Involvement of the Thalamus, Hippocampus, and Brainstem in Hypsarrhythmia of West Syndrome: Simultaneous Recordings of Electroencephalography and fMRI Study.

BACKGROUND AND PURPOSE: West syndrome is a developmental and epileptic encephalopathy characterized by epileptic spasms, neurodevelopmental regression, and a specific EEG pattern called hypsarrhythmia. Our aim was to investigate the brain activities related to hypsarrhythmia at onset and focal epileptiform discharges in the remote period in children with West syndrome using simultaneous electroencephalography and fMRI recordings. MATERIALS AND METHODS: Fourteen children with West syndrome underwent simultaneous electroencephalography and fMRI at the onset of West syndrome. Statistically significant blood oxygen level-dependent responses related to hypsarrhythmia were analyzed using an event-related design of 4 hemodynamic response functions with peaks at 3, 5, 7, and 9 seconds after the onset of each event. Six of 14 children had focal epileptiform discharges after treatment and underwent simultaneous electroencephalography and fMRI from 12 to 25 months of age. RESULTS: At onset, positive blood oxygen level-dependent responses were seen in the brainstem (14/14 patients), thalami (13/14), basal ganglia (13/14), and hippocampi (13/14), in addition to multiple cerebral cortices. Group analysis using hemodynamic response functions with peaks at 3, 5, and 7 seconds showed positive blood oxygen level-dependent responses in the brainstem, thalamus, and hippocampus, while positive blood oxygen level-dependent responses in multiple cerebral cortices were seen using hemodynamic response functions with peaks at 5 and 7 seconds. In the remote period, 3 of 6 children had focal epileptiform discharge-related positive blood oxygen level-dependent responses in the thalamus, hippocampus, and brainstem. CONCLUSIONS: Positive blood oxygen level-dependent responses with hypsarrhythmia appeared in the brainstem, thalamus, and hippocampus on earlier hemodynamic response functions than the cerebral cortices, suggesting the propagation of epileptogenic activities from the deep brain structures to the neocortices. Activation of the hippocampus, thalamus, and brainstem was still seen in half of the patients with focal epileptiform discharges after adrenocorticotropic hormone therapy.

Clinical outcomes of early active mobilization following flexor tendon repair using the six-strand technique: short- and long-term evaluations.

We evaluated the factors influencing outcomes of flexor tendon repair in 112 fingers using a six-strand suture with the Yoshizu #1 technique and early postoperative active mobilization in 101 consecutive patients. A total of 32 fingers had injuries in Zone I, 78 in Zone II, and two in Zone III. The mean follow-up period was 6 months; 16 patients (19 fingers) participated in long-term follow-up of 2 to 16 years. The total active motion was 230° SD 29°; it correlated negatively with age. The total active motion was 231° SD 28° after repair of the lacerated flexor digitorum superficialis tendon, and was 205° SD 37° after excision of the flexor digitorum superficialis tendon ends (p = 0.0093). A total of 19 fingers showed no significant increases in total active motion more than 2 years after surgery. The rupture rate was 5.4% in our patients and related to surgeons' level of expertise. Five out of six ruptured tendons were repaired by inexperienced surgeons. Level of Evidence IV.

Tumor metastasis-associated human MTA1 gene: its deduced protein sequence, localization, and association with breast cancer cell proliferation using antisense phosphorothioate oligonucleotides.

Using differential cDNA library screening techniques based on metastatic and nonmetastatic rat mammary adenocarcinoma cell lines we previously cloned and sequenced the metastasis-associated gene mta1. Using homology to the rat MTA1 gene we cloned the human MTA1 gene and found it to be overexpressed in a variety of human cell lines. We found a close similarity between the human MTA1 and rat MTA1 genes, as shown by 88% and 96% identities of the nucleotide and predicted amino acid sequences, respectively. Both genes encode novel proteins that contain a proline-rich region (SH3 binding motif), a putative zinc finger motif, a leucine zipper motif, and five copies of the SPXX motif often found in gene regulatory proteins. Using Southern blot analysis, the MTA1 gene was found to be highly conserved among all species examined; and using Northern blot analysis, MTA1 transcripts were found in virtually all cell lines of human origin that were analyzed, including melanoma and breast, cervix and ovarian carcinoma cells and normal breast epithelial cells. However, the expression level of the MTA1 gene in a normal breast epithelial cell was approximately 50% of that found in rapidly growing breast adenocarcinoma cell lines and an atypical mammary cell line. Experimental inhibition of MTA1 protein expression using antisense phosphorothioate oligonucleotides resulted in growth inhibition of human MDA-MB-231 breast cancer cells with relatively high expression of the MTA1 gene. Furthermore, the MTA1 protein was localized in the nuclei of cells transfected using a mammalian expression vector containing the full-length MTA1 gene. The results suggest that the MTA1 protein may function in cellular signaling processes important in the progression and growth of cancer cells, possibly as a nuclear regulatory factor.

Estimation of fluoride intake in relation to F, Ca, Mg and P contents in infant foods.

