Ultrastructural evidence for colocalization of kappa light chain- and beta 2-microglobulin-derived amyloids using double labelling immunogold electron microscopy

In systemic amyloidosis, it is essential to decide what type of amyloid protein is deposited in tissues before the therapy can be selected and the prognosis assessed in each patient. We examined tissues affected by amyloid deposition from a patient with multiple myeloma by immunohistochemistry and double labelling immunogold electron microscopy and demonstrated colocalization of kappa light chain- and beta 2-microglobulin-derived amyloids in the same tissue. beta 2-Microglobulin-derived amyloid had ultrastructurally characteristic features that distinguished it from kappa light chain-derived amyloid. This is the first report of the colocalization of two different amyloids by immunoelectron microscopy.

Deficiency in nitric oxide bioactivity in epicardial coronary arteries of cigarette smokers

OBJECTIVES

This study sought to examine nitric oxide-mediated regulation of epicardial coronary arterial tone in cigarette smokers.

BACKGROUND

Cigarette smoking is a major risk factor for coronary artery disease and is highly prevalent in patients with coronary spastic angina. Long-term exposure to cigarette smoking has been recently reported to suppress endothelium-dependent arterial relaxation in vivo humans.

METHODS

Responses of epicardial coronary artery diameter to single or combined infusion of acetylcholine and NG-monomethyl-L-arginine (L-NMMA) into the left main coronary artery were examined in 11 current smokers and 17 nonsmokers using quantitative coronary angiography.

RESULTS

Acetylcholine dilated one-third of the proximal segments and most of the distal segments of coronary arteries in nonsmokers, whereas it constricted most of the proximal and distal segments in smokers. L-NMMA decreased the basal diameter of coronary arteries in nonsmokers but had minimal effect on the basal diameter in smokers. L-NMMA abolished the dilator response to acetylcholine in the coronary arteries of nonsmokers but had minimal effect on the constrictor response to acetylcholine in the arteries of smokers. The dilator response to nitroglycerin was significantly increased in the coronary arteries of smokers compared with in those of nonsmokers. The constrictor response to L-NMMA at rest was significantly correlated with the dilator response to nitroglycerin and with the diameter changes to acetylcholine in both smokers and nonsmokers.

CONCLUSIONS

Nitric oxide bioactivity at rest and at acetylcholine-stimulated conditions in smokers was decreased, leading to the supersensitivity of the artery to the dilator effect of nitroglycerin as well as the constrictor effect of acetylcholine in smokers. Cigarette smoking affects nitric oxide-mediated regulation of coronary artery tone.

[Effects of lacidipine, a new dihydropyridipine derivative, on various cerebral ischemia models]

We examined the cerebral protective effects of lacidipine (L) using three different types of cerebral ischemia models, and the effects were compared with those of nicardipine (N). (1) In the transient forebrain ischemia model of the rat, oral administration of L (0.3 and 1 mg/kg) before ischemia significantly decreased the number of acidophilic neurons in CA1 regions of the hippocampus 7 days after ischemia. N (3 mg/kg, p.o.) before ischemia also produced a significant reduction in the number of acidophilic neurons, and it's effectiveness was almost the same as that of L (1 mg/kg). (2) In the focal cerebral ischemia model of the rat, oral administration of L (1 and 3 mg/kg) before of after left middle cerebral artery occlusion (MCAO) significantly reduced infarct size at 24 hr after MCAO. Such an ameliorative effect was also observed when N was administered orally. However, the effect of N at 30 mg/kg was less than that of L at 1 mg/kg. (3) In the delayed cerebral vasospasm model of the dog after subarachnoid hemorrhage (SAH), intravertebral artery injection of L (10 micrograms/kg) or N (10 micrograms/kg) dilated the contracted basilar artery 3 days after SAH to the level before SAH. Finally, while both L and N increased cerebral blood flow (CBF) in a dose-dependent manner in conscious normal rat, the increment of CBF induced by L at a given level of reduced-blood pressure was greater than that induced by N. These results indicate that lacidipine may be a potential therapeutic agent that exerts a protective effect against brain damage after cerebral ischemia.

