Different characteristics of hepatoid and non-hepatoid alpha-fetoprotein-producing gastric carcinomas: an experimental study using xenografted tumors

The characteristics, including metastatic potential, of 5 xenografts of alpha-fetoprotein (AFP)-producing gastric carcinomas in nude mice, designated TSG1, TSG3, TSG11, TSG17 and TSG20, were examined. Of these xenografts, TSG1, TSG11 and TSG20 were regarded as hepatoid adenocarcinomas based on their morphological resemblance to hepatocellular carcinoma, frequent immunoreactivity for liver-cell markers, and excessive production of AFP with a high concanavalin A (Con-A)-binding property of hepatic type. On the other hand, TSG3 and TSG17 tumors showed the features of poorly differentiated medullary adenocarcinoma with scattered AFP-positive cells consistent with low AFP levels in mouse sera, and negative immunoreactivity for other liver-cell markers. Ultrastructurally, these tumors were composed of undifferentiated cells with a little adenocarcinomatous differentiation. Moreover, the AFP produced by TSG3 and TSG17 tumors had an extremely high Con-A nonbound fraction (80% to 90%), which was different from that of the hepatic or yolk-sac types. Therefore, both TSG3 and TSG17 tumors were regarded as non-hepatoid, poorly differentiated adenocarcinomas which could be differentiated from any types of AFP-producing gastric carcinoma. Furthermore, cells from hepatoid adenocarcinoma strains (TSG1, TSG11 and TSG20) injected into the spleens of nude mice produced liver metastases in all the mice examined, whereas cells from non-hepatoid carcinoma strains (TSG3 and TSG17) produced few or no liver metastases. Our data show that some non-hepatoid AFP-producing gastric carcinomas have lower liver-metastasizing potential than hepatoid AFP-producing gastric carcinomas.

Ultrastructural changes in glycerol-extracted skeletal muscle fibers after chemical modification of myosin heads with p-phenylenedimaleimide

We examined the structural changes in relaxed glycerinated rabbit psoas muscle fibers induced by modification of the myosin heads with p-phenylenedimaleimide (p-PDM), which reacts with sulfhydryls on the myosin head to cause its loss of ability to combine with actin and to hydrolyse ATP. In the longitudinal sections of both chemically fixed and quickly frozen muscle fibers, ladder-like structures, interpreted as the myosin heads extending nearly at right angles with the thick filaments, were more prominent in the p-PDM-modified fibers than in the control fibers. Fourier transform diffractograms of the longitudinal sections exhibited a distinct 14.3-nm meridional reflection, which arises from axial spacing of the myosin heads on the thick filament, in the p-PDM-modified fibers, but not in the control fibers. These results indicate that the p-PDM-modification of the myosin heads causes an increase in the regularity of myosin head arrangement on the thick filament.

A case of Behçet's disease with occlusion of both caval veins and "downhill" esophageal varices

A case of Behçet's disease (BD) with occlusion of both caval veins and "downhill" esophageal varices is reported. A 59-year-old male patient had esophageal varices, established as the "downhill" type by endoscopy, venography, and contrast-enhanced computed tomography (CE-CT) scan. Venography via both jugular veins did not lead to the visualization of the superior vena cava (SVC), but revealed numerous collateral veins, which formed esophageal varices en route. Venography via both femoral veins did not lead to the visualization of the inferior vena cava (IVC), but revealed numerous collateral veins, which flowed into the portal vein together with the jugular flow. CE-CT scan revealed the disappearance of the SVC and the lower part of the IVC, below the hepatic vein. The patient was diagnosed as having BD, based on his history of recurrent oral and skin lesions over the past 26 years.

[The effectiveness of cervical epidural block for the treatment of status asthmaticus]

Epidural anesthesia is currently used for the operation of patients who have bronchial asthma. We have ascertained the effectiveness of cervical epidural block for the treatment of status asthmaticus even in the ICU. The present patient had repeated history of severe asthma and was no longer expected to respond to the routine therapy. After we failed to wean him from the ventilator several times, we performed cervical epidural block on him. His condition improved dramatically after the block and he was easily weaned from the ventilator. The three notable improvements are (1) no use of sedatives, (2) normalized arterial blood pH with decrease in expiratory resistance and (3) stabilization of circulation. Sympathetic nervous system is excited in patients with asthmatic attack. As a result, high concentrations of catecholamines deteriorate general condition of patients. On the other hand, cervical epidural block seems to be effective to prevent hyperactive sympathetic nervous system. Our result suggests that alpha-adrenergic effect of epinephrine which is given as a routine therapeutic drug, will very likely worsen asthmatic attack.

