Comparison of photodynamic therapy to transpupillary thermotherapy for polypoidal choroidal vasculopathy.

PURPOSE: To compare the therapeutic efficacy of photodynamic therapy (PDT) to that of transpupillary thermotherapy (TTT) for polypoidal choroidal vasculopathy (PCV). METHODS: PDT or TTT was performed on 46 eyes of 46 patients with PCV; 19 eyes were treated with TTT (TTT group) and 27 eyes with PDT (PDT group). PCV was diagnosed by fundus examination, fluorescein angiography (FA) , and indocyanine green angiography (ICGA) . The best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR) units and OCT-determined foveal thickness were evaluated before and after treatment. For statistical analyses, the Student's t-test and chi(2) test were used. RESULTS: The number of treatments during the 12-month follow-up period was significantly higher in the TTT group (1.7 times) than in the PDT group (1.3 times; P=0.0134). The difference in the BCVA between the TTT and PDT groups at the baseline was not significant (P=0.3150), but the BCVA in the PDT group was significantly better than that in the TTT group at 3, 6, and 12 months after treatment (P=0.0093, P=0.0074, P=0.0006, respectively). The foveal thickness decreased markedly at 6 months after treatment in the PDT group (P<0.0001) but not significantly in the TTT group (P=0.8982). A vitreous haemorrhage was observed after treatment in two eyes in the TTT group. CONCLUSIONS: BCVA was significantly better and the fovea was significantly thinner in the PDT group than in the TTT group after treatment. Thus, PDT may be more effective than TTT for the treatment of eyes with PCV.

Primary motor cortex stimulation within the central sulcus for treating deafferentation pain.

Nine patients with post-stroke pain, six with brachial plexus injuries, two with phantom limb pain, one with spinal cord injury, and one with brain stem injury were treated with a modified motor cortex stimulation (MCS) protocol. Preoperative pharmacological tests were performed with phentolamine, lidocaine, ketamine, thiopental, morphine, and placebo. We placed a grid electrode in the subdural space to decide upon the best stimulation point for pain relief over a few weeks with the purpose of determining the placement of a Resume electrode. In five patients, Resumes were implanted in the interhemispheric fissure to reduce lower extremity pain. In five other patients, Resumes were placed within the central sulcus to stimulate area 4 and area 3b. In addition, electrodes were also placed on the surface of the precentral gyrus. Fourteen of the 19 patients showed pain reduction (6 excellent, 3 good, and 5 fair) using the MCS with our results indicating area 4 within the central sulcus to be the optimal stimulation point for pain relief. We speculate that conventional method may sometimes fail to stimulate area 4 and that focal stimulation of the primary motor cortex within the central sulcus may improve the efficacy of this treatment. Our pharmacological tests show that patients with ketamine sensitivity seem to be good candidates for MCS. Test stimulation with a subdural multi-grid electrode and Resumes in the cetral sulcus were helpful in locating the best stimulation point for pain relief.

[Wood creosote: a historical study and its preparation in combination with herbal drugs].

Two kinds of creosote have been found based on historical evidence of the medicinal uses and origins. One is wood creosote, and distillate of wood-tar containing guaiacol and creosol. The other type of creosote is coal-tar creosote, obtained from coal-tar, containing naphthalene and anthracene as the major constituents. Wood creosote was prepared for the first time in Germany in 1830 and was used for medicinal purposes. It had been listed officially in the German, American, and Japanese Pharmacopoeia as an antibacterial agent for the treatment of pulmonary tuberculosis, diarrhea, and external injury. In recent days, it has been deleted from the Pharmacopoeia in Western countries and not officially used for medicinal purposes. However, wood creosote is still been listed in the Japanese Pharmacopoeia and is used for the treatment of diarrhea. Since the interest of common people in herbal medicines and self-medication has been increasing, the use of wood creosote has also been modified in combination with some herbal drugs, "Seiro-gan" especially is quite popular in Japan as a self-medication for digestive trouble, including food poisoning or diarrhea.

The transcript for a novel protein with a zinc finger motif is expressed at specific stages of mouse spermatogenesis.

The cDNA for an RNA that is expressed predominantly in mouse spermatogenic cells was cloned and characterized. It was found to encode novel zinc finger protein. We first generated a cDNA fragment from mouse osteoblastic cells by the differential display method. To our surprise, Northern blot analysis revealed that the corresponding transcript was expressed at high levels in the testis rather than in osteoblastic cells. Therefore, using this fragment as a probe, we isolated the full-length cDNA (3340 bp) from a mouse testis cDNA library. Analysis of the open reading frame of the cDNA indicated that the encoded protein was a polypeptide of 942 amino acids residues that included three distinct domains, namely, a zinc finger domain of the Cys(2)-His(2) type, four basic amino acid-rich domains, and a myosin II-homology domain. In situ hybridization indicated that the transcript was present in seminiferous tubules of adult mice. Elevated expression of the transcript during testicular development in mice was restricted to spermatocytes at the pachytene stage of meiotic prophase and to round and elongated spermatids, as indicated by Northern blot analysis and RT-PCR. Our results suggest that this novel zinc finger protein might act as a transcriptional regulator during spermatogenesis and, in particular, during meiotic division.

