[Usefulness of magnetic resonance imaging for evaluation of therapeutic efficacy of bone metastases from bladder cancer: a case report]

A 70-year-old man had a prostate-invading bladder cancer with multiple bone metastases. The bladder cancer seemed to have metastasized via the vertebral vein system because there was no metastasis in other organs. Transurethral resection of bladder tumor was performed followed by one course of M-VAC (methotrexate, vinblastine, doxorubicin) therapy and MEP (methotrexate, etoposide and cisplatin) therapy. After chemotherapy, magnetic resonance imaging (MRI) of the spine revealed further progression of disease, although bone scintigraphy did not, and the patient died of disease.

Immunochemical approaches to AGE-structures: characterization of anti-AGE antibodies

Recent immunological approaches have greatly helped broaden our understanding of the biomedical significance of advanced glycation end products (AGEs) in aging and age-enhanced disease processes. Recently, Nepsilon-(carboxymethyl) lysine (CML), one of the glycoxidation products of AGEs, was demonstrated to be a major immunological epitope among AGEs. In the subsequent study, we characterized 13 different polyclonal anti-AGE antibodies and showed that these antibodies could be classified into three groups (Groups I, II and III). Group I was specific for CML and both Group II and Group III were specific for other epitopes (non-CML). Time-course study suggested that the epitope of Group II was formed earlier than that of Group III. In the present study, we prepared two monoclonal anti-AGE antibodies (2A2 and 3A3) whose epitope structures appeared to be closely related to Group III and Group II, respectively. The result indicates that AGE-proteins express at least two major non-CML epitopes.

Glycolaldehyde-modified low density lipoprotein leads macrophages to foam cells via the macrophage scavenger receptor

It was shown that proteins modified with advanced glycation end products (AGE) are effectively endocytosed by macrophages or macrophage-derived cells in vitro, and immunohistochemical studies involving anti-AGE antibodies demonstrated the accumulation of AGE-modified proteins (AGE-proteins) in macrophage-derived foam cells in human atherosclerotic lesions in situ, suggesting the involvement of AGE-modified LDL in the atherogenic process in vivo. To examine this suggestion, LDL was modified with glycolaldehyde, a highly reactive intermediate of the Maillard reaction. Physicochemically, glycolaldehyde-modified LDL (GA-LDL) was characterized by increases in negative charge, fluorescence intensity, and reactivity to anti-AGE antibodies, properties highly similar to those of AGE-proteins. The cellular interaction of GA-LDL with mouse peritoneal macrophages showed that GA-LDL was specifically recognized and endocytosed, followed by lysosomal degradation. The endocytic uptake of GA-LDL by these cells was competitively inhibited by acetylated LDL (acetyl-LDL), and the endocytic degradation of acetyl-LDL was also competed for by GA-LDL. Furthermore, incubation of GA-LDL with these macrophages and Chinese hamster ovary cells overexpressing the macrophage scavenger receptor (MSR), but not with peritoneal macrophages from MSR-knockout mice, led to the intracellular accumulation of cholesteryl esters (CE). These results raised the possibility that AGE-modified LDL, if available in situ, is taken up by macrophages mainly via MSR and then contributes to foam cell formation in early atherosclerotic lesions.

The multiple roles of macrophage scavenger receptors (MSR) in vivo: resistance to atherosclerosis and susceptibility to infection in MSR knockout mice

Both type I and type II MSRs are integral membrane proteins containing a collagenous domain and elicit an extraordinarily wide range of ligand binding capability. They were found during the search for the molecule(s) responsible for the accumulation of modified LDL during atherogenesis. However, all prior the evidence relating to their physiological and pathophysiological roles in vivo had been indirect. Targeted disruption of the MSR gene results in a reduction in the size of atherosclerotic lesions in an apo E deficient animal. Macrophages from MSR deficient mice exhibit a marked decrease in modified LDL uptake in vitro, whereas modified LDL clearance from plasma remains normal, suggesting that there are alternative mechanisms for the uptake of modified LDL from the circulation. In addition, MSR knockout mice are more susceptible to L. monocytogenes and HSV-1 infection, indicating a role for MSR in host defense against various pathogens.

