Structure and regional distribution of nociceptin/orphanin FQ precursor

We have cloned cDNA carrying the entire coding sequence of the precursor protein for nociceptin/orphanin FQ, a neuropeptide-ligand for an opioid-receptor like G-protein coupled receptor. The deduced nociceptin/orphanin FQ precursor shows sequence similarity to the opioid peptide precursors and shares characteristic structural features particularly with preprodynorphin. In situ hybridization analysis of nociceptin precursor mRNA in the mouse central nervous system revealed that it is highly expressed in discrete neuronal sites with the pattern distinct from those of opioid peptides.

Two-year follow-up study of the effect of acid fog on adult asthma patients

Acid fog is a complex mixture of atomospheric pollutants containing multiple stimuli that may be capable of inducing bronchoconstriction. To investigate the effect of ambient acid fog on bronchoconstriction, we examined the relation between the hospital visit for asthma symptoms of 102 patients and various meteorological conditions for over the two-year period from January 1992 to December 1993. Dense fog occurs frequently every summer in Kushiro, a city located in Hokkaido, northernmost island in Japan. The acidity of the fog ranged from pH 3.32 to 6.91 (mean pH = 5.05) during this period. A significant increase (p < 0.05) of hospital visits on a foggy day was found in 9 cases, and a tendency (p < 0.10) was found in 10 cases. The odds ratio for a hospital visit on a high water vapor pressure day (> 12 h Pa) was significantly high (p < 0.01) in 5 cases among the above 19 cases. To exclude the effect of high water vapor pressure, the data was restricted to the condition of a foggy day with low water vapor pressure (< 12 hPa); 9 patients had a significant increase (p < 0.05) in hospital visits on such a day. These results indicated that hospital visits for asthma symptoms was increased on acid fog days in 8.8% of adult asthma patients. Inhalation of naturally occurring acid fog may have adverse effects on the respiratory tract of the asthmatic patient.

Dose-response relationship between coffee and the risk of pancreas cancer

A case-control study was conducted and previous epidemiological data were reviewed in order to investigate the dose-response relationship between coffee and the risk of pancreas cancer. The case-control study was community-based and was carried out in Hokkaido, Japan, employing 141 patients with pancreas cancer and 282 controls (two for each case) matched for sex, age and place of residence. The dose-response relationship between coffee (cups/day) and the relative risk of this disease formed a U-shaped curve. The lowest relative risks (0.18 for male and 0.53 for female) were found among "occasional" drinkers. Epidemiological articles published between 1981 and 1993 were selected from Index Medicus using the two key words "coffee" and "pancreas cancer". In many of the previous case-control studies the curve of the dose-response relationship was also U-shaped, when the relative risks were calculated specifically using four or five levels of coffee dose. The nadirs of the relative risks, most of which ranged from 0.5 to 0.7, were found most frequently at small doses (1-2 or 3-4 cups/day). The results of meta-analysis of these studies formed a U-shaped curve. Studies of other types showed almost the same results. Thus it appears that small amounts of coffee might prevent pancreas cancer, whereas large amounts might cause the disease.

Efficacy of mandibular topical anesthesia varies with the site of administration

This study compared the threshold of pain sensitivity in the anterior mandibular mucobuccal fold with the posterior. This was followed by a comparison of the reduction of needle insertion pain in the anterior mucobuccal fold and the pterygo-temporal depression by either topical anesthesia or nitrous oxide inhalation. The pain threshold was determined by an analgometer, a pain-measuring device that depends on pressure readings; additionally, pain caused by a needle inserted by a normal technique was assessed using a visual analog scale (VAS). The threshold of pain was significantly lower in the incisor and canine regions than in the premolar and the molar regions (P < 0.001). Compared to a placebo, topical anesthesia significantly reduced the pain from needle insertion in the mucobuccal fold adjacent to the mandibular canine (P < 0.001), but did not significantly reduce pain in the pterygotemporal depression. The addition of 30% nitrous oxide did not significantly alter pain reduction compared to a control of 100% oxygen. These results suggest that topical anesthesia application may be effective in reducing the pain of needle insertion in the anterior mandibular mucobuccal fold, but may not be as effective for a standard inferior alveolar nerve block. The addition of 30% nitrous oxide did not lead to a significant improvement.