Menstrual cyclic variation of endothelium-dependent vasodilation of the brachial artery: possible role of estrogen and nitric oxide

Estrogens have been reported to influence endothelial functions. This article's aim is to examine whether endothelium-dependent vasodilation of brachial arteries is changed in parallel with the physiological variation of the ovarian hormones during the menstrual cycle in young healthy female subjects. With high-resolution ultrasonography, we measured the diameter and blood flow of brachial arteries at rest, during reactive hyperemia, and after sublingual nitroglycerin administration in 15 young healthy female subjects (mean 29.6 +/- 2.6 years). All female subjects were studied in each of three different phases of one menstrual cycle (M, menstrual phase; F, follicular phase; L, luteal phase). The increase in arterial diameter during reactive hyperemia was lowest in the menstrual phase and highest in the follicular phase (4.9 +/- 0.8% in M; 14.1 +/- 0.9% in F; 9.2 +/- 1.1% in L; p < 0.005 between any two means among the groups). No significant difference was apparent in the percentage of increase in blood flow during reactive hyperemia among the three phases. The percentage of increase in arterial diameter after nitroglycerin administration also was not significantly different among the three phases of the cycle. The serum estradiol level was lowest in the menstrual phase and was highest in the follicular phase (17.5 +/- 1.6 pg/ml in M, p < 0.0005, M versus F and L; 107.8 +/- 18.0 pg/ml in F, p < 0.05, F versus L; 74.4 +/- 7.3 pg/ml in L). The serum level of nitrite-nitrate, measured by the Griess reaction, was highest in the follicular phase and was lowest in the menstrual phase of the three different phases (40.4 +/- 7.9 mumol/l in M, p < 0.01, M versus F, and p < 0.05, M versus L; 106.7 +/- 17.6 mumol/l in F, p < 0.05, F versus L; 62.2 +/- 6.2 mumol/l in L). In conclusion, a significant variation of the endothelium-dependent vasodilation parallels the levels of serum estradiol and nitrite-nitrate during the menstrual cycle in female subjects.

Neurons in the caudal ventrolateral medulla projecting to the paraventricular hypothalamic nucleus receive synaptic inputs from the nucleus of the solitary tract: a light and electron microscopic double-labeling study in the rat

We used light and electron microscopic techniques to investigate the possibility that neurons in the nucleus of the solitary tract (NST) might send projection fibers to neurons in the caudal ventrolateral medulla (CVLM) projecting to the paraventricular hypothalamic nucleus (PVN) by the anterograde and retrograde double labeling method in the rat. The retrograde tracer, wheat germ agglutinin-conjugated horseradish peroxidase-colloidal gold complex, was injected into the PVN, and the anterograde tracer, Phaseolus vulgaris leucoagglutinin (PHA-L), was injected into the NST of each rat. Many retrogradely labeled neurons were encountered in the CVLM, including the A1 region. On the other hand, a dense network of anterogradely labeled terminals was found in the CVLM. Electron microscopic examination revealed synaptic contacts between PHA-L-immunoreactive nerve terminals and dendrites of retrogradely labeled neurons in the CVLM. The results indicate that CVLM neurons projecting to the PVN receive axon terminals of NST neurons.

Role of adenosine in pathogenesis of syndrome X: assessment with coronary hemodynamic measurements and thallium-201 myocardial single-photon emission computed tomography

OBJECTIVES

This study was performed 1) to examine the role of adenosine in the pathogenesis of syndrome X in patients with this syndrome and abnormal results on myocardial scintigrams during exercise, and 2) to determine the susceptibility to myocardial ischemia in this subset of patients with syndrome X.

BACKGROUND

A role for adenosine in the pathogenesis of syndrome X has recently been postulated, but there are few clinical data supporting this hypothesis.