Elevated serum levels of the soluble form of gp130, the IL-6 signal transducer, in HTLV-1 infection and no involvement of alternative splicing for its generation

By using an ELISA, increased levels of the soluble form (sgp130) of gp130, the IL-6 signal transducer, were detected in the sera of various HTLV-1-associated conditions (HC, ATL, HAM) as compared to normal healthy individuals. Sgp130 levels seemed to be correlated with disease severity. The 94 KD of sgp130 was specifically precipitated in the sera of HTLV-1-infected patients as revealed by Western blot analysis. A reverse transcriptase (RT)-polymerase chain reaction (PCR) method was used to detect the message for transmembrane (TM) lacking gp130 in mRNA isolated from peripheral blood mononuclear cells (PBMCs) of patients infected with or without HTLV-1 and those of various hematopoietic cell lines. Two PCR products, 648 and 507 bp were observed in the PBMCs from HTLV-1-infected patients. But the 507 by PCR product was not detected in the PBMCs from normal healthy individuals and HTLV-1-positive cell lines although the 648 bp product was equally expressed. A nucleotide sequence analysis of the 507 bp fragment showed deletion of the 141 bp at the region spanning from nucleotide 1702 (G) to 1842 (T) of the 648 bp product that matched completely with a conventional gp130 molecule. This deleted region was located upstream of the transmembrane (TM) domain, but not within the TM region itself. However, no frame shift was observed. These results indicate that the generation of sgp130 may not be due to an alternative splicing mechanism.

Immunohistochemical study of human advanced glycation end-products (AGE) and growth factors in cardiac tissues of patients on maintenance dialysis and with kidney transplantation

Cardiovascular disease is one of the most common complications of dialysis and renal transplant patients, and high levels of AGE are present in end-stage renal failure. To address the potential involvement of AGE and growth factors in the pathophysiology of cardiovascular complications, we performed immunostaining using cardiac tissues from autopsy cases of patients on maintenance dialysis (10 cases), long-term surviving renal transplant patients with functioning grafts (8 cases), control subjects with normal renal function (7 cases) and non diabetic subjects with mild renal insufficiency (8 cases). We used two types of AGE-antibodies, 6D12 [monoclonal anti-AGE antibody, recognizing N epsilon-(carboxymethyl) lysine(CML)-modified AGE] (oxidative AGE) and non-CML-PA [polyclonal, not recognizing CML], and antibodies against PDGFs, PDGF receptors and TGF beta. Positive 6D12 staining was observed in the coronary arterial walls and in macrophages. The accumulation of 6D12-reactive AGE in the coronary arterial walls of maintenance dialysis patients was significantly greater than that of control subjects (p < 0.05). Renal transplantation significantly reduced this accumulation (p < 0.05). On the other hand non-CML-PA mainly detected AGE in intracardiac arterioles and neural tissues. There was little difference in the accumulation of non-CML-AGE among the four groups. PDGFs and PDGF receptors were mainly detected in vascular endothelial cells and infiltrating cells of cardiac tissues of renal transplant patients, but not of maintenance dialysis patients. TGF beta was not detected in cardiovascular tissue of transplant patients. Our results indicated that the accumulation of oxidative AGE (CML-AGE) in the cardiac vascular tissue is one of the factors for cardiovascular complications of maintenance dialysis patients, and also that renal transplantation has a reducing effect on CML-AGE accumulation. PDGFs may be involved in the cardiovascular complications after renal transplantation.

Relationship of epidermal growth factor binding capacity to histopathologic features and prognosis in human renal cell carcinoma

We studied the association between epidermal growth factor (EGF) binding capacity and histopathologic features or prognosis in human renal cell carcinoma (RCC) by Scatchard analysis in 67 patients. EGF binding capacity was significantly greater in metastatic than in nonmetastatic tumors, and in nuclear grade 3 than nuclear grade 1 tumors. Multivariate analysis revealed that tumor stage, nuclear grade, EGF binding capacity, and tumor size significantly correlated with overall survival. These results suggest that EGF binding may be an important determinant of prognosis in patients with RCC.