The role of hemolysate in the facilitation of oxyhemoglobin-induced contraction in rabbit basilar arteries

The importance of factors within hemolysate in modulating oxyhemoglobin (oxyHb)-induced contraction was examined in an in vitro model of rabbit basilar arteries. When the basilar arteries were exposed to purified oxyHb alone, the contractile response observed was significantly weaker than that seen in arteries exposed to hemolysate containing an equal concentration of oxyHb. In order to delineate the nature of the factors within hemolysate that facilitate contraction, hemolysate was fractionated, and various components were tested individually for their ability to elicit this effect. A low-molecular-weight fraction of hemolysate, ranging from 0.5 to 2.0 kD, elicited only a mild contraction. However, when this fraction was combined with purified oxyHb, the contractile response was comparable in magnitude to that of unfractionated hemolysate. These studies confirm that purified oxyHb is capable of inducing contraction in vitro. The data also demonstrate that oxyHb elicits a significantly weaker contraction than does hemolysate. In addition, the results suggest that low-molecular-weight components in hemolysate (in the 0.5- to 2.0-kD range), while incapable of inducing a potent contraction alone, may act in concert with oxyHb to elicit the vasoconstriction seen following subarachnoid hemorrhage.

[Angiography in vasculitis]

The method of angiography in vasculitis has recently been changed due to the development of digital subtraction angiography (DSA). Intra-venous DSA is widely used in the diagnosis of vasculitis, although intra-arterial DSA is needed for depicting small vessel lesions. Low-osmolality contrast medium is another advancement in the angiography of vasculitis, which can make peripheral angiography painless. We discussed angiographic features in vasculitis diseases, including Takayasu arteritis, Buerger disease, moyamoya disease, and vasculo-Behçet disease. Angiography is the most important in order to diagnose vasculitis and evaluate the degree and extent of disease. Further, interventional radiology, which uses the technic of angiography for the purpose of therapy, is employed for the vascular treatment of vasculitis.

[Comparison of diagnostic value of coronary artery disease between ATP-stress and exercise-stress thallium myocardial SPECT images]

A study was made between adenosine triphosphate disodium (ATP)-stress thallium myocardial scintigrams and exercise-stress scintigrams to compare their respective extents and degree of defects. The subjects of the study were 33 ischemic heart disease patients, who received ATP stress and treadmill exercise stress with a mean interval of 25 days. ATP was infused for 5 minutes with an infusion rate of 0.16 or 0.18 mg per kg of body weight per minute. Thallium was injected three minutes after infusion. The percent-defect index (percentage of the extent and degree of the defects for all 33 patients), was calculated with visual scoring using a five-zone myocardial division method and semi-quantitative four-grade representation method for both the ATP and exercise SPECT images. The extent of the defects in ATP- and exercise-stress images was 51.5% and 44.2%, and that in redistribution images was 36.4% and 33.9%, respectively. The degree of defects in ATP- and exercise-stress images was 35.8% and 32.3%, while that in redistribution images was 20.8% and 17.2%, respectively (p = NS in all cases). In conclusion, the image quality of thallium SPECT with ATP stress was equivalent to that of exercise stress, indicating identical diagnostic values for coronary lesions.

Bradykinin and Met-T-kinin-Leu stimulated PGE2 production by rat macrophage and fibroblast

T-kininogen degradation and kinin release were observed in rat macrophages cultured under acidic conditions. Bradykinin and Met-T-kinin-Leu (a kinin precursor) stimulated PGE2 production by macrophages and fibroblasts but had no effect on O2- production. PGE2 production by macrophages stimulated with 10 microM bradykinin increased by approximately 148% compared to non-stimulated macrophages (0.47 +/- 0.13 vs 0.31 +/- 0.16 ng 10(6) cells-1 30 min-1), and increased by 161% in stimulated as opposed to non-stimulated fibroblasts (0.50 +/- 0.07 vs 0.31 +/- 0.05 ng 10(5) cells-1 30 min-1). No O2- production was detectable in fibroblasts despite stimulation with PMA, A23187, bradykinin, and Met-T-kinin-Leu. O2- production by macrophages was 4.2 +/- 0.3 and 3.0 +/- 0.2 nmol 10(6) cells-1 min-1 after stimulation with PMA and A23187, respectively, but no O2- production was observed after stimulation with bradykinin or Met-T-kinin-Leu. These data suggest that bradykinin and the kinin precursor are implicated in granulomatous tissue formation and wound healing through arachidonic acid and its metabolites but not through O2-.

