To characterize the perifollicular sheath of the human scalp hair follicle, morphological features, growth pattern, the effect of dihydrotestosterone on growth behavior, and levels of 5α-reductase type I, 5α-reductase type II, aromatase, 17β-hydroxysteroid dehydrogenase, and androgen receptor mRNAs were compared in perifollicular sheath cells, dermal papilla cells, and nonfollicular dermal fibroblasts. Perifollicular sheath cells displayed a similar flattened morphology and the same aggregative trait as dermal papilla cells, but differed from nonfollicular dermal fibroblasts. Perifollicular sheath cells grew faster than dermal papilla cells but slower than dermal fibroblasts. Dihydrotestosterone at concentrations of 30 ng/ml and 300 ng/ml significantly reduced the growth rate of perifollicular sheath cells, whereas dihydrotestosterone had no effect on nonfollicular fibroblasts or dermal papilla cells. The perifollicular sheath of the follicle was clearly stained with an antibody against α-smooth muscle actin, but dermal papilla cells within follicles were not stained. However, a large percentage of both dermal papilla and perifollicular cells in culture were stained by this antibody. Nonfollicular fibroblasts were moderately stained by this antibody. Perifollicular sheath cells and dermal papilla cells contained similar levels of 5α-reductase type I, 5α-reductase type II, aromatase, 17β-hydroxysteroid dehydrogenase, and androgen receptor mRNA. These results provide evidence that the perifollicular sheath and the dermal papilla form a functional unit distinct from the surrounding nonf ollicular connective tissue.

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Not much attention has been paid to fractures in children. Therefore, statistical analysis is needed to investigate this subject. We observed 178 fractures of 169 children less than 5 years old. We focused on four variables: age, cause of injury, fracture position, and treatment. Ages ranged from 1 day to 4 years and 11 months (mean, 2 years 2 months) . Excluding 23 birth fractures, the number of fractures increased with age. The causes of injuries for the 81 children investigated were injuries at birth (27.2%), falling from heights (21.0%), falling down (17.3%), traffic accidents (11.1 %), bicycle accidents (8.6%), other causes (9.9%), and unknown (4.9%) . Clavicular fractures were most common for children younger than 1 year of age. Humeral fractures were most prevalent among those aged from 2 to 4 years. Eight children were operated on by osteosynthesis and two children were operated on by debridement from ankle to foot. The others were treated nonoperatively. A child's fracture usually heals quickly. If excessive deformity occurs after the fracture, a long time is needed for correction. In such cases, manual reduction and fixation with plaster casting are necessary.

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Cochlear nerve fibers were studied with regard to their course to lower basal turn and their relation to the surrounding bony tissue in the modiolus. Fifteen human temporal bones from persons ranging in age from 70 to 80 years were used. The cochlear nerve fibers run apically taking a spiral course from the internal auditory meatus to the inside of the cochlea, whereas the nerve fibers destined for the lower basal turn go in an opposite direction before entering the modiolus. The dividing point of the fiber arrangement corresponds to an area of the basilar membrane 9 to 10 mm from the basal end. The cochlear nerve passes through the tractus spiralis foraminosus and the modiolar longitudinal canals before reaching Rosenthal's canal. The diameters of the modiolar longitudinal canals directly connected to the spiral tract are smaller than those of the passing nerve bundles; thus, the nerve bundles are in contact with the surrounding bony wall. On the other hand, the nerve bundles destined for the upper turns have more space around the bundles. The vulnerability of the nerve fibers in the lower cochlear turn may be explained by this structural characteristic of the nerve bundle, i.e., its relationship to the bony canal. Methods for preparing a cochlear nerve specimen are presented in this paper. The nerve fibers in the lower basal turn were sectioned from the cochlear nerve trunk up to the fundus of the internal auditory meatus. This removed, quadrangular or triangular nerve bundle mass was first stained and then mounted on a slide in the usual manner. After 1 week, the flattened, stained nerve bundle was removed from the glass slide, and the tissue was embedded in paraffin and sectioned. Thus, individual nerve fibers can be readily evaluated in a thin specimen. An alternative method is to first make paraffin sections of flattened, unstained nerve fibers followed by staining of the sections on glass slides. These methods were useful in evaluating nerve fibers running to the lower basal turn.

