity was not observed in any of the normal, hyperplastic, or neoplastic endometrium. The presence or absence of EGFR or TGF-alpha in endometrial carcinoma correlated with surgical stage, depth of myometrial invasion, and findings from peritoneal washing cytology. EGF expression significantly correlated with the age of the patients and that of CR with surgical stage and peritoneal washing cytological findings. There was a significant correlation between EGFR and TGF-alpha expression, and between EGF and TGF-alpha. Co-expression of EGFR and TGF-alpha, EGFR and CR, and TGF-alpha and CR in carcinoma specimens significantly correlated with advanced surgical stage, deeper myometrial invasion, and positive peritoneal washing cytology. In normal as well as hyperplastic endometrium, endometrial glands immunohistochemically positive for TGF-alpha were generally positive for ER, but in poorly differentiated endometrial carcinoma, cells positive for TGF-alpha tended to be negative for ER. The results of the present study show that among EGF-related proteins, expression of TGF-alpha and CR seem to be associated with the progression of human endometrioid endometrial carcinoma. Additionally, expression of TGF-alpha became increasingly estrogen independent with increasing histological carcinoma grades.

Adrenal 4-binding protein in common epithelial and metastatic tumors of the ovary.

Adrenal 4-binding protein (Ad4BP) is a transcription factor that regulates the expression of steroidogenic enzymes. Ovarian tumors other than sex cord stromal tumors are occasionally associated with functioning stroma or hormonal abnormalities. To determine the steroidogenic potential of these tumors, the authors determined the immunohistochemical distribution of Ad4BP in 75 patients with primary common epithelial tumors (20 cystadenomas, 15 carcinomas of low malignant potential, and 40 carcinomas), and seven patients with metastatic carcinoma of the ovary. Ad4BP immunoreactivity was observed in intratumoral stromal cells in 3 of 15 (20%) carcinomas of low malignant potential, 26 of 40 (65%) carcinomas, and three of seven (43%) metastatic carcinomas. Ad4BP immunoreactivity was not observed in the stroma of cystadenomas. Among the positive cases, Ad4BP-positive stromal cells were particularly distributed adjacent to invasive carcinomatous glands. Among ovarian carcinomas, mucinous carcinoma showed a significantly higher number of Ad4BP-positive intratumoral stromal cells than did other histological types. Results suggest that invasion of primary or metastatic carcinoma into the ovarian stroma, especially in the case of mucinous carcinoma, may render the stromal cells to acquire the potential of metabolizing and synthesizing steroid hormones.

Transfection of young guinea pig vestibular cells in vitro with an adenovirus vector.

This study shows distributions of lacZ-positive cells in the vestibular labyrinthine explants of young guinea pigs with mature ears. When adenovirus lacZ vectors were administered to the vestibular labyrinth following removal of the otoconial membrane, lacZ-positive cells were observed in the mesothelial cells in the perilymphatic space, in the sensory and supporting cells in the utricle and ampulla, and in the transitional and dark cells in the ampulla. When the otoconial membrane was preserved, lacZ-positive cells were not distributed in the utricular sensory epithelium. These findings suggest that adenovirus vectors can transform a variety of vestibular epithelial cells, but that it is difficult for adenovirus vectors to pass through the otoconial membrane.

Expression of NeuroD and TrkB in developing and aged mouse olfactory epithelium.

To better understand the roles of NeuroD, a member of the basic helix-loop-helix transcription factor family, during the differentiation of olfactory receptor neurons, we studied the expression of NeuroD in developing and aging mouse olfactory epithelium (OE). During embryonic period, NeuroD expression is confined in the basal compartment of OE. During neonatal period, NeuroD expression is detected in the middle compartment and in the basal compartment of OE. In the adult, the number of NeuroD expressing cells in the basal compartment significantly decreased, while the NeuroD-positive cells in the middle compartment was maintained throughout lifetime. This dual phase expression pattern of NeuroD suggests multiple roles of NeuroD in the neurogenesis of ORNs.

Cat 'P300' and cholinergic septohippocampal neurons: depth recordings, lesions, and choline acetyltransferase immunohistochemistry.