Insulin enhances macrophage scavenger receptor-mediated endocytic uptake of advanced glycation end products

Hyperglycemia accelerates the formation and accumulation of advanced glycation end products (AGE) in plasma and tissue, which may cause diabetic vascular complications. We recently reported that scavenger receptors expressed by liver endothelial cells (LECs) dominantly mediate the endocytic uptake of AGE proteins from plasma, suggesting its potential role as an eliminating system for AGE proteins in vivo (Smedsrod, B., Melkko, J., Araki, N., Sano, H., and Horiuchi, S. (1997) Biochem. J. 322, 567-573). In the present study we examined the effects of insulin on macrophage scavenger receptor (MSR)-mediated endocytic uptake of AGE proteins. LECs expressing MSR showed an insulin-sensitive increase of endocytic uptake of AGE-bovine serum albumin (AGE-BSA). Next, RAW 264.7 cells expressing a high amount of MSR were overexpressed with human insulin receptor (HIR). Insulin caused a 3.7-fold increase in endocytic uptake of 125I-AGE-BSA by these cells. The effect of insulin was inhibited by wortmannin, a phosphatidylinositol-3-OH kinase (PI3 kinase) inhibitor. To examine at a molecular level the relationship between insulin signal and MSR function, Chinese hamster ovary (CHO) cells expressing a negligible level of MSR were cotransfected with both MSR and HIR. Insulin caused a 1.7-fold increase in the endocytic degradation of 125I-AGE-BSA by these cells, the effect of which was also inhibited by wortmannin and LY294002, another PI3 kinase inhibitor. Transfection of CHO cells overexpressing MSR with two HIR mutants, a kinase-deficient mutant, and another lacking the binding site for insulin receptor substrates (IRS) resulted in disappearance of the stimulatory effect of insulin on endocytic uptake of AGE proteins. The present results indicate that insulin may accelerate MSR-mediated endocytic uptake of AGE proteins through an IRS/PI3 kinase pathway.

Role of macrophage scavenger receptors in diet-induced atherosclerosis in mice

To clarify the role of type I and type II macrophage scavenger receptors (MSR-A) in the progression of diet-induced atherosclerosis, we generated mice lacking both MSR-A and low-density lipoprotein receptor (LDLR). After 4 or 12 weeks of a high-fat diet, the sizes of atherosclerotic lesions in MSR-A/LDLR double knockout mice were significantly reduced (p < 0.05) compared with those in LDLR single knockout mice. However, atherosclerotic lesions mainly composed of foamy macrophages were still observed in double knockout mice. Formation of atherosclerotic lesions in double knockout mice was partially explained by the participation of scavenger receptors other than MSR-A such as MARCO, CD36, and macrosialin/CD68. These receptors were clearly demonstrated in the atherosclerotic lesions in double knockout mice as well as LDLR single knockout mice by immunohistochemistry or by reverse transcriptase-polymerase chain reaction. Because the very low density lipoprotein (VLDL) fraction was elevated in the double and single knockout mice, we further examined the possibility that VLDL may participate in foam cell formation in atherosclerotic lesions. When incubated with VLDL isolated from LDLR-deficient mice, cholesterol ester accumulation and foamy transformation occurred in MSR-A-deficient macrophages as well as in normal macrophages. These data indicate that MSR-A plays an essential role in the development of diet-induced atherosclerosis. It also appears that other scavenger receptors, such as MARCO, CD36, and macrosialin/CD68, as well as uptake of VLDL are involved in foam cell formation during atherogenesis in MSR-A/LDLR double knockout mice.

Molecular cloning, functional expression and tissue distribution of rat acyl-coenzyme A:cholesterol acyltransferase

Acyl-coenzyme A:cholesterol acyltransferase (ACAT) is an enzyme catalyzing the intracellular formation of cholesteryl esters from free cholesterol and fatty acyl-CoA. In the present study, we cloned rat ACAT cDNA and determined its tissue distribution. Rat ACAT cDNA, having a coding region of 1635 bp with its deduced protein sequence of 545 amino acids and two typical motifs such as signature sequences and leucine heptad motif, showed 83, 92 and 90% identity with human, mouse, and hamster ACAT, respectively. Expression of rat ACAT cDNA in A293 cells and CHO cells resulted in a 3.0 to 3.5-fold increase in the enzyme activity. Among twelve tissues examined, ACAT activity was highest in adrenal followed by liver and intestine while that of aorta was extremely low. The mRNA level was also the highest in adrenal among four tissues examined. However, in contrast to its high ACAT activity, the liver mRNA level was extremely low (adrenal >> intestine > aorta >> liver). Consistent with mRNA levels, immunohistochemical analyses with a specific ACAT antibody detected significant ACAT signals in adrenal and intestine but a negligible signal in liver. These results indicate that adrenal most abundantly expresses ACAT in rat. Furthermore, rat liver showed a high ACAT activity but an extremely low ACAT mRNA and negligible immunohistochemical reactivity, suggesting the presence of a structurally different ACAT protein(s) in rat liver.