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Argon laser irradiation was applied to the stria vascularis of the third turn through the otic capsule of guinea pigs and to the osseous spiral lamina and the organ of Corti through the round window membrane. A laser probe, 0.6 mm in diameter, was connected to an argon laser. A glass fiber of 200μm in diameter was encased in the probe. Each time, the power applied was 50-300 mW and of 0.5-second duration. The tip of the probe was 0.5 to 1 mm away from the otic capsule. Twenty-six to 48 days after irradiation, the animals were killed under deep anesthesia after intravital fixation with Heidenhein-Susa solution. The conventional celloidin-embedding technique was used to make sections of 20μm thickness for microscopic observation. The spiral ligament showed atrophy and the stria vascularis disappeared in the third turn. The otic capsule remained intact. The organ of Corti was partly or completely missing. Extension of Reissner's membrane covered the atrophic spiral ligament and was connected to the basilar membrane after the spiral ligament had disappeared. Irradiation (1W×0.5 seconds) through the round window membrane destroyed the organ of Corti and fractured the bony shelf of the osseous spiral lamina with loss of dendrites of cochlear neurons. The round window membrane remained intact.

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We studied the morphologic changes of dendrites in the rat brain resulting from hypoxic insult and investigated changes under conditions of hypothermia induced before or after hypoxic insult. Hypoxic damage after 3 to 5 minutes of apnea was manifested as morphologic changes in cell bodies in a delayed fashion and in dendrites immediately after restoration of breathing. We believe that these morphologic changes at such an early stage result in synaptic dysfunction and explain the poor neurologic recovery in patients resuscitated after cardiopulmonary arrest. Several basic and clinical studies have found that hypothermia during brain resuscitation protects neurologic function and improves clinical outcome. In the present study, cooling at 34°C decreased pathologic changes in basal dendrites of the cortex but such morphologic effects were not evident in apical dendrites of the cortex. Cooling also lessened degenerative change in the hippocampus at 6 days compared with that within 48 hours after the insult. However, whether cooling delays or protects against pathologic changes after hypoxic damage remains controversial. Furthermore, the effect of hypothermia on synaptic disconnection must be reexamined because dendritec changes first appeared just after insult despite the finding that hypothermia before insult protects against chronic morphologic changes in dendrites.

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Lactoferrin, an iron-binding glycoprotein, has been found to have various biological functions in various tissues. Although, many studies have been reported on salivary lactoferrin in adults and children, little is known regarding lactoferrin in salivary fluid of neonates, especially under conditions of chorioamnionitis (CAM) . Salivary lactoferrin concentrations in neonates gradually increased as the days advanced and when breast feeding started, the levels elevated significantly. Salivary lactoferrin levels in neonates measured on the day of delivery in the group delivered with chorioamnionitis were 3.4±0.5 μg/ml and were significantly higher (p<0.05) than those without chorioamnionitis (0.8 ±0.3 p g/ml) . The changes in the lactoferrin concentra-tions of salivary fluids in neonates were demonstrated. Furthermore, the elevation of salivary lactoferrin concentrations in neonates in response to the amniotic infection suggested the novel function as a host defense against infections.

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A human macrophage-like cell line, MABS-1, was established from adherent colonial cells that appeared in a culture of a monocytic leukemia cell line, MOBS-1, established from peripheral blood mononuclear leukocytes of a patient with monocytic leukemia (M5b) . These cell lines were of monocyte/ macrophage lineage, because both MOBS-1 and MABS-1 cells have activities of phagocytosis, α-naphthyl butyrate esterase, and express HLA-DR. MABS-1 cells werr larger and had wider cytoplasm that did MOBS-1 cells and tightly adhered to plastic and glass with pseudopodia and microvilli. Furthermore, MABS-1 cells, but not MOBS-1 cells, had the following characteristics of macrophages. They expressed CD68 (KP-1 antigen) in cytoplasm and CD14 on the cell surface. Generation of superoxide anion, a sign of activated phagocytes, was detected in MABS-1 cells by nitroblue tetrazolium reduction without phorbol ester stimulation. Modes of chromosome numbers of MABS-1 and MOBS-1 clels were 75 and 53, respectively, and karyotypic abnormalities detected in these cell lines with trypsin-Giemsa G-banding methods agreed at 3 points and disagreed at 25 points. However, DNA fingerprint analysis of mitochondrial DNA D-loop regions revealed that the hereditary relationship between these cell lines was close. These data suggest that MABS-1 cells originate from MOBS-1 cells but are more differentiated toward the macrophage direction than are the parent MOBS-1 cells.