The purposes of this present study were to determine F, Ca, Mg and P contents of infant foods available in Thailand and Japan in relationship to ionization of F from dietary sources and also to estimate the daily F intake of infants during the first six months of life. Samples of 31 and 24 foods from Thailand and Japan were analysed. Microdiffusion technique was used to separate F from food samples. The combination of an F electrode with an ion analyzer was used to determine F. Determination of Ca and Mg of ashed samples were carried out by the atomic absorption spectrophotometry and Chen, Toribara and Warner method was used in P analysis. F content found in infant formulas and supplemented foods were generally low, especially in infant foods in Thailand, while Ca, Mg and P contents were high in various food items tested. The estimation of daily F intake showed that foods cannot provide an infant with a daily F intake at the optimal level. The results of this study indicate that some food constituents play significant roles in daily F intake by influencing F absorption.

[Autologous blood transfusion in transurethral resection of the prostate].

With the purpose to avoid the risk of transfusion mediated infection and complication, predeposited autologous blood transfusion was performed. From April 1990 to March 1991, transurethral resection of the prostate (TUR-P) were performed in 27 patients (mean age: 72.5 years) with benign prostatic hypertrophy (BPH). Autologous blood (200-400 ml, mean 244 ml) was predeposited 3 weeks prior to TUR-P in 18 patients (mean age: 73.9 years) and transfused during or just after the operation in 16 (five patients required some homologous blood in addition to their own banked blood). Another three patients were transfused with homologous blood only. The mean values for hemoglobin concentration were 13.7 +/- 0.4 g/dl before blood deposition and 12.8 +/- 0.5 g/dl on the day of operation (recovery rate: 92.5 +/- 2.7%). Although no complication was found in autologous blood transfusion group (11 patients), one case of systemic exanthema and one case of type C hepatitis were observed in homologous blood transfusion group (8 patients). In TUR-P, positive correlations were observed among resected prostate weight (Pro-wt), blood loss (B.) and operation time (Op-T.). Correlation efficient between Pro-wt. and B. was 0.80, that of B. and Op-T. was 0.77 and that of Pro-wt. and Op-T. was 0.85. From these results and ultransomographic measurement of the prostate weight, the amount of blood loss can be calculated preoperatively, there by the amount of blood needed for transfusion will be estimated.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of daily fluoride intakes from food samples in Japan and Brazil.

The purpose of this study was to analyse the fluoride content of Japanese infant foods and foods in Brazil and to estimate daily fluoride intake calculated for a 6-month-old infant which reflects supplemental fluoride increased from infant foods and decreasing breast-feeding and commercial milk-feeding. Fluoride concentrations of 26 samples were assessed by a modified microdiffusion method and fluoride ion selective electrode. The fluoride content varied from 0.53 to 1.33 microgram/g for milk-base formulas, from 0.46 to 2.94 micrograms/g for infant foods in Japan, and from 0.06 to 0.25 microgram/g for foods in Brazil. The daily fluoride intake was calculated according to feeding pattern. The minimum and maximum fluoride values were 0.080 mg/day and 0.248 mg/day, respectively. These fluoride intakes, expressed in milligrams per kg of fluoride intake, ranged from 0.010 to 0.033 mg F/kg body weight. No significant differences in fluoride intake values were found between Japanese infant foods and foods in Brazil. The results of this study indicate that daily fluoride intakes of Japanese infant foods and foods in Brazil could be considered within the optimal recommended level.

Immunohistochemical demonstration of LHRH-neurons in young rat hypothalamus: light and electron microscopy.

Localization and ultrastructural appearance of immunoreactive LHRH neurons were studied in 2-, 8- and 21-day-old rats. The lower half of the diencephalon including the septo-preoptic area was serially cut at 10 microns in the frontal plane, and all sections stained with an anti-LHRH serum were examined light microscopically. Although the antiserum could not demonstrate LHRH-immunoreactive perikarya in adult rats, they were stained in these young rats. The immunoreactive perikarya were scattered in the following regions: nucleus tractus diagonalis, medial septum, medial preoptic area, lateral septum, lateral preoptic area, tuberculum olfactorium, suprachiasmatic area, supraoptic area, pericommisural area, anterior commissure, vascular organ of the lamina terminalis (OVLT), lateral hypothalamic region and lateral tuberal region. The first three regions contained many cells but others showed only sporadical cells. The cells were most frequently observed in 8-day-old rats. Most of the cells appeared to be bipolar showing two immunoreactive processes. Electron microscopy observation was made using the section prepared by a pre-embedding technique. In the immunoreactive perikarya, secretory granules, ribosomal particles, and the particles on the outer surface of endoplasmic reticulum appeared to be immunoreactive, but the Golgi area was immunonegative. The secretory granules appeared along the cytoplasmic membrane but were surprisingly few in number. By contrast, the immunoreactive nerve terminals in the median eminence and in the OVLT contained many granules. These findings suggest that LHRH produced in the perikarya is prompted to be transported and stored in the axonal terminals.

Electron microscopic study of immunoreactive LHRH perikarya with special reference to neuronal regulation.

In early postnatal rats, immunoreactive LHRH perikarya in the preoptic area were studied by light and electron microscopy. Synaptic junctions were found between the immunoreactive perikaryon or its process, and the immunonegative nerve fibers. The significance of these synapses is discussed in relation to possible mechanisms by which the activities of LHRH neurons are regulated.