METHODS

Exercise thallium-201 myocardial scintigraphy after intravenous administration of aminophylline, an adenosine receptor blocking agent, or saline solution and adenosine thallium-201 scintigraphy were performed in 26 patients with syndrome X. Hemodynamic variables during exercise and perfusion defect size after aminophylline and saline infusions were compared. At cardiac catheterization, coronary hemodynamic variables during separate infusions of adenosine and doubutamine were also examined and were compared among patients with abnormal or normal scintigrams and 10 control subjects.

RESULTS

Perfusion abnormalities on exercise-thallium-201 scintigraphy occurred in 14 of 26 patients with syndrome X. Intravenous infusion of aminophylline suppressed the scintigraphic perfusion defect and prolonged the time to 1-mm ST segment depression in patients with syndrome X with abnormal exercise scintigrams. Intravenous infusion of adenosine induced a perfusion defect in the same myocardial area where the perfusion defect was observed at exercise in 7 of the 14 patients with syndrome X. At cardiac catheterization, patients with syndrome X with abnormal exercise scintigrams had lower coronary flow reserve and a greater frequency of myocardial lactate production and ST segment depression in response to the infusions of adenosine and doubtamine than did the other two groups. During adenosine infusion, great cardiac vein blood flow and oxygen content were significantly increased and myocardial oxygen consumption and lactate extraction were significantly reduced from baseline without a significant increase in rate-pressure product in this subset of patients with syndrome X.

CONCLUSIONS

Patients with syndrome X with abnormal exercise scintigrams have high susceptibility to myocardial ischemia during exercise or pharmacologic stress tests, probably owing to reduced coronary flow reserve. A heterogeneous response to endogenous adenosine may contribute to scintigraphic perfusion abnormalities and myocardial ischemia during exercise in this subset of patients with syndrome X.

Immunohistochemical study with anti-advanced glycation end-products antibody in murine amyloidosis

Advanced glycation end-products (AGE) are formed in the late phase of the non-enzymatic glycosylation reaction in conditions such as diabetes mellitus and aging. In amyloidosis, AGE have been found in the A beta 2M amyloid associated with long-term hemodialysis and in the beta-protein in Alzheimer's disease. Murine AApoAII and AA amyloidosis were examined immunohistochemically using anti-AGE monoclonal antibody, 6D12. AApoAII amyloid deposits studied in one senescence-accelerated mouse P1 (SAMP1), congenic mice that have the amyloidogenic apolipoprotein A-II of SAMP1 mice, and AKR mice all reacted with biotinylated 6D12 by formic acid pretreatment, whereas AA amyloid deposits did not react with the antibody. The immunoreaction with anti-apolipoprotein A-II for amyloid deposits in senile mice was approximately homogeneous in intensity; on the other hand the reaction with biotinylated 6D12 was irregular in distribution and intensity over the amyloid deposits. These findings suggest that amyloid precursor proteins are not associated uniformly with AGE modification before deposition as amyloid; it is more likely that the AGE modification progresses gradually and unevenly after amyloid deposition. Murine amyloidosis may be a useful model to elucidate the role of AGE in amyloidosis.

Nitric oxide activity is deficient in spasm arteries of patients with coronary spastic angina

BACKGROUND

Coronary spasm can be induced by acetylcholine, serotonin, ergonovine, or histamine, all of which cause vasodilation when the endothelium is intact by releasing nitric oxide (NO). Coronary spasm is promptly relieved by nitroglycerin, which vasodilates through its conversion to NO. It is thus possible that NO release may be deficient in the spasm arteries in patients with coronary spastic angina (CSA). The aim of this study was to determine whether NO release is deficient in coronary arteries of patients with CSA.