Conversion of Amadori product of Maillard reaction to Nepsilon-(carboxymethyl)lysine in alkaline condition

Nepsilon-(carboxymethyl)lysine (CML) is known to be formed by oxidative cleavage of Amadori products between C-2 and C-3 of the carbohydrate chain. We report here that CML formation from Amadori compounds is highly accelerated under alkaline conditions. Incubation of glycated human serum albumin (HSA) in 0.1 N NaOH led to the formation of CML whereas glycated HSA reduced by NaCNBH3 or non-glycated HSA did not generate CML. Nalpha-t-butyloxycarbonyl-Nepsilon-fructoselysine (Boc-FL), a model compound of Amadori product, was converted to CML under alkaline conditions. CML level of human sera (n=224) preincubated with 0.1 N NaOH correlated well with glycated albumin value (r=0.912) and hemoglobin A1c (r=0.797).

Biochemical evidence for oligomerization of rat adrenal acyl-coenzyme A:cholesterol acyltransferase

Acyl-coenzyme A:cholesterol acyltransferase (ACAT) in rat adrenal was compared with that in rat liver. Immunoblot analyses of the microsomal fractions from adrenal with an anti-human ACAT antibody detected a 45 kDa protein. Upon pretreatment of these microsomal fractions with chemical cross-linkers such as BS3 and Sulfo-EGS, the 45 kDa band decreased with a concomitant increase in high molecular weight proteins (55, approximately 100, and approximately 230 kDa), suggesting that ACAT constitutes oligomers of 45 kDa monomers associated with a 10 kDa protein. In sharp contrast, the same immunoblot analysis of rat liver microsomal fractions identified a 50 kDa protein which was not cross-linked by these cross-linkers. Moreover, when four ACAT inhibitors were tested for their effects on adrenal and liver enzymes, NTE-122, CI-976, and E5324 were more effective for the liver enzyme, whereas 58-035 was much more effective for adrenal ACAT. These biochemical and pharmacological observations support the notion that the rat liver ACAT protein is distinct from the adrenal counterpart.

Isolation of macrophage-like cell mutants resistant to the cytotoxic effect of oxidized low density lipoprotein

A high concentration of oxidized low density lipoprotein (Ox-LDL) showed a cytotoxic effect on mouse macrophage-derived J774 cells. Mutant cells were selected from these cells that were resistant to the cytotoxic effect of Ox-LDL. One mutant form, named JO21b cells, was characterized in the present study. In spite of a marked resistance to the cytotoxic effect of Ox-LDL, JO21b cells were apparently as sensitive as the parent cells not only to toxic moieties of Ox-LDL, such as 7-ketocholesterol and lysophosphatidylcholine, but also to t-butyl hydroperoxide, an artificial lipid hydroperoxide analog. However, the cellular association of 125I-labeled Ox-LDL with, and subsequent endocytic degradation by JO21b cells was reduced by 70-80% compared with J774 cells. Similarly, accumulation of cholesteryl esters in JO21b cell by Ox-LDL was also reduced by 70%. Northern blot analyses of type I and type II macrophage scavenger receptors (type I and type II MSR) demonstrated that the mRNA levels of JO21b cells were lower than those of J774 cells. Moreover, peritoneal macrophages obtained from MSR-knockout mice showed a higher resistance to the cytotoxic effect of Ox-LDL than those from their wild-type littermates. Our results suggest, therefore, that macrophage scavenger receptor-mediated endocytic uptake of oxidized low density lipoproteins (Ox-LDL) may play an enhancing role in Ox-LDL cytotoxicity to macrophages or macrophage-derived cells.