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.

Chronological changes of characteristics of early gastric cancer and therapy: experience in the Cancer Institute Hospital of Tokyo, 1950-1994

Gastric cancer, the leading cause of death from cancer in Japan, has long been studied. We received our first patient with early gastric cancer in 1950 and have since treated 2382 patients with this cancer up to 1990. The percentage of early gastric cancers diagnosed has been on the increase following the improvement in diagnostic skills and the establishment of mass screening. At present, more than half of the gastric cancers presenting are in the early stages. Chronological changes in diagnoses of early gastric cancer are characterized by the increased findings of (a) small tumors less than 4 cm in diameter (b) depressed-type carcinoma (c) lesions of the upper part of the stomach, and (d) undifferentiated-type adenocarcinoma. The standard method of treatment for early gastric cancer was standard radical operation in the 1970s. In the 1980s endoscopic mucosal resection and limited operation were adopted and their use has been increasing annually. The prognosis for early gastric cancer is quite favorable (the 5-year survival rate is more than 90%), and it is regarded as a disease with good prognosis. To obtain still better therapeutic results, it is essential to increase the proportion of early gastric cancers where endoscopic mucosal resection or limited operation is indicated, and improve the techniques of those procedures.

Ca(2+)-induced Ca2+ release in myocytes from dyspedic mice lacking the type-1 ryanodine receptor

While subtypes 1 and 2 of the ryanodine receptor (RyR) function as intracellular Ca2+ release channels, little is known about the function of the third subtype (RyR-3), first identified in brain. Myocytes from mice homozygous for a targeted mutation in the RyR-1 gene (dyspedic mice) can now be used for a study on the function of RyR-3, which is predominantly expressed in these cells according to our reverse transcription-polymerase chain reaction analysis. We here demonstrate in these myocytes caffeine-, ryanodine- and adenine nucleotide-sensitive Ca(2+)-induced Ca2+ release with approximately 10 times lower sensitivity to Ca2+ than that of RyR-1. Although RyR-3 does not mediate excitation-contraction coupling of the skeletal muscle type, we propose that RyR-3 may induce intracellular Ca2+ release in response to a Ca2+ rise with a high threshold.

A case of steatocystoma multiplex with prominent cysts on the scalp treated successfully using a simple surgical technique

The case described is a 35-year-old male with multiple cysts on the upper half of his body. This patient was diagnosed as having steatocystoma multiplex, based on clinical and histological findings. The lesions consisted of widespread and unusually prominent cysts, which were removed by a simple surgical technique using a dermatological trepan and artery forceps. We provide here a detailed description of the surgical procedures employed.

Abnormal junctions between surface membrane and sarcoplasmic reticulum in skeletal muscle with a mutation targeted to the ryanodine receptor

Junctions that mediate excitation-contraction (e-c) coupling are formed between the sarcoplasmic reticulum (SR) and either the surface membrane or the transverse (T) tubules in normal skeletal muscle. Two structural components of the junctions, the feet of the SR and the tetrads of T tubules, have been identified respectively as ryanodine receptors (RyRs, or SR calcium-release channels), and as groups of four dihydropyridine receptors (DHPRs, or voltage sensors of e-c coupling). A targeted mutation (skrrm1) of the gene for skeletal muscle RyRs in mice results in the absence of e-c coupling in homozygous offspring of transgenic parents. The mutant gene is expected to produce no functional RyRs, and we have named the mutant mice "dyspedic" because they lack feet--the cytoplasmic domain of RyRs anchored in the SR membrane. We have examined the development of junctions in skeletal muscle fibers from normal and dyspedic embryos. Surprisingly, despite the absence of RyRs, junctions are formed in dyspedic myotubes, but the junctional gap between the SR and T tubule is narrow, presumably because the feet are missing. Tetrads are also absent from these junctions. The results confirm the identity of RyRs and feet and a major role for RyRs and tetrads in e-c coupling. Since junctions form in the absence of feet and tetrads, coupling of SR to surface membrane and T tubules appears to be mediated by additional proteins, distinct from either RyRs or DHPRs.

