[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.

Serum thyroglobulin in the follow-up of patients with treated differentiated thyroid cancer

To determine the significance of serum thyroglobulin (Tg) level in terms of presence or absence of thyroid cancer, we evaluated available serum Tg data on and off T4 therapy in 180 patients with differentiated thyroid cancer who have now been followed up to 18 yr. The presence of cancer was established by radioiodine scans, x-rays, and clinical examination. Thirty-two patients with detectable serum Tg autoantibodies were excluded from this analysis. Tg was measured by RIA with a sensitivity of 1 ng/mL. Patients who had all stages of cancer, but who had no evidence of active disease after treatment, were grouped according to operative and 131I ablative therapy. In patients with a partial thyroidectomy with or without ablation, the presence of Tg did not indicate the presence of cancer since levels were often above either a 5 ng/mL or a 10 ng/mL cutoff. The presence of residual normal thyroid tissue decreases the diagnostic value of serum Tg assay. In patients who underwent near total (NTT) or total thyroidectomy (TT) and 131I ablation, 3 of 55 (5.5%) patients had Tg greater than 5 ng/mL and 1 of 55 (1.8%) patients had Tg greater than 10 ng/mL during therapy, whereas off therapy 13 of 57 (22.8%) patients had Tg greater than 5 ng/mL and 6 of 57 (10.5%) patients had Tg levels greater than 10 ng/mL. In this group of patients, a Tg level less than 10 ng/mL during suppressive therapy indicated the absence of apparent tumor in 54 of 55 (98.2%) of patients. Whereas sensitivity of the assay was increased by withdrawal of hormone, "false positives" increased especially at lower (3-6 ng/mL) cut-off levels. No cut-off value properly categorized all patients. These data suggest, that even in patients who underwent 131I ablation and total thyroidectomy and were thought to be cured, small foci of thyroid tissue which are undetectable by standard 2 mCi 131I scans may exist and produce some Tg. However, these residual cells do not appear to cause an adverse prognosis in most patients. In patients with recurrent or continued disease, during T4 treatment, Tg levels ranged between 2-21,000 ng/mL and 5 of 11 patients had a Tg less than 5 ng/mL. Off treatment, Tg levels ranged between 6-10,700 ng/mL and 3 of 13 patients had a Tg less than 10 ng/mL. In 4 patients Tg levels were less than 10 ng/mL on treatment but greater than 10 ng/mL off therapy.(ABSTRACT TRUNCATED AT 400 WORDS)

Thrombolysis of canine femoral artery thrombus by a novel modified tissue-type plasminogen activator (E6010)

The thrombolytic activity of a novel modified tissue-type plasminogen activator (t-PA) (E6010) was examined in a canine model with copper coil-induced femoral artery thrombus. This model, in which thrombolytic activity can be easily and directly quantified by determining changes in thrombus weight, should be useful for comparing the activities of various thrombolytic agents. Using this model, the present study showed that the thrombolytic activity of bolus intravenous injection of E6010 was identical to that of continuous intravenous infusion of recombinant t-PA at the same dose. This thrombolytic activity can be explained by changes in blood concentrations of the administered thrombolytic agents. On the other hand, administration of the thrombolytic agents dose-dependently caused significant changes in the levels of hemostatic and fibrinolytic factors. These changes were not so marked with administration of E6010, and therefore we concluded that E6010 is unlikely to cause bleeding complications after administration.

Re-evaluating pulp protection: calcium hydroxide liners vs. cohesive hybridization

Certain clinical and biological studies have reported that prepared dentin and the underlying pulp must be protected with a calcium hydroxide base and liners that supposedly impart biological and structural integrity to tissues. Since the mid-1950s, dentists have relied on a number of calcium hydroxide medicaments for this goal. But recent studies imply that clinicians need to re-evaluate the generous use of certain calcium hydroxide medicaments under restorations.