[Relationships between wakefulness of mothers and their infants' movements during night sleep of postpartum 6 weeks]

Relationships between wakefulness of mothers and their infants' movements during night sleep in postpartum period were studied under conditions in daily life. Subjects were ten primiparae, aged 23-31 yrs (mean age, 26.8 yrs), who had a normal course of pregnancy and delivery. Eight of their infants were breast-fed, and two were formula-fed. Mother's polysomnograms, (EEG, EOG, EMG, and ECG) and actigrams of infants' legs were simultaneously recorded using Medilog 9000 at home in the 1st, 3rd and 6th postpartum weeks. Mothers' sleep stages and their infants' movements were visually scored by an epoch of one minute. The infants' movements were classified into four states, MOV0, MOV1, MOV2, and MOV3. We defined MOV0 as no activities during one epoch, MOV1 as less than 20 seconds activities, MOV2 as from 20 to 40 seconds activities and MOV3 as from 40 to 60 seconds activities. The average times of wakefulness on the mothers were 102.6 min (SD = 23.5), 84.8 min (SD = 52.8) and 79.4 min (SD = 40.5) for 1st, 3rd and 6th postpartum weeks, respectively. There were no significant differences among them. The mothers' wakefulness coincided with the infants' movements MOV3 was 86.9% for total epochs of MOV3, while deep sleep of the mothers was observed during epochs of MOV0 and MOV1. This trend did not change across the postpartum weeks. The time-lag between the mothers' wakefulness and their infants' movements was calculated. In 85.4% of 48 times of mother's awakenings for feeding their infants, their infants began to move before their mothers woke up. In 63.4% of the cases, the mothers woke up within two minutes after their infants began to move. In the present study, eight of the ten mothers satisfactorily adapted themselves to the life style in the postpartum period, while two had difficulties in adaptation. In conclusion, ten mothers' wakefulness during night sleep in postpartum period was related to their infants' movements, and its relationship did not change through the 1st, 3rd and 6th weeks of delivery.

High-voltage high-resolution electron microscopy study of alkaline-earth copper oxides

Two families of alkaline-earth copper oxides are studied by using high-voltage high-resolution electron microscopy. One is Sr(n-1) Cu(n)O(2n-1) (n = 2, 3), the so-called spin-ladder compounds, and the other is ACuO2 (A = Ca-Sr) crystallizing in the infinite-layer structure, which is a parent structure for all copper oxide superconductors. It is demonstrated in the former compounds that oxygen columns as well as metal columns are directly imaged in a "structure" image. Moreover, twin-related lattice defects, which can be the origin of free Cu2+ spins observed previously in magnetic measurements, have been detected in SrCu2O3. An interesting irradiation effect under a 1,000-kV electron beam has been observed in the infinite-layer compound: An unusual structural phase transformation to a NaCl-type lattice is induced, accompanied by the formation of nm-size twin domains.

Structural evolution in boron nitrides during the hexagonal-cubic phase transition under high pressure at high temperature

Structural evolution during the phase transition from h (hexagonal)- to c (cubic)-boron nitrides (BN) under high pressure (6.5-7.7 GPa) at high temperature (1,700-2,150 degrees C) was examined by using high-resolution transmission electron microscopy (HRTEM) and electron energy loss spectroscopy (EELS). At the initial stage of the evolution, some starting h-BN plates were strongly folded, while others were slightly bent. As a result, a strong texture was formed. HRTEM revealed that the interplanar distance between sp2 sheets became slightly shortened and they were slightly sheared to each other during the folding and bending. As a result, m (monoclinic)-BN was formed near the folding plane with lattice parameters; a = 0.433 nm, b = 0.250 nm, c = 0.32-0.33 nm, and beta = 90-92 degrees. In a succeeding stage, the value of beta increased to 92-95 degrees. c-BN grains appeared with nano-scale twins and sometimes partly included wurtzite-type BN. They started to grow with secondary twins at higher temperature. EELS analysis revealed that the band structure of sp2 sheets changed during the transition from h-BN to m-BN; the density of state for the pi* bond became prominently high in m-BN as compared to that in h-BN.

Reduced expression of the macrophage scavenger receptors in macrophage-like cell mutants resistant to brefeldin A

Brefeldin A (BFA)-resistant mutants, JB15, JB23 and JB33, were isolated from mutagenized murine macrophage-like (J774) cells and their modified low density lipoprotein (LDL) metabolism was studied. When JB23 cells, the most resistant clone, were incubated with acetylated LDL, intracellular accumulation of cholesteryl esters (CE) was reduced by 31% as compared with J774 cells. The cell-association of 125I-acetyl-LDL with, and subsequent endocytic degradation by JB23 cells were reduced by 40-60% compared with J774 cells. Western and Northern blot analyses showed that the protein and mRNA levels of the macrophage scavenger receptors (MSR) were reduced by 68% and 55% respectively in JB23 cells as compared with those in J774 cells. These results indicate that a putative BFA-target molecule(s) might regulate MSR gene expression as well as macrophage-derived foam cell formation.