Two novel testicular serine proteases, TESP1 and TESP2, are present in the mouse sperm acrosome.

To identify a novel candidate(s) for acrosomal proteins that act on the sperm/egg interaction, a DNA fragment was PCR-amplified from a cDNA library of acrosin-deficient mouse testis and then used as a probe to screen a mouse testis cDNA library. Complementary DNA clones encoding each of two similar but different serine proteases, TESP1 and TESP2, have been identified. The nucleotide sequences of these clones indicate that mouse TESP1 and TESP2 are initially synthesized as preproproteins of 367 and 366 amino acids, respectively. Comparison of the two TESP sequences with those of typical serine proteases suggests that each TESP zymogen is probably converted into a two-chain mature enzyme consisting of light and heavy chains covalently linked by a single pre-existing disulfide bond. The conversion may be accomplished by another protease(s) with a trypsin-like cleavage specificity, since it is unlikely that the mature TESP1 and TESP2 are capable of splitting the Lys-Ile bond between the light and heavy chains. Northern blot analysis of total cellular RNA demonstrates that the TESP1 and TESP2 genes are expressed only in the testis, and the transcripts are abundantly present in the haploid round spermatids. Moreover, immunocytochemical analysis of mouse cauda epididymal sperm using affinity-purified antibodies reveals that these two TESPs are both localized in the sperm acrosome and are released during the acrosome reaction induced by calcium ionophore A23187. These findings provide additional clues for elucidating the mechanisms involved in the sperm/egg interactions, including penetration of the zona pellucida by sperm.

Immunopotentiating activities of polysaccharide fraction from pine seed shell extract.

The function of polysaccharide (PSE) extracted from pine seed shells as a immunopotentiator was investigated. The phagocytosis and chemotaxis of mouse peritoneal macrophages (MP) were augmented by oral administration of PSE. The incorporation of 3H-thymidine by Con A-stimulated mouse splenic cells was significantly intensified by administration of PSE but the adherent-cells (MP)-eliminated splenic lymphocytes was not increased. It is shown that the existence of activated MP is needed for the activation (proliferation) of T lymphocytes. The responsiveness of mouse T cells to alloantigen was also augmented by administration of PSE. The number of anti-SRBC plaque-forming cells in the spleen of mouse and chicken was also significantly increased. The results indicate that MP are first activated by oral administration of PSE and that the activation of T cells is then initiated indirectly by humoral factors (cytokines) produced by activated MP.

An acetophenone glycoside from Exacum affine.

A new acetophenone glycoside, affinoside, was isolated from the aerial parts of Exacum affine and its structure was determined as 2-O-primeverosylpaenol. The known glucosides, gentiopicroside, 2'-O-E/Z-p-coumaroylloganin and glucopaeonol, were also identified.

Successful treatment of dark-colored epidermal nevus with ruby laser.

The pulsed ruby laser has a selective thermolytic effect. Recently, it has been available for the treatment of superficial pigmented disorders. We studied 5 cases of epidermal nevus treated with the pulsed ruby laser. In comparison with the usual methods including electrocautery, cryotherapy and skin abrasion, ruby laser therapy is an excellent tool due to technological ease and rapid improvement. Depigmentation after treatment in 2 cases was the only side effect of this therapy. Bose cases had a dark pigmentation of the skin. Despite of the risk of discoloration, the ruby laser is one of the most effective tools for therapy of pigmented epidermal nevus.

Amino acid sequences of porcine Sp38 and proacrosin required for binding to the zona pellucida.

We previously purified a boar sperm protein, sp38, and demonstrated that this protein bound to the 90-kDa family of zona pellucida (ZP) glycoprotein in a calcium-dependent manner. Sp38 competed with proacrosin for the binding to the zona pellucida. Herein we have isolated cDNA clones encoding sp38 from a boar testis cDNA library in lambda gt11. The amino acid sequence deduced from the cDNA sequence indicated that sp38 is initially synthesized as a 350-residue precursor protein. The N-terminal 51-residue sequence preceded the N-terminus of the mature sp38. Thus, the sp38 precursor is post-translationally modified to produce the mature protein of 299 residues. Immunostaining of sperm cells using an antibody prepared against a fusion protein of sp38 with T7 gene 10 protein suggested that sp38 is localized at the intraacrosomal region and is released after the acrosome reaction. The 11-residue sequence, KRLSKAKNLIE, in sp38 shared a significant degree of similarity with the 8-residue sequence, KRLQQLIE, in the C-terminal region of porcine proacrosin. Both synthetic oligopeptides corresponding to these two sequences inhibited the binding of 125I-labeled sp38 to zona pellucida glycoprotein.

Demonstration of antidiarrheal and antimotility effects of wood creosote.

