Three-dimensional structure of maize alpha-zein proteins studied by small-angle X-ray scattering.

alpha-zeins of maize (Zea mays) that are storage proteins contain nine or ten tandem repeats comprising of about 20 amino acids. Small-angle X-ray scattering (SAXS) of alpha-zeins was measured in 70% (v/v) aqueous ethanol containing beta-mercaptoethanol or without reagent in a protein concentration range of 2.0 to 40.0 mg/ml. The overall radius of gyration of whole particles, Rg, and the corresponding radius of gyration of the cross-section, Rc, of reduced alpha-zeins are 4.00 +/- 0.03 nm and 1.39 +/- 0.05 nm, respectively, in the 70% (v/v) aqueous ethanol containing 2% (v/v) beta-mercaptoethanol. Analyses using the Rg and Rc values indicate that reduced alpha-zeins exist as asymmetric particles with the length of about 13 nm in the solution. A structural model is developed under assumption that each of tandem repeats units forms single alpha-helix and they are joined by glutamine-rich 'turns' or loops, as employed by Argos et al., [Argos, O., Pedersen, K., Marks, M.D. and Larkins, B.A. (1982) J. Biol. Chem. 257, 9984-9990] and Garratt et al. [Garratt, R., Oliva, G., Caracelli, I., Leite, A. and Arruda, P. (1993) Proteins Struc. Func. Genet. 15, 88-99], and that the longest dimension of 13 nm comes from linear stacking of the anti-parallel helices of tandem repeat in the direction perpendicular to the helical axis. The resultant model is presented by an elongated prism-like shape with an approximate axial ratio of 6:1.

Aneurysm of the left aortic sinus caused by Takayasu's arteritis: compression of the left coronary artery producing coronary insufficiency.

A 45 year old Japanese woman with an aneurysm of the left aortic sinus is described. The main trunk of the left coronary artery was displaced upward, and the proximal portion of the circumflex branch was markedly compressed and displaced posteriorly, causing subendocardial infarction and angina. The diagnosis of Takayasu's arteritis was made based on: 1) age, sex and nationality of the patient; 2) inflammatory signs followed by weakness of the right radial pulse; and 3) typical angiographic findings. Five previously reported cases are reviewed.

Effects of diltiazem on cardiovascular responses during exercise in systemic hypertension and comparison with propranolol.

Sixteen patients with uncomplicated systemic hypertension were treated with placebo, diltiazem (180 mg/day) and propranolol (60 mg/day) for 1 month each. Each patient performed multistage symptom-limited treadmill exercise tests during each period of administration. There was no significant difference in maximal exercise duration between placebo, diltiazem and propranolol. Diltiazem significantly decreased both systolic and diastolic blood pressure (BP) and heart rate at rest, during submaximal exercise at the same work load and maximal exercise. Propranolol produced similar changes in systemic BP and heart rate at rest and during exercise. However, the reductions in systolic BP, heart rate and pressure-rate product with diltiazem during exercise were smaller than those with propranolol at small doses, suggesting that diltiazem in its usual therapeutic dose was almost devoid of beta-blocking activity. Thus, diltiazem may be of benefit to hypertensive patients because it reduces systemic BP even during exercise. It is particularly useful when systemic hypertension occurs in association with coronary artery disease because of its effects of coronary artery dilatation and heart rate reduction.

Potential prevention of myocardial rupture resulting from acute myocardial infarction.

The clinical characteristics of 30 cases of myocardial rupture resulting from acute myocardial infarction were analyzed. Predisposing factors of myocardial rupture appeared to be the following (1) age 60 years or older, (2) female, (3) no previous history of angina or myocardial infarction, (4) hypertension on admission, (5) persistent or recurrent chest pain, (6) physical activity and/or emotional unrest, (7) less than 10 days since the onset of myocardial infarction. From 1979 to 1982, we tried to eliminate these risk factors in the acute stage of myocardial infarction, of which hypertension appeared to be the most important and main correlating factor. The incidence of myocardial rupture before elimination of risk factors was 31.2% (26 of 84 patients) which was reduced to 8.8% after elimination. In the years 1981 and 1982, only two cases of myocardial rupture were found in each year, 4.3% and 5.6% of MI patients, respectively.

Relationship between Joint National Committee-VI classification of hypertension and ambulatory blood pressure in patients with hypertension diagnosed by casual blood pressure.