Glycoxidation in aortic collagen from STZ-induced diabetic rats and its relevance to vascular damage

Glycoxidation reactions lead to the formation of permanent, irreversible chemical modifications and cross-links in protein, such as the glycoxidation products carboxymethyllysine (CML) and pentosidine. It has been implicated that CML as well as Amadori products play a role in the formation of superoxidative products, such as H2O2 and advanced glycosylation endproducts in trapping LDL. Therefore, a possible relationship between glycoxidation and lipoperoxidation might exist because oxidized lipoprotein, which has been directly linked to atheroma formation, could be produced by the superoxidative products released from the pathway of CML formation. Using a CML-specific monoclonal antibody (6D12) and a specific antiserum against hexitol-lysine (HL), an Amadori product, we studied the relationship between glycoxidation and lipoperoxidation by determining the aortic CML contents with ELISA and the fluorescence levels of lipoperoxidation side products, malondialdehyde (MDA) and hydroxynonenal (HNE) from STZ-induced diabetic rats and age-matched control rats. The immunohistochemical and ultrastructural changes relevant to glycoxidation and lipoperoxidation were also studied. The CML content measured by ELISA in DM rats was significantly higher than that in the control rats at 28 weeks (n = 11, P < 0.01). The levels of MDA-linked and HNE-linked fluorescence in the DM rats increased in a similar way and were significantly higher than the levels in control rats at 28 weeks (n = 11, both P < 0.01 at 28 weeks). The CML contents correlated with the fluorescence levels of both MDA-linked (n = 19, r = 0.638, P < 0.01) and HNE-linked fluorescence (n = 19, r = 0.629, P < 0.01) only in the DM rats, but not in the control rats. Our immunohistochemical study thus demonstrated that CML was initially formed in the aortic media of diabetic rats in the 16th week of diabetes, localized primarily in the extracellular matrix surrounding the aortic smooth muscle cells after HL occurred early in the 2nd week of diabetes. Consequently, a significant increase in the extracellular matrix and decrease in the area of the SMCs were observed in the aortic media in the DM rats by a morphometrical study. The in vivo results of this study provided the first evidence that CML correlated with fluorescence levels of MDA and HNE, and thus suggested the existence of a close relationship between glycoxidation and lipoperoxidation in vivo. This information is thus considered to shed some new light on the etiology of atherogenesis in diabetes.

Determination of glycated albumin by enzyme-linked boronate immunoassay (ELBIA)

A new affinity method for quantification of glycated albumin by an enzyme-linked boronate-immunoassay (ELBIA) has been established, based on the interaction between boronic acids and the cis-diols of glycated human serum albumin (HSA) trapped by anti-HSA antibody. To evaluate the ELBIA, we first examined the accuracy of the conventional boronate affinity chromatographic (BAC) method. In the BAC method, 8.1-18.9% of nonglycated albumin calibrator nonspecifically bound to the boronate affinity column, values that were regarded as the column blank. In the modified BAC method, therefore, we substracted the column blank value from the measured glycated albumin value to obtain the true value. Because glycated albumin values measured by ELBIA were exactly the same as reported by the modified BAC method, we suggest that the ELBIA results reflect the real status of albumin glycation. We have also developed a fully automated ELBIA system, allowing multiple, rapid, and precise measurements of glycated albumin.

[Participation in the IEC Workshop on Adolescent Sexual Health--a challenge to protect reproductive health/right in Latin America and Caribbean Region]

In order to explore the possibility of new global activity in nursing/midwifery to be performed by the WHO Collaborating Center for Nursing Development in Primary Health Care at St. Luke's College of Nursing, the center sent two faculty members to attend the IEC Workshop on Adolescent Sexual Health held in November 1996 in Mexico. The two representatives took part as resource persons and reported to the workshop on the activities of nurses and midwives for adolescent sexual health in Japan. During the session, they obtained information on the actual situation of adolescent sexual health in Latin America and Caribbean region and the novel strategies which were carried out in cooperation between governmental and non governmental organizations. The workshop also provided a good opportunity for international communication and information exchange with health workers in the region about adolescent sexual health. By participating in the workshop, we obtained first-hand information on various aspects of cooperation in international health.