METHODS AND RESULTS

NG-monomethyl-L-arginine (L-NMMA), an inhibitor of NO synthase, was infused into coronary arteries in 21 patients with coronary spastic angina (CSA) and in 28 control patients. Coronary spasm was induced by intracoronary injection of acetylcholine and was documented angiographically in all patients with CSA. L-NMMA dose-dependently decreased basal luminal diameter of coronary arteries in control patients, whereas it had no effect on basal diameter of the spasm arteries in patients with CSA. L-NMMA abolished the dilator response to acetylcholine and enhanced the constrictor response to acetylcholine in control arteries, whereas it had no effect on the constrictor response to acetylcholine in spasm arteries. Intracoronary infusion of L-arginine did not affect the diameter of spasm or control arteries. The dilator response to nitroglycerin was increased markedly in spasm arteries compared with control arteries, whereas response to diltiazem did not differ between them.

CONCLUSIONS

There is a deficiency in endothelial NO activity in spasm arteries, which leads to the supersensitivity of the artery to the vasodilator effect of nitroglycerin and to the vasoconstrictor effect of acetylcholine in patients with CSA. This deficient endothelial NO activity plays an important role in the pathogenesis of coronary spasm.

Is there a direct retina-raphe-suprachiasmatic nucleus pathway in the rat?

Possible pathways from the retina to the suprachiasmatic nucleus (SCN) relaying in the dorsal raphe nucleus (DRN) were investigated in rats using combined anterograde and retrograde tracing with immunohistochemistry. After injection of wheat germ agglutinin-conjugated horseradish peroxidase-colloidal gold complex into the SCN, many neurons were retrogradely labeled in the middle levels of the DRN. Approximately one half of these neurons contained serotonin. After injection of cholera toxin B subunit into the eyes, a few anterogradely labeled afferent fibers were detected in the rostral DRN, however, not in contact with retrogradely labeled neurons. Our findings provide direct evidence that serotonergic projections to the rat SCN stem from the DRN nuclei. They also suggest that retina-raphe-SCN projections, a presumed third visual input to the mammalian circadian pacemaker, may include further neuronal connections or brain sites.

Molecular cloning and characterization of a novel form of neuropeptide gene as a developmentally regulated molecule

To examine the molecular basis controlling neuronal differentiation, subtraction library construction and differential screening were used to identify cDNAs whose mRNA levels are regulated in mouse NS20Y cells by dibutyryl cyclic AMP treatment. One of them, N27K, whose mRNA increases transiently during both neuronal differentiation in NS20Y cells and development in mouse brain. The deduced amino acid sequence of N27K comprises 212 amino acid residues and is a novel form of a precursor protein for a new neuropeptide nociceptin/orphanin FQ, which we independently cloned as N23K. That is, the putative protein encoded by N27K is 25 amino acids longer than that encoded by N23K. Using an antibody against a C-terminal peptide of the N27K protein that recognizes a 27-kDa protein in Western blot analysis, a punctate structure in the perinuclear region and areas near the tip of neurites is visualized in neurally differentiating NS20Y cells. The time of maximal expression correlates with periods of neurite extension, and expression decreases as the neuritic network develops. Immunohistochemistry of tissue sections of the mouse central nervous system revealed that reactivity for the anti-N27K protein antibody can detected in early generated neurons at embryonic day 14, in virtually all immature neurons at postnatal day 1, and in subsets of neurons of discrete brain regions such as the hypothalamus and spinal cord in adults. This remarkable redistribution suggests that N27K may be involved in a process in neurite outgrowth and nervous system development.

Meningeal sinus histiocytosis mimicking lymphoplasmacyte-rich meningioma. Case report

Extranodal sinus histiocytosis with massive lymphadenopathy involving the meninges is a rare clinical entity. The authors describe the unusual case of an occipital meningeal lesion in a 25-year-old man in whom they found inflammation of the occipital lobe mimicking lymphoplasmacyte-rich meningioma. The clinical similarities and differences are discussed.