Mortality of inhabitants in an area polluted by cadmium: 15 year follow up

OBJECTIVE

To assess the influence of environmental exposure to cadmium (Cd) on long term outcome of inhabitants living in an area polluted by Cd.

METHODS

A follow up study for 15 years (from 1974-5 to 1991) was carried out on 2408 inhabitants (amounting to 95% of the target population, 1079 men and 1329 women) of the Kakehashi River basin in Ishikawa Prefecture, Japan. These inhabitants had been the subjects of the health impact survey in 1974-5 to evaluate (by measurement of urinary retinol binding protein (RBP)) renal dysfunction induced by Cd. Analysis of mortality was performed by dividing subjects into a urinary RBP positive (> or = 4 mg/l) group and RBP negative (< 4 mg/l) group.

RESULTS

After adjustment for age with Cox's proportional hazard model, RBP > or = 4 mg/l showed a significant relation to mortality in both sexes. At this time, the mortality risk ratio of the RBP positive to negative group was 1.71 in the men and 1.42 in the women. When the SMRs according to causes of deaths in the RBP positive group were compared with those of the RBP negative group or the overall Japanese population increases of SMR for cardiovascular diseases, especially heart failure, and renal diseases were found in both sexes.

CONCLUSION

These results suggest that the prognosis of the exposed inhabitants with renal tubular dysfunction is unfavourable, and these increases of mortality are due to heart failure and renal diseases.

[Effect of fog on diurnal changes in peak expiratory flow rates in an asthmatic]

To evaluate the effects of fog on asthmatics, we analyzed the symptoms of a 45-year-old female during the foggy season and the relation between diurnal peak expiratory flow rate (PEFR) and fog and other meteorological factors. Her asthma attacks had been induced by specific smells: perfume, smoke from burning grass or industrial smoke. Two years previously, she had moved to the suburbs of Sapporo, where fog frequently occurs. From that time her asthmatic symptoms had been exacerbated, so it was suspected that the fog might have had some influence. We analyzed 251 measures of PEFR from June to August 1994. The average and standard deviation of PEFR in the absence of fog and specific smells was 403 +/- 40 L/min (n = 195). PEFR was significantly lower (p < 0.01) when it was foggy (347 +/- 60 L/min; n = 40), when specific smells were present (333 +/- 60 L/min; n = 5) and when there were both fog and specific smells (340 +/- 53 L/min: n = 11). On the other hand, there were no changes associated with other meteorological factors: barometric pressures, relative humidity, mean temperature, minimal temperature and most frequent wind direction. These results suggested that the inhalation of fog decreases PEFR and is an exacerbating factor in bronchial asthma.

Transient nephrogenic diabetes insipidus accompanied by possible psychogenic polydipsia

A 50-year-old Japanese man had been suffering from polydipsia and polyuria for 2 months without any other specific symptoms. His daily urinary output reached 5 liters. On admission, no abnormalities of the kidneys, heart, thyroid, adrenals, pituitary or hypothalamus were detected by laboratory tests and MRI of the head. Pure psychogenic polydipsia was ruled out because his urine volume did not decrease sufficiently with 18 h of water deprivation and the subsequent injection of aqueous vasopressin. Plasma arginine vasopressin (AVP) levels against plasma osmolality remained within the normal range during the test. These results indicated that diabetes insipidus in this case was caused by renal insensitivity to AVP. The symptoms disappeared spontaneously, and marked improvement was observed in a second water deprivation test 1 month later, although the maximum urine concentration was still subnormal. The combination of both latent insufficiency of AVP secretion and impairment of the renal countercurrent system induced by psychogenic polydipsia was speculated as a possible mechanism for the transient nephrogenic diabetes insipidus in this case.

Effects of glucocorticoid on neurones of rat dentate gyrus in dissociated culture

This study was undertaken to evaluate the short-term effects of glucocorticoid on the morphological characteristics of cultured rat dentate gyrus (DG) cells using immunocytochemistry for a cytoskeletal protein, micro-tubule-associated protein 2 (MAP2). A selective cell culture system of DG neurons was successfully established. Synthetic glucocorticoid, dexamethasone (DEX) increased the total length of immunoreactive (IR) processes of the DG neurones in a dose-dependent manner. DEX also increased the ratio of multipolar neurones with more than three processes. The area of cell body of immunoreactive processes increased with 5 microM DEX treatment. Our results suggest that cytological features of DG cells are strongly influenced by the action of glucocorticoid.