The role of septohippocampal circuits in the generation of the P300 response in cats (n = 12) was explored in a series of depth recording, tract-tracing and lesion experiments. Systematic mapping of the hippocampus in 1-mm increments from rostral to caudal extent revealed large positive potentials, greater in amplitude to rare than to frequent stimuli, within the 200-500 ms range. Each map revealed maximal amplitude responses at diverse, widely distributed hippocampus loci. Furthermore, these electrical responses displayed polarity inversion within the hippocampus that was generally localized to the pyramidal cell layer; polarity inversion was also observed in the adjacent entorhinal cortex and amygdala. Injections of propidium iodide, a tract-tracing agent, into these inversion sites resulted in retrograde labeling of small clusters of choline acetyltransferase (ChAT)-positive neurons in the medial septal nucleus and vertical limb of the diagonal band. Aspiration lesions that bilaterally destroyed large amounts of caudal hippocampus from stereotaxic levels A4 to A1 resulted in a decreased number of cells expressing ChAT in the rostral basal nuclear complex. In only 2 cats was the preoperative presence of a significant vertex P300 absent postoperatively. In the majority of cases (5 of 8 animals), hippocampal aspiration produced an enhancement of the preoperative P300 potential. We conclude that cholinergic mechanisms are importantly, albeit not exclusively, involved in the mediation of P300 potentials in cats. Neurons mediating P300 responses appear to be organized in diverse clusters of septal and diagonal band cells. These septal cells may facilitate, and in turn be facilitated or inhibited as a function of hippocampal, or other, allocortical feedback loops.

Isolation of Dane particles containing a DNA strand by metrizamide density gradient.

Dane-particle cores labelled with [3H]TTP were subjected to ultracentrifugation in a metrizamide density gradient. Two populations of core particles with different densities were obtained, and radioactivity was found only in the cores that sedimented at the lower density (1.19-1.23 g/cm3). All the cores in this group, when spread in a monolayer, were found to expel a closed circular double-stranded DNA molecule. In contrast, the core particles that sedimented at the higher density (1.23-1.27 g/cm3) were not associated with radioactivity, nor was any DNA strand extruded from them. These results show that metrizamide density gradients allow the separation of complete hepatitis B virions for the study of viral DNA.

Experience with the two-windows method for mediastinal lymph node dissection in lung cancer.

BACKGROUND: Continuing to refine minimally invasive thoracoscopic surgical procedures, we have established the two-windows method. METHODS: Skin incisions required by this method consist of a 2- to 3-cm skin incision posteriorly, and a 2- to 3-cm skin incision anteriorly in the fourth intercostal space, with the inferior angle of the scapula as the midpoint. We used this method to perform pulmonary lobectomies in combination with thoracoscopy and mediastinal lymph node dissection in 100 consecutive patients with lung cancer (preoperative diagnosis, stage I, T1 N0 M0). RESULTS: The mean operative time was 2 hours 46 minutes, the mean blood loss was 68.2 mL, and the mean number of mediastinal lymph nodes dissected was 24.3. In developing this minimally invasive thoracoscopic procedure, which facilitates mediastinal lymph node dissection, we realized that it is best performed through the fourth intercostal space. Because the tracheal bifurcation can be seen directly below this level, surgical manipulation in this area can be easily performed. This enables the same extent of mediastinal lymph node dissection as that performed during a standard thoracotomy. Another advantage of this method is that a standard posterolateral thoracotomy incision can be made whenever necessary by simply connecting the two incisions. CONCLUSIONS: We believe that the two-windows method is capable of serving as the standard method for the surgical treatment of stage I lung cancer.

Application of the fold plication method for unilateral lung volume reduction in pulmonary emphysema.

BACKGROUND: Unilateral lung volume reduction procedures are used to treat pulmonary emphysema. The most significant technical problem with this operation is an air leak from the pulmonary stump. Bovine pericardium has been used to prevent air leaks but is associated with interstitial pneumonia and a high cost. METHODS: The fold plication method was devised to prevent postoperative air leaks to avoid interstitial pneumonia, and to decrease cost. This technique was applied in 20 consecutive patients with emphysema who underwent a unilateral lung volume reduction operation via a thoracoscopic two windows approach. RESULTS: The operative time was approximately 1 hour. There was minimal postoperative bleeding, no persistent air leaks, and no evidence of pneumonia. Pulmonary function improved in all patients. CONCLUSIONS: The unilateral fold plication method is an economical and safe alternative to bovine pericardial patching after lung volume reduction operation to prevent stump air leaks.

Blunt chest trauma with deep pulmonary laceration.

BACKGROUND: Deep pulmonary laceration (DPL) is rare and its survival rate is low. The present study focused on the prognostic factors of DPL. METHODS: The present study concerned 17 DPL patients treated in Tokai University Hospital between 1988 and 1998. The prognostic factors of DPL were compared with systolic blood pressure (SBP), PaO2, and the volume of intrathoracic blood loss. Characteristic findings of initial chest roentgenograms of DPL were investigated. RESULTS: Eleven patients were saved and 6 patients died. An SBP of less than 80 mm Hg on arrival at the hospital and a blood loss of more than 1,000 mL through the chest tube within 2 hours after arrival were poor prognostic factors. Hypoxemia on arrival was not a poor prognostic factor. Chest roentgenograms showed macular infiltrative shadow with moderate lung collapse and deviation of the mediastinal shadow toward the unaffected side. Selective bronchial occlusion with a Univent prevented suffocation by intrabronchial blood. CONCLUSIONS: Two poor prognostic factors of DPL are SBP less than 80 mm Hg on arrival and blood loss of more than 1,000 mL through the chest tube within 2 hours after arrival.