Repeating hemorrhage with a long duration after radiotherapy for glioma: radiological and histological observations

A case of radiation necrosis which was observed 6 years after radiotherapy for a glioma in the right parietal lobe is reported. This patient developed hemiparesis, and radiological examinations showed similar findings consisted with recurrent glioma. Histological examination disclosed the lesion to be radiation necrosis. Repeated episodes of hemorrhage and cystic formation in the right hemisphere appeared during 8 to 10 years after radiotherapy, and removal of the mass lesion conducted four times. Histological examinations of each specimen showed the increasing proliferation of neo-vessels accompanied by hemorrhage and cystic formation.

Monoclonal antibodies (NU-T1 and NU-T2) recognizing antigens expressed on human T cells

Two murine monoclonal antibodies (mAb) designated as NU-T1 and NU-T2 were generated to identify the novel antigens expressed on human T cells. NU-T1 reacted with peripheral blood T cells, but not with granulocytes or monocytes, whereas NU-T2 were not reactive with peripheral blood lymphocytes, granulocytes or monocytes. Both NU-T1 and NU-T2 reacted with thymocytes. The incidence of NU-T1 or NU-T2 reactivity with the leukemic cells from patients with various types of leukemia was as follows: 12/12 or 4/12 in acute lymphocytic leukemia (ALL) of T cell type, 6/6 or 0/7 in adult T cell leukemia, 0/6 or 0/19 in ALL of non-T non-B cell type, and 0/8 or 0/8 in acute myelocytic leukemia, respectively. The incidence of NU-T1 and NU-T2 reactivity with human leukemic T cell lines were 4/10 and 5/10, respectively. In contrast, neither NU-T1 nor NU-T2 reacted with B cell lines, non-T non-B cell lines, or myeloid cell lines tested. These results indicate that NU-T1 and NU-T2 recognize two distinct differentiation antigens expressed on the cells in the T cell lineage. These mAb would be useful reagents to study the function of human T cells and the immunophenotyping of human T cell malignancies.

Morphological study of vagal innervation in human semilunar valves using a histochemical method

To determine the innervation of human semilunar valves, we examined the pulmonary and aortic valves of the normal autopsied hearts of 3 men (53 to 71 years old). Whole valve tissues with the aorta or pulmonary trunk were stained for acetylcholinesterase by a histochemical method. Acetylcholinesterase-positive nerve fibers with a diameter of 2 to 20 mm were located on the ventricular side of the semilunar valves. Innervation of the semilunar valves was extremely sparse compared with that of the atrioventricular valves and that of the aortic or pulmonary arterial wall. The nerves originated from the subendocardium of the ventricles and the adventitia of the arterial walls. The nerves were more distributed in the basal site than in the marginal site of the semilunar valve. The nerve fibers formed a network in basal two-thirds of the leaflet. Thick nerves ramified in the thin nerve plexus. The thick nerves had a varicose-like structure. Thin nerves had a dot- and brush-like ending. The nerves in human semilunar valves may play a role in valve motion.

The POU domain transcription factor Brn-2 is required for the determination of specific neuronal lineages in the hypothalamus of the mouse

We generated mice carrying a loss-of-function mutation in Brn-2, a gene encoding a nervous system specific POU transcription factor, by gene targeting in embryonic stem cells. In homozygous mutant embryos, migratory precursor cells for neurons of the paraventricular nuclei (PVN) and the supraoptic nuclei (SO) of the hypothalamus die at approximately E12.5. All homozygous mutants suffered mortality within 10 days after birth, possibly because of a complete deficiency of these neurons in the hypothalamus. Although neither developmental nor histological abnormalities were observed in heterozygous mice, the levels of expression of vasopressin and oxytocin in the hypothalamus of these animals were half these of wild-type mice. These results strongly suggest that Brn-2 plays an essential role in the determination and development of the PVN and SO neuronal lineages in the hypothalamus.