[MR imaging of a case of cerebral tuberculoma--correlation between MRI and histological findings]

A case of cerebral tuberculoma is reported with its representative MRI findings and the corresponding histological appearance. A 46-year-old female admitted to our hospital with complaint of left hemifacial seizure. CT scan discoled a slightly high density tumor (1.5cm in diameter) located in the right frontal lobe. This tumor was enhanced homogeneously by contrast media. While, MRI revealed three concentric layers within this tumor; the central core showed iso- and low signal intensity (SI) in T1- and T2-weighted imagings (T2WI), respectively. The middle layer showed low and high SI in T1- and T2-WI, respectively. The outer layer appeared iso- and low SI in T1- and T2-WI, respectively. Only the middle layer was enhanced by Gd-DTPA. The total resection of the tumor was performed. The histological appearance corresponded well to those MRI findings. The central core was caseous necrosis, and the middle layer contained Langhans giant cells and epithelioid cells with substantial edema. The outer layer was the capsule that consisted of collagenous fibers. The peculiar relationship between the MRI and histological findings is discussed in detail.

Hepatitis C virus particle detected by immunoelectron microscopic study

To clarify the morphology of hepatitis C virus (HCV), an indirect immunogold electron microscopic study was carried out on two plasma samples with high HCV RNA titres using polyclonal and monoclonal antibodies specific to the putative HCV envelope protein. Spherical virus-like particles, 55 to 65 nm in diameter with spike-like projections, were found in 1.14 to 1.16 g/ml fractions after sucrose density gradient centrifugation. These particles were found only in HCV-infected blood donors and had morphological features similar to those of flaviviruses. Moreover, these particles specifically reacted with the polyclonal and monoclonal antibodies to the putative HCV envelope protein. This is the first known report in which the morphology of the HCV particle is clearly shown.

[Cochlear implant in a child with congenital severely impaired hearing]

A 6-year 9-month-old child with congenital severely hearing impaired received a Nucleus 22 channel implant. Twenty-two CG electrodes are now in use. In the 5 months since the cochlear implant, the patient has made good progress. Her vowel discrimination score has reached 100%. However, her consonant discrimination has remained at the chance level. On the other hand, auditory reception of environmental sounds has shown relative improvement. Problems encountered in pediatric use of the cochlear implant are also discussed herein.

Pituitary adenylate cyclase-activating polypeptide: effects on pancreatic-adrenal hormone secretion and glucose-lipid metabolism in normal conscious dogs

The effects of pituitary adenylate cyclase-activating polypeptide (PACAP) on plasma insulin, glucagon, catecholamine, cortisol, glucose, triglyceride (TG), free fatty acid (FFA), cholesterol, and cyclic adenosine monophosphate (cAMP) concentrations were examined in unanesthetized normal dogs. A bolus injection of 6 pmol/kg PACAP27 elicited a transient increase in plasma insulin, epinephrine, and norepinephrine concentrations, with a peak value at 2 minutes after injection. Injections of 60 and 600 pmol/kg caused greater increases in these hormone concentrations in a dose-dependent manner. The plasma cortisol concentration was not changed by a bolus injection of 6 pmol/kg PACAP27, and was gradually increased by injections of 60 and 600 pmol/kg. Significant increases were observed from 10 and 5 minutes after the injection of 60 and 600 pmol/kg, respectively. The plasma glucagon concentration was not changed by either 6, 60, or 600 pmol/kg. The plasma glucose concentration decreased with 60 pmol/kg PACAP27 and increased with 600 pmol/kg. The plasma FFA concentration was increased gradually, with a peak value at 10 minutes after the injection, in a dose-dependent manner. The plasma TG concentration was slightly increased with 600 pmol/kg with a peak value at 10 minutes, although plasma cholesterol did not change. The plasma cAMP concentration increased significantly with 600 pmol/kg PACAP27, but not with 6 or 60 pmol/kg. These effects of PACAP27 were observed with a bolus injection of PACAP38 of an equal potency. Infusion of graded doses of PACAP27 (1, 3, and 10 pmol/kg/min every 20 minutes) caused a gradual increase in plasma cortisol, catecholamine, FFA, and cAMP concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes of serum hemolytic activity and the number of reticulocytes in canine Babesia gibsoni-infection

When the serum hemolytic activity in Babesia gibsoni-infected dogs was determined with self red blood cells from the infected animals, the decrease in the activity is paralleled with the increase in the number of reticulocytes. The activity determined with red blood cells from phenylhydrazine-induced anemia also decreased parallel with the increase in the number of reticulocytes. These results suggest that the rapid decrease in the serum hemolytic activity after reaching the peak is due to the increase in reticulocytes, which are probably unsusceptible to the hemolytic factor(s).

Effects of exogenously applied calponin on Ca(