Effects of continuous intravenous infusion of isosorbide dinitrate on development of tolerance to vasodilating action in human epicardial coronary arteries

This study was performed to determine the effects of long-term intravenous infusion on the coronary vasodilating actions of continuous intravenous and bolus intracoronary administration of isosorbide dinitrate (ISDN). With quantitative coronary angiography, the coronary diameter and the vasodilating response to intracoronary ISDN (1 mg) at angiographically normal segments were studied before and after intravenous administration of ISDN, 10 to 60 micrograms/min for 1 hour, 2 days, or 5 days. The vasodilating effects of intravenous ISDN were 72% +/- 13%, 65% +/- 21%, and 6% +/- 11% of the response to intracoronary ISDN in the baseline study in each group. Irrespective of the duration of intravenous infusion, subsequent intracoronary ISDN dilated coronary arteries to extent similar to that observed in each baseline study. In conclusion, significant coronary vasodilating effects of intravenous ISDN were observed after a 2-day infusion, whereas tolerance to the vasodilating effects apparently developed within 5 days of infusion. The vasodilating response to bolus intracoronary ISDN was preserved even when the vasodilating effects of intravenous ISDN were no longer present.

Interleukin 1 and tumor necrosis factor production as the initial stimulants of liver ischemia and reperfusion injury

The mechanisms by which polymorphonuclear neutrophils (PMNs) are recruited by the ischemic and reperfused liver are still unknown. The purpose of this study was to determine whether tumor necrosis factor-alpha (TNF) and/or interleukin-1 alpha (IL-1) acted as potential mediators for PMN infiltration after liver ischemia and reperfusion. The potential effect of FK 506, a powerful immunosuppressant, was also studied. Male Sprague-Dawley rats were subjected to 60 and 90 min of total hepatic ischemia, with an extracorporeal porto-systemic shunt. FK 506 (0.3 mg/kg) was intravenously administered 4 hr before ischemia (FK 506 group), and control animals received normal saline solution (NS group). Plasma TNF, IL-1 levels, and PMN infiltration in liver tissue were serially examined at the end of ischemia, 5, 30, 60, and 360 min after reperfusion. The degree of liver necrosis was assessed at 360 min following reperfusion. In the NS group, IL-1 and TNF revealed a transient elevation at 30 and 60 min after reperfusion, following 60 min of ischemia. When the ischemia was increased to 90 min, the IL-1 activity had a rapid elevation (330.5 +/- 129 pg/ml) at 5 min, which remained at high levels (197.8 +/- 70.4 pg/ml) until 6 hr after reperfusion, whereas the TNF activity decreased to normal levels following a similar peak (355 +/- 181.9 pg/ml) at 5 min after reperfusion. The time course of IL-1 release in the NS group, with 90 min of ischemia, correlated directly with the PMN infiltration.(ABSTRACT TRUNCATED AT 250 WORDS)

Pancreatic beta-cell secretory defect associated with mitochondrial point mutation of the tRNA(LEU(UUR)) gene: a study in seven families with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS)

Recent evidence suggests possible linkage between diabetes mellitus and mitochondrial gene mutation. We surveyed mitochondrial tRNA(LEU(UUR)) (3243) mutation in 7 mitochondrial encephalomyopathy, lactic acidosis and stroke-like episode (MELAS) families and identified 24 mutated subjects (7 MELAS probands and 17 non-MELAS relatives) as well as 11 non-mutant family members. An OGTT in the 24 mutant relatives revealed 14 diabetic subjects, 3 with impaired glucose tolerance and 7 with normal glucose tolerance and all non-mutant family members as having normal glucose tolerance. Insulinogenic index was significantly reduced in the mutant diabetic subjects and those with impaired and normal glucose tolerance in comparison with the normal control subjects and the non-mutant members. Urinary 24-h C-peptide immunoreactivity excretion was markedly reduced in the mutant diabetic subjects and those with normal and impaired glucose tolerance, compared with the control subjects and the non-mutant family members. Plasma C-peptide immunoreactivity 6 min after glucagon injection was markedly reduced in the mutant diabetic subjects and those with normal and impaired glucose tolerance compared with the control subjects and the non-mutant family members. Si, an index of insulin sensitivity of the four mutant subjects was within normal range. Islet cell antibodies were negative in sera of eight mutated diabetic subjects, 2 and 6 with impaired and normal glucose tolerance, respectively. Diabetic retinopathy and nephropathy were demonstrated in 7 (50%) and 12 (85.7%) of 14 mutant diabetic subjects, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[The accuracy and side effects of pharmacologic stress thallium myocardial scintigraphy with adenosine triphosphate disodium (ATP) infusion in the diagnosis of coronary artery disease]