BACKGROUND: White-coat hypertension has been diagnosed arbitrarily based on different criteria. In 1997, the Joint National Committee-VI (JNC-VI) reported a new classification of hypertension and strongly emphasized the importance of ambulatory blood pressure (ABP) monitoring. The report pronounced normal ABP values for the first time. HYPOTHESIS: The study's aim was to clarify the relationship between casual blood pressure (BP) and ABP of patients with essential hypertension in each stage of JNC-VI classification, and the prevalence of white-coat hypertension diagnosed by using JNC-VI normal ABP criteria. METHODS: Ambulatory blood pressure was monitored non-invasively in 232 patients with essential hypertension whose casual BP was > or = 140/90 mmHg. The patients were classified according to JNC-VI classification, and their casual BP was compared with ABP. The criterion of white-coat hypertension was defined as casual BP > or = 140/90 mmHg with normal ABP according to JNC-VI criteria (< 135/85 during daytime and < 120/75 during nighttime). RESULTS: Mean ABP increased as the stage advanced, and the differences between casual BP and ABP also increased. There were considerable overlaps in the distribution of ABP among stages. The prevalence of white-coat hypertension was 13% overall: 30% of the patients with isolated systolic hypertension, 19% of those in stage 1, 10% in stage 2, and 4% in stage 3. CONCLUSIONS: Classification of hypertension based on casual BP may not always correspond in severity to that based on ABP. Ambulatory blood pressure monitoring recommended by JNC-VI is very useful for the evaluation of hypertension to differentiate white-coat hypertension from true hypertension.

Vasospastic angina in thyrotoxicosis--case reports.

We encountered 2 patients with thyrotoxicosis accompanied at its onset by progressive angina. The ST segment was elevated in one patient and depressed in the other patient during the spontaneous attacks. Coronary arteriographic findings were normal during control, and spasm was induced by ergonovine. No patients had chest pain even without antianginal medication after successful treatment of thyrotoxicosis. The coronary artery may become sensitive to spasm during thyroid hormone excess even in cases without significant coronary artery disease and previous chest pain.

Successful treatment of acute, severe aortic regurgitation caused by Takayasu's arteritis: a case report.

Acute, severe aortic regurgitation due to dilatation of the aortic root was studied in a 16-year-old Japanese female with Takayasu's arteritis. The patient was admitted because of acute pulmonary edema followed by systemic illness characterized by fever, anorexia, and general fatigue. The echocardiogram and aortogram demonstrated acute, severe aortic regurgitation due to dilation of the aortic root. She was successfully treated with aortic valve replacement and steroid. Microscopic examination of the aortic wall demonstrated granulomatous lesions with multinucleated giant cells. Now, three years later, she remains asymptomatic and hemodynamically stable.

Myocardial ultrastructure in Kearns-Sayre syndrome.

Myocardial ultrastructural changes are described in a twenty-five-year-old female with typical Kearns-Sayre syndrome. The electrocardiogram revealed complete atrioventricular block with an occasional torsades de pointes type of ventricular tachycardia. His bundle recording demonstrated HV block with normal AH interval. An endomyocardial biopsy showed "ragged-red fibers" by the modified Gomori trichrome stain, and on electron microscopy there were increased numbers of morphologically abnormal mitochondria: ie, gian mitochondria, a whorled pattern of the cristae, and electron-dense substances, and paracrystalline inclusions in the mitochondria. The patient has been well since pacemaker implantation, but she may develop a clinically overt cardiomyopathy due to progression of myocardial involvement.

Incidence and clinical course of right ventricular infarction: assessment with radionuclide ventriculography.

The incidence and prognosis of right ventricular infarction were studied by radionuclide ventriculography (RNV) in 50 consecutive cases of acute myocardial infarction. RNV was performed within thirty-six hours of symptoms and one month after onset. Right ventricular infarction was absent in all 25 patients with anterior infarction. It was found in 15 of the 25 patients with inferior infarction, accompanied by a marked reduction in right ventricular ejection fraction (28 +/- 8%), but was notably alleviated one month later with normalization of right ventricular ejection fraction (39 +/- 7%) and wall motion. These phenomena seem to be specific in right ventricular infarction.

Elevation of bone conduction threshold in children with middle ear effusion.

A retrospective study of children having otitis media with effusion revealed fluctuations in bone conduction thresholds as well as in air conduction thresholds. Previous investigations in this area presented both low- and high-tone bone conduction hearing loss which were reversible. We conducted a detailed study including complete otologic, audiologic and tympanometric evaluation of 27 (41 ears) children who had fluctuating bone conduction hearing loss. From these audiologic examinations, 3 types of bone conduction hearing loss could be classified: high-tone, low-tone and flat-type bone conduction hearing loss. We observed the shift of bone conduction thresholds in children after removal of middle-ear fluids by the appropriate medical management.

Immunologic characteristics of cytokines in otitis media with effusion.