Distribution of PASII/PMP22 and connexin 32 proteins in the peripheral nervous system

Various mutations of PO, PASII/PMP22 and connexin 32 genes were recently reported in hereditary neuropathies, such as Charcot-Marie-Tooth disease (CMT) and Dejerine Sottas disease (DS). However, physiological roles of the proteins in PNS are not well understood. To address the functions of the proteins, we examined their localization in PNS comparatively by immunohistochemical methods. In Western blotting, a polyclonal antibody against the carboxyl terminal peptide of PASII/PMP22 reacted to 20-24 kD bands of PASII/PMP22 in mammalian PNS myelin, but produced no reaction in either mammalian or carp CNS myelin proteins. Monoclonal anti-connexin 32 antibody recognised connexin 32 of a dimer or monomer form in rat and human PNS myelin. By histological examination, PASII/PMP22 expressed dominantly in rat PNS compact myelins, while connexin 32 localized exclusively in the nodes of Ranvier, but not in compact myelins. In cell culture, axonal contact induced a remarkable increase of PASII/PMP22 in the Schwann cell in contrast to faint staining in immature Schwann cells. While localization of connexin 32 is quite different from that of PASII/PMP22, the mutations of the two proteins often induce similar phenotypes of hereditary neuropathies.

Hepatic amyloidosis in Japan: histological and morphometric analysis based on amyloid proteins

To investigate the relationship between the tissue distribution and the types of amyloid proteins, the detailed histopathologic features of the available liver in 284 cases of amyloidosis were examined. We classified hepatic amyloidosis into three types, namely, the vascular pattern, parenchymal pattern, and stromal pattern according to the topographic distribution pattern of amyloid. Of the 152 amyloid A (AA) cases, all but one exhibited the vascular pattern; the single exception had the parenchymal pattern. Among 117 amyloid light chain (AL) cases, 51.3% exhibited the vascular pattern and 43.6% the parenchymal pattern. The stromal pattern was observed in 5.1% of the cases but was found only in AL amyloidosis. The parenchymal and stromal patterns in the liver seemed to be characteristic morphological distributions of AL amyloidosis. Routine histochemical study is useful to distinguish AL from AA, although some ethnic differences were apparent. Morphometric results showed that the walls of the hepatic arteries with amyloid deposition were significantly thicker than walls in arteries from the control group. The arterial walls in AA amyloidosis, especially, were significantly thicker than walls in AL amyloidosis of any pattern.

[A study on the rhodopsin gene in Japanese retinitis pigmentosa--screening of mutation by restriction endonucreases and frequencies of DNA polymorphisms]

We analyzed 11 sites of the rhodopsin gene using polymerase chain reaction (PCR) amplification and restriction endonucleases in 30 unrelated Japanese patients with autosomal dominant retinitis pigmentosa (ADRP). No point mutation was found in any patient. The frequencies of the single nucleotide (nt) substitution at nt 269, nt 5145 and nt 5321 were examined in three groups, 38 unrelated patients with ADRP, 23 patients with autosomal recessive retinitis pigmentosa (ARRP), and 67 normal controls. There was no significant difference in the frequencies of substitution among these three groups. The frequencies of A269G, G5145A, and C5321A were 52%, 36%, and 5%, respectively. These values were different from those of the American population. The polymorphisms, A269G and G5145A, are useful as DNA makers for linkage analysis.

A histochemical and electron microscopic study of skeletal and cardiac muscle from a Fabry disease patient and carrier

Histochemical and electron microscopic studies were performed in an attempt to clarify the muscle pathology in an 18-year-old man with Fabry disease, showing proximal limb muscle atrophy, and his 52-year-old mother, who is a Fabry carrier with hypertrophic cardiomyopathy. Despite the relatively mild myopathic changes revealed by histochemistry, electron microscopy demonstrated the widespread accumulation of abundant lamellated bodies in myofibers, associated with increased glycogen granules and autophagic vacuoles. The cardiac muscle of the proband's mother revealed a mosaic pattern of normal-appearing and hypertrophic myofibers containing a number of ring-like, lamellated bodies. Although further studies are necessary to support our findings, skeletal muscle is apparently involved in patients with Fabry disease, and a mosaic pattern of cardiac muscle involvement possibly reflecting Lyonization, may be one of the characteristic findings of a Fabry disease carrier.