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We analyzed age-related changes of protein expression in rat brain cytosol to clarify proteins which might be involved in the development of the central nervous system. About 30 proteins that are expressed specifically at the prenatal stage were isolated from the cytosol fraction by preparative electrophoresis and subjected to amino acid sequence analysis. Although several of these fetal specific proteins, such as elongation factor-1 and HMG-1, which are known to be related to growth and differentiation have been characterized, the structure and function of almost all other proteins are still unknown. We purified and analyzed the partial sequence of one protein, p30, whose molecular weight was estimated to be 30 kDa on sodium dodecylsulf ate-polyacrylamide gel electrophoresis. The several partial amino acid sequences of the purified p30 were found to contain homologous sequences with Rho GDP-dissociation inhibitor and Ran binding protein 1, but other sequences were unidentified. The Rho GDP-dissociation inhibitor and Ran binding protein 1, with molecular weights of 27 kDa, regulate Rho and Ran, respectively, which are members of the ras p21-related small GTP-binding protein superf amily, and were separable from p30 on gel electrophoresis. Although the molecular mechanism of the action of p30 is still to be clarified, it might have an important role in the development of the central nervous system.

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Effects of adenine-induced chronic renal failure (CRF) on hepatic microsomal oxidative drug-metabolizing enzymes and heme-metabolizing enzymes were examined. Male Sprague-Dawley rats, 5 weeks old, were used in this study. An adenine-induced CRF model was produced in rats by feeding a diet containing adenine (0.5 w/w% in regular chow) for 5 weeks under regular conditions. The state of CRF was confirmed by changes in serum levels of blood urea nitrogen (BUN) and creatinine, after which activities and contents of hepatic microsomal drug-metabolizing enzymes were determined. In CRF rats, significant and successive increases in serum BUN and creatinine were observed. Morphologic changes were observed in the kidneys of CRF rats: the volume increased approximately three fold and the color changed to ivory white. Significant decreases in the demethylation of erythromycin, which is mainly metabolized by cytochrome P450 3A2 (CYP3A2), and in the activity of mitochondrial delta-aminolevulinic acid synthetase (ALAS) were observed (p<0.001 and p<0.05 ), respectively) . Aminopyrine N-demethylase activity was slightly decreased. On the other hand, cytochrome b5 contents and aniline hydroxylase activity were significantly increased in CRF rats (p<0.01 and 0.05, respectively) . The changes in erythromycin N-demethylase and ALAS activities were negatively correlated with serum BUN and creatinine concentrations. In conclusion, the hepatic microsomal drug-metabolizing enzyme system was affected by conditions of CRF. The adenine-induced CRF model will be a useful tool for estimating changes in drug metabolism in CRF.

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We present two cases of ruptured distal posterior inferior cerebellar artery (distal-PICA) aneurysms and discuss treatment strategies. Case 1 involved a 37-year-old woman who presented in a drowsy state following a sudden headache. A second computed tomographic study revealed a subarachnoid hemorrhage with a cerebellar hematoma. Vertebral angiography revealed a distal-PICA aneurysm. We performed neck clipping of the aneurysm and removed the hematoma. Case 2 involved a 67-year-old woman who suffered a sudden headache. Her consciousness declined to a comatose state. Computed tomography revealed a massive cerebellar hematoma. Because of impending herniation, we performed the operation without preoperative angiography. The operation revealed a ruptured distal-PICA aneurysm in the hematoma. Ruptured distal-PICA aneurysms are sometimes complicated by cerebellar hematomas, which worsen the neurologic outcome to that associated with a severe-grade subarachnoid hemorrhage. We believe that these case must be treated as cerebellar hematomas and require emergency surgery.

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A 30-year-old woman presented with the sudden onset of severe headache, nausea, and vomiting. On admission the patient was alert and results of a neurologic examination were normal. A computed tomogram of the brain revealed the presence of Intraventricular hemorrhage, predominantly in the fourth ventricle, and hydrocephalus. However, subarachnoid blood was not seen in the basal cistern. A third cerebral angiogram performed on the 13th day after admission showed a saccular aneurysm arising from the telovelotonsillar segment of the posterior inferior cerebellar artery. Six days later, a bilateral suboccipital craniectomy was performed, and the neck of the aneurysm was clipped. We believe that demonstration of an isolated fourth ventricular hemorrhage should raise a strong suspicion of a distal posterior inferior cerebellar artery aneurysm.

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