[An experiment in a new method of nursing education--the problem-based learning for prenatal nursing]

At the opening of lectures in 1995 on the Science of maternity Nursing in the Special Subjects of Nursing, a problem-based learning was tried as a new educating method in the unit of "Prenatal Nursing." In the present paper, reviewing the introduction/implementation of the method, subjects in the future are described. This process contained two major flows, one was the training of tutors in problem-based learning, including participating the workshop held at McMaster University, and the other was the preparation for the class at the introduction of the new educational method, such as the overall subject composition and the development of teaching materials of prenatal nursing and resources, etc. according to the procedures of the problem-based learning. As the results of the actual implementation, various different reactions in comparison with the lecture method were observed both in tutors and students. As the subjects hereafter, the following three points have been clearly elucidated, that is, in order to proceed the problem-based learning under the present condition that it is not in the comprehensive curriculum, to prevent the overload and conflict in the student learning, considering and adjusting the relationship with contents and methods of concurrent subjects and units, to establish the system for tutorial assessment and evaluation, and to insure tutors and fulfill their training system.

Advanced glycosylation end products in adrenal lipofuscin

The present study examined the presence of advanced glycosylation end products (AGEs) in lipofuscin present in the brain and adrenal gland of aging rats by immunohistochemistry using antibodies raised against AGEs. Lipofuscin identified as yellow to brown granules emitting bright yellow to orange autofluorescence with ultraviolet light were detected in cortical neurons, cerebellar Purkinje cells, and adrenal cells in the inner part of the zona reticularis. However, none of the antibodies visualized lipofuscin in these areas. The outer part of the zona reticularis contained yellow granules emitting a faint orange autofluorescence. These granules were immunostained by an antibody that reacted with AGEs structures unrelated to the carboxymethyllysine moiety. Newly formed adrenal cortical cells are thought to migrate from the outer layer to the inner layer of the zona reticularis. Therefore, our results suggest that glycosylation-related processes are involved in lipofuscinogenesis, at least in its early stage, in the adrenal zona reticularis.

Relationship of testicular volume to semen profiles and serum hormone concentrations in infertile Japanese males

OBJECTIVE

We studied the relationship between testicular volume and semen quality and also between testicular volume and seminiferous tubular or Leydig cell function in infertile Japanese males.

METHODS

The testicular volumes of 486 infertile Japanese males were measured by an orchidometer. Semen samples were analyzed according to the guidelines of the World Health Organization. Serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone were measured by radioimmunoassay. The subjects were divided into 10 groups according to testicular volume, and the variables from each group were analyzed and compared.

RESULTS

Testicular volume had the strongest positive correlation with sperm density, followed in decreasing order by total sperm count per ejaculate, total motile sperm count per ejaculate, and percentage of motile sperm. Testicular volume had the strongest negative correlation with serum FSH concentrations, followed by serum LH concentrations. In contrast, no significant correlations were found between testicular volume and semen volume or serum testosterone concentrations. Multiple regression analysis of dependence of testicular volume on semen profiles and serum hormone concentrations revealed that the only significant factor was serum FSH concentration. Sperm density was under the limit of normal in patients with a testicular volume of less than 30 mL. In these patients, serum FSH concentrations were abnormally increased. Patients with a testicular volume of less than 10 mL were azoospermic, while volumes of less than 20 mL were associated with severe oligozoospermia.

CONCLUSIONS

Testicular volume has a direct correlation with semen profiles, and the critical testicular volume indicating normal testicular function is approximately 30 mL. The measurement of testicular volume can be helpful for rapidly assessing fertility at the initial physical examination.

Immunochemical evidence for increased formation of advanced glycation end products and inhibition by aminoguanidine in diabetic rat lenses

Water-soluble and urea-soluble protein fractions from control and streptozotocin-diabetic rats were analyzed for AGEs with a CML-specific monoclonal anti-AGE antibody and a polyclonal anti-AGE antibody. AGEs, CML in particular, were significantly increased in the diabetic rats whereas aminoguandine treatment resulted in significant decrease in AGEs. The data also confirm that CML, a glycoxidation product, is a major epitope of AGE structures in lenses.