The diagnostic accuracy and side effects of pharmacologic stress thallium myocardial scintigraphy with ATP infusion were studied in 172 patients with or without coronary artery disease. ATP was infused for five minutes at a rate of 0.16 mg/kg/min (group A) or 0.18 mg/kg/min (group B) via antecubital vein. One hundred and eleven (67 of group A, 44 of group B) of 172 patients underwent coronary arteriography (CAG). In 111 patients received CAG, overall sensitivity, specificity and accuracy of this method were 88%, 84% and 87%, respectively. In 67 patients of group A, these were 92%, 81% and 90%. In 44 patients of group B, 79%, 87% and 82% were documented (NS, between group A and B). Chest pain, flushing, bradycardia and ST depression were included in side effects caused by ATP infusion. At least one of these side effects were observed in 84% of the all 172 patients, 89% of group A and 75% of group B (NS). But, all of the side effects were spontaneously alleviated within two minutes without any therapy. In conclusion, pharmacologic stress myocardial scintigraphy with ATP infusion is very accurate and safe, and infusion rate of 0.16 mg/kg/min is optimal for this purpose.

[A case of prostatic cystadenoma]

We report a case of prostatic cystadenoma in a 45-year-old man with the complaint of urinary retention. The large mass was palpated on rectal examination. The tumor was localized in the position of the left lobe of the prostate and was seen as multi-ocular on computerized tomographic (CT) scan. The serum levels of prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) were slightly elevated. The tumor was enucleated retropubically, it weighed 210 g and had an multilocular structure macroscopically. The cyst seen on microscopic examination was lined with cuboidal or columnar epithelial cells and the lining cells were focally multilayered and formed papillary projections. The stroma surrounding the glands was composed of fibrous tissue containing smooth muscle fibers. The epithelial cells were immunoreactive for PAP and PSA.

Pulpal response after complete crown preparation, dentinal sealing, and provisional restoration

This study evaluated the acute pulpal healing response following preparation, etching, and sealing of the prepared vital dentin with a 4-methacryloxyethyl trimellitate anhydride (4-META) bonding system. Adult monkey teeth received crown preparations with chamfer margins, prepared with a diamond used at ultra high speed with water cooling. Vital dentin was etched with 10% citric acid-3% ferric chloride, rinsed, and sealed with 4-META system. A provisional crown was formed with a low-viscosity light-curing adhesive resin. Teeth were fixed and evaluated histopathologically. Pulpal responses at 3 days showed only minimal disruption of the odontoblastic zone. At 7 days, the pulps presented reorganizing odontoblastoid cells, and, at 10 days, the pulps showed new odontoblastoid cells with a thin rim of reparative dentin. Pulps of crown preparations that were etched and then sealed with the 4-META system presented healing patterns similar to those of pulps associated with Class V preparations lined with calcium hydroxide, observed in (previous) similar studies.

[A case of lipoid pneumonia showing a pulmonary nodule mimicking lung cancer]

A 49-year-old man was admitted to our hospital because of hemosputum, left chest pain and an abnormal shadow on chest X-ray. Computed tomography of the chest revealed a tumor-like shadow with a low density area in the left lower lung field. Ga scintigraphy revealed strong Ga uptake in the left lower lung. Fiberoptic bronchoscopy showed obstruction of subsegmental bronchi of it. B9+10. Neither transbronchial biopsy nor sputum cytology showed any malignant cells. Transcutaneous lung biopsy showed infiltration of foamy macrophages in alveolar spaces and lymphocytes and plasma cells in alveolar septa. Since there was a possibility of complicating lung cancer, and because of refractory hemosputum, the patient underwent left lower lobectomy. The cut surface of the resected left lobe showed the features of golden pneumonia with cavitation. The histological features of the resected specimen were those of lipoid pneumonia, and no cancer cells were detected.

Effects of early manual instruction on the oral-language development of two deaf children

The speech and language training provided to deaf children at our clinic is done by the Kanazawa Method, which consists of reception and expression training in sign communication and auditory/oral language, as well as written-language training. In our investigation, we analyzed the acquisition of passive and active vocabulary in sign and oral language. The subjects were two children congenitally deaf at the 105 dB level or greater. Recorded-language samples through the age of 54 months were analyzed. Acquisition of sign occurred more quickly than oral-language acquisition. The children's production of active nouns, function words, and "wh-" question words in sign was equivalent to that of hearing peers, and later this proficiency transferred to oral language. These results suggest that early presentation of sign is effective in the acquisition of function words and interrogative sentences, both of which are especially challenging for the Deaf.