Levels of cytokines, interleukin (IL)-1 alpha, IL-1 beta, tumor necrosis factor (TNF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were investigated in samples of the middle ear effusions (MEEs) from 144 ears with otitis media with effusion (OME) by enzyme-linked immunosorbent assay, followed by cytologic analysis. Middle ear effusions of the acute purulent type contained a significantly higher concentration of cytokines compared with normal control sera (p < .001). Cytokines were observed at lower levels in MEE in adults than in children. Tests of children at the chronic stage of MEE showed higher levels of TNF than IL-1 and GM-CSF. Meanwhile, IL-1 beta showed significantly higher concentrations in acute purulent types than in serous and mucoid types (p < .01). In cytologic analysis, the mean level of IL-1 beta was significantly higher in the neutrophil-rich group than in other groups (p < .05). Cytokines possess several biologic properties, some of which are associated not only with acute otitis media but also with chronic otitis media. This study showed that cytokines, especially IL-1 beta, contribute to infiltration into the middle ear by inflammatory cells. This implies that the persistent presence of cytokines in MEE could be a factor in prolonged OME.

Carcinoid tumour of the middle ear.

Carcinoid tumours belong to the rarer neoplasms of the middle ear. In 1980, Murphy et al. described the first case of a carcinoid tumour of the middle ear. Only five cases could be traced in the literature. The light and electron microscope features of a primary atypical carcinoid tumour of the middle ear are presented and compared with those described in the literature. Primary carcinoid of the middle ear appears to be derived from the epithelial lining of the middle ear. Distant metastases have not been reported. The duration and nature of the symptoms are of little diagnostic value. An atypical carcinoid tumour in the left ear of a 33-year-old woman is described.

[Serum and urinary level of sodium piperacillin in patients with liver disease (author's transl)].

Serum and urinary levels of PIPC (sodium piperacillin) in patients with liver disease were investigated. Serum and urinary levels of PIPC are affected by the degree of liver disease which is estimated most exactly by KICG, and it is available for determination of dose and administration interval. When PIPC was administered intravenously at a dose of 2 g, serum level in patients with liver disease was showed high and prolonged. Therefore this is convenient for PIPC of which biological half life is comparatively short. In patients with serious liver cirrhosis, PIPC is probably cumulated by continuous administration and in this case, dose and administration interval will be needed to regulate.

[Five cases of Parkinson disease with the past history of hand injury].

Incidental occurrence of Parkinson disease following to the history of peripheral trauma was reported in 1932 by Naville and Morsier. So far as we know not more than 50 cases with such an interesting outbreaks have been reported. In Japan no report has been published. We happened to have opportunities to observe five cases of Parkinson disease with similar past history of peripheral trauma comprising two males and three females. Their age at onset ranged from 40 to 74 years and all the five cases had histories of finger injury, including amputation in four cases, followed by insidious onset of tremulous movement at the same site of the trauma during the period between two months and 36 years. So far as we know, no evident explanation is made concerning to the etiological interrelation between onset of Parkinson disease and trauma of the fingers. It appears to be suggestive of the possible mechanism, in which chronic persistent facilitation from the site of trauma up to the diencephalospinal dopamine system, recently advocated by Lindvall and others, result in Parkinson disease beginning at the homolateral site of the previous peripheral trauma.

[Efficacy of tonsillectomy for improving skin lesions of Pustulosis palmaris et plantaris--evaluation of 289 cases at the Department of Otolaryngology of Sapporo Medical University].

In recent years, Pustulosis palmaris et plantaris (PPP) has been described as one of the representative second lesions of focal tonsillitis in Japan. We selected 289 cases of PPP, treated with bilateral tonsillectomy at our department over the past 12 years for this clinical evaluation. In 211 of those 289 tonsillectomy cases, follow-up was done for more than 3 months after operation. Prior to tonsillectomy, 196 cases suffered from PPP only, 90 cases had the complication of osteo-arthral lesions such as sterno-costa-clavicular hyperosteosis (SCCH), rheumatoid arthritis, and soon, whereas only 3 cases showed simultaneous lesions of Psoriasis vulgaris. The efficacy of tonsillectomy for improving the skin lesions was classified into 6 grades, mainly based upon individual evaluation by each patient as follows; disappeared, remarkably improved, improved, slightly improved, unchanged, and worsened. According to our 211 cases, post tonsillectomy improvement of skin lesions was very obvious, with disappearance occurring in 54.3% of cases and remarkable improvement in 21.4%. Age of onset and the duration from onset to tonsillectomy showed no association with effectiveness. However, the shorter the duration from onset to tonsillectomy, the fewer days were required for improvement of the skin lesions. The rate of improvement of PPP rose in conjunction with the number of days after tonsillectomy. We conclude that it requires 12 months, at minimum, to determine the efficacy of tonsillectomy as a treatment for PPP.