Structure and chromosomal mapping of genes for the mouse kappa-opioid receptor and an opioid receptor homologue (MOR-C)

Recent cDNA cloning studies have defined four members of the opioid receptor family, i.e., delta-, mu- and kappa-subtypes, and an opioid receptor homologue for unknown ligands. In this report, we isolated and analyzed mouse genomic DNA segments containing the kappa-opioid receptor gene and a gene for the opioid receptor homologue (designated as MOR-C). The genes are closely related each other in exon-intron organization, suggesting their evolutional relationship. Using in situ hybridization, we show that the kappa-opioid receptor gene and the MOR-C gene map to mouse chromosome 1A2-3 and 2H2-4, respectively.

A trial to discriminate spontaneous regression from non-regression cases during mass screening for neuroblastoma

We tried to discriminate between cases of spontaneous regression and non-regression during mass screening for neuroblastoma, taking advantage of differences in respect to the urinary homoranillic acid/vanillyl mandelic acid (HVA/VMA) ratio and the original tumor site among true positive, false negative and natural occurrence cases. After classifying them into a total of six groups depending on the two factors, ratio: < 1, 1-2 or > or = 2 and tumor site: adrenal or extra-adrenal in origin, we calculated the mathematical probability of a given true positive case being one of spontaneous regression. A tumor of extra-adrenal origin was likely to regress spontaneously, especially one with an HVA/VMA ratio < 1 or > or = 2 (82.2-100%). A tumor of adrenal origin with an HVA/VMA ratio < 1 seemed unlikely to regress spontaneously (0-4%). The present method, employing simple preoperative information, would be useful in future for the selection of true positive cases which should be observed without treatment.

Abnormal insulinemia

The recent development of molecular biology enables us to identify three abnormal insulins (insulin Chicago, insulin Los Angeles and insulin Wakayama). In Japan, three pedigrees in which affected individuals secrete [LeuA3] insulin (insulin Wakayama) have been identified. In each family, hyperinsulinemia associated with an abnormally elevated insulin to C-peptide molar ratio was demonstrated to occur in an autosomal dominant pattern of inheritance. In accordance with in vivo observations, semisynthetic [LeuA3] insulin demonstrated reduced in vitro receptor binding and biological activity relative to the human standard. The development of diabetes mellitus in affected family members was not uniform, was influenced by aging, and was different among families. Patients with impaired glucose tolerance demonstrated reduced insulin secretory reserve. Some of these features are thought to resemble the nature of non-insulin dependent diabetes mellitus (NIDDM). Therefore, insulin Wakayama may be a useful model for the study of the development of NIDDM.

[The molecular mechanism of insulin biosynthesis and mutant insulin gene syndrome]

The biosynthetic process of insulin in pancreatic beta cells consists of many steps including transcription of insulin gene to mRNA, translation of mRNA to preproinsulin, production of proinsulin by cleavage of signal peptide, and conversion of proinsulin to insulin and C-peptide. This process also includes intra-cellular trafficking (nucleus, cytoplasm, endoplasmic reticulum, Golgi apparatus, secretary granule, and extra-cellular secretion). The factors concerning and regulating these steps are discussed, although some of these have not been fully understood. The possible influences of insulin gene mutations (mutant insulin gene syndrome) to these steps are also discussed. Understanding of the molecular mechanism of insulin biosynthesis might be usefull to explain the defective insulin production of NIDDM.

[Role of IAPP in the pathogenesis and development of NIDDM]

Islet amyloid deposits are the characteristic lesions of the pancreas of the patients with non-insulin-dependent diabetes mellitus (NIDDM). Islet amyloid polypeptide (IAPP or amylin) is a 37 amino acid peptide, which was extracted and characterized from islet amyloid deposits in patients with NIDDM. Recent studies and characterization of IAPP cDNA suggest that IAPP is a normal islet hormone and is co-secreted with insulin from islet beta cells of the pancreas. In this paper, we review recent advance of the research for IAPP including our results, and discuss the role of IAPP in the development of NIDDM, and we propose a new type of diabetes, "amyloid diabetes".