Wood creosote administered to rats prevented castor-oil-induced diarrhea with an ED50 of 53 mg/kg p.o. This antidiarrheal effect was apparently produced by acceleration of net fluid absorption from the intestine, as shown by a 52% decrease (p < 0.001) of residual fluid volume in an intestinal loop, and partly by suppression of intestinal motility. Wood creosote also inhibited spontaneous longitudinal contractions of isolated ileal segments in rats (IC50 = 28 mg/l) and guinea pigs (IC50 = 17 mg/l). Contractions of the guinea pig ileum induced by electrical stimulation, bradykinin and acetylcholine were also inhibited dose-dependently. We conclude that wood creosote has an antidiarrheal activity and that this effect is exerted by inhibition of intestinal motility and by augmentation of net fluid absorption from the intestine.

"Two-route chemotherapy" using cis-diamminedichloroplatinum(II) and its antidote, sodium thiosulfate, combined with angiotensin II is effective against peritoneally disseminated cancer in rats.

"Two-route chemotherapy" (TRC) using cis-diamminedichloroplatinum(II) (DDP) and its antidote, sodium thiosulfate (STS), combined with the angiotensin II (AT-II)-induced hypertension method was evaluated for its efficacy against peritoneally disseminated tumors in rats. A bolus i.p. injection of DDP (15 mg/kg) was given 1 min after the initiation of an AT-II (16.5 micrograms/kg) i.v. infusion lasting 11 min. Immediately after the termination of the AT-II infusion, 1,580 mg/kg STS was injected i.v. over a further 5 min. This modified TRC significantly improved the antitumor effect, evaluated by survival (increase in life span, 273%), compared with that achieved with other treatments, as follows: 15 mg/kg DDP i.p. and the concomitant i.v. infusion of 1,580 mg/kg STS (conventional TRC), 153% increase in life span; 5 mg/kg DDP i.p. with or without AT-II i.v. (167% and 107% increases in life span, respectively). As an index of nephrotoxicity, blood urea nitrogen (BUN) levels seen after modified TRC (21.1 mg/dl) were as low as those observed after conventional TRC (19.1 mg/dl), despite the postadministration of STS, and were much lower than those seen after DDP alone or DDP plus AT-II (35.6 and 35.7 mg/dl, respectively). Further evaluation of the effectiveness of modified TRC using various doses of DDP gave similar results. The feasibility of the administration of STS 10 min after DDP treatment was explained by the significant inhibition of DDP delivery to the kidney during the AT-II-induced hypertension. Thus, TRC combined with AT-II has a superior therapeutic effect against peritonitis carcinomatosa induced in rats.

Potentiation of cytotoxicity of zinostatin under acidic conditions in vitro and in vivo.

The cytotoxicity and antitumor effects of zinostatin (NCS) were examined under various conditions of pH using cultured HeLa cells and a transplantable tumor line of WKA rats. The cytotoxicity of NCS against HeLa cells was highly dependent on the pH at ranges of 6-8. When HeLa cells were treated with 0.075 microgram/ml of NCS, the survival rate was about 1% at pH 6.0, while it was near 90% at pH 7.4 and pH 8.0. Even at pH 6.5-6.75, the survival rate was about 50% lower than that seen with pH 7.4 and pH 8.0. The ratio of the dose of NCS for a 90% cell mortality at pH 6.0 to that at pH 7.4 was less than one-seventh. Antitumor effects were assessed by local intra-arterial infusion against tumors 4 or 9 days after inoculation of 10(6) RBT-1 tumor cells into the thigh of rats. When NCS (0.7 mg/kg) in phosphate-buffered saline (PBS) (pH 7.4) or 5 mM lactate (about pH 3.0) was administered, the ratio of average tumor weight about 2 weeks after treatment (tumor weight of the rats given NCS in PBS/tumor weight of the rats given NCS in lactate) was 3.2 or 1.7 for the rats treated 4 or 9 days after tumor inoculation, respectively. Lactate or PBS alone had no effect on the growth of tumor. After treatment there was no difference in body weight change between the group treated with NCS in lactate and the group treated with NCS in PBS. We conclude that the cytotoxicity of NCS was potentiated under acidic conditions, both in vitro and in vivo.

Centrally mediated hyperglycemia by 6-aminonicotinamide.

Some metabolic changes induced by the intraventricular administration of 6-aminonicotinamide (6-AN) were studied in mice. Five or ten microgram/animal of 6-AN produced a marked hyperglycemia, lowered glycogen content in the brain and liver, and reduced the adrenal epinephrine content. Adrenalectomy or hexamethonium prevented 6-AN-induced hyperglycemia and decrease of glycogen content in the liver but not in the brain. Decrease of adrenal epinephrine content induced by 6-AN was overcome by hexamethonium. Pretreatment with 6-AN (10 microgram/animal) markedly lowered the toxic action, but not the hypoglycemic action, of a large dose of insulin.

Long-term follow-up results of bilateral thalamotomy for parkinsonism.

27 patients who underwent bilateral thalamotomy for parkinsonism over the past 10 years have been clinically evaluated. Mean follow-up period was 6.2 years after second surgery. In these cases, 8 returned to full social life without any medication, 4 were capable of social life with medical treatment, 6 were self-sufficient and 3 were semi-self-sufficient in ADL, respectively. Therapeutic drug doses were reduced in all cases. L-Dopa-induced dyskinesia was not observed after second surgery. Speech disturbance, which was not severe, was recognized in 12 cases as a complication.