Identification of dual specificity phosphatases induced by olfactory bulbectomy in rat olfactory neuroepithelium.

Dual specificity protein tyrosine phosphatases (dsPTPs) are a subfamily of protein tyrosine phosphatases implicated in the regulation of extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase/stress-activated protein kinase (JNK/SAPK), and p38 mitogen-activated protein kinases (MAPKs) which are target enzymes activated by a wide range of cell-surface stimuli. Like these kinases, a class of dsPTP has been implicated in cell differentiation, regeneration, and apoptosis. In order to isolate dsPTPs which might play an important role in neuronal regeneration and apoptosis in olfactory neuroepithelium, we subcloned DNA fragments amplified by reverse transcription-polymerase chain reaction (RT-PCR), using degenerate oligonucleotide primers based on the conserved amino acid regions within the catalytic domain of dsPTPs, from rat olfactory epithelial RNA 1 and 4 h after an olfactory bulbectomy. The PCR products were subcloned into the pCRII vector, and 23 clones were chosen for further characterization. The sequence of these 23 individual clones revealed that two clones were identical to the rat dsPTP, MKP-3, and the other 21 clones were identical to the rat dsPTP, MKP-1. By Northern analysis, the MKP-1 transcript was induced and peaked 4 h following a bulbectomy. Similar results were obtained with the MKP-3 transcript. These results suggest that MKP-1 and MKP-3 may be involved in the early steps of apoptosis in vivo in rat olfactory neuroepithelium.

Temporal stream of cortical representation for auditory spatial localization in human hemispheres.

We measured human evoked magnetic fields to binaural sounds with an interaural time delay as a cue for auditory localization. By analyzing the topography of auditory-evoked magnetic fields in the middle-latency, we demonstrated that particular cortical regions represent the direction of sound localization by their activity level. Upon presenting a binaural sound, the first representations were found in the middle frontal region as well as the superior temporal region of the right hemisphere approximately 19 ms after the stimulation, but their patterns differed. Other cortical regions including the prefrontal and parietal spatial areas were affected within roughly 60 ms. The results showed that the right hemisphere is dominant even in the preattentive stage of auditory spatial processing of sounds from different directions.

Mechanism of short-term memory and repetition in conduction aphasia and related cognitive disorders: a neuropsychological, audiological and neuroimaging study.

To evaluate the role of the sub-cortical white matter and cortical areas of the supramarginal gyrus in short-term memory impairment (shortened digit or letter span) and repetition difficulty, four patients with conduction aphasia and impaired short-term memory and two patients with only short-term memory impairment were given digit span, letter span, speech audiometry and dichotic listening tests. The results showed that in most of the patients letter span was inferior to digit span and that bilateral ear suppression in the dichotic listening test was observed in two patients with a lesion in the inferior part of the supramarginal gyrus, suggesting that what was affected was phonological information and that the supramarginal gyrus was the storage site. The overlapped lesion of conduction aphasia patients with short-term memory impairment was the periventricular white matter at the upper to middle part of the trigone, while patients with only short-term memory impairment had a lesion in the inferior supramarginal gyrus in common. Thus, damage to the periventricular white matter at the trigone may yield the phonemic paraphasia characteristic of conduction aphasia, while damage to the inferior part of the supramarginal gyrus may result in the impairment of short-term memory. We believe that as a part of the mechanisms of short-term memory and repetition, phonological information is processed in the primary auditory cortex and goes through the periventricular white matter to the inferior part of the supramarginal gyrus and is temporarily stored there.

Pure word deafness due to left hemisphere damage.

We report the case of a 55 year-old right-handed man who presented with a long lasting pure word deafness following left thalamic bleeding. There was no sign of aphasia. The auditory deficit was specific for language, while recognition of music and environmental sounds was normal. CT, MRI and PET examinations showed that the lesion was anatomically and functionally confined to the left cerebral hemisphere, mainly the white matter of the temporal and parietal lobes. Wernicke's area was largely preserved. It is proposed that pure word deafness was consequent to the isolation of Wernicke's area from incoming auditory information due to the interruption both of the association fibers from the right auditory area traveling across the corpus callosum and of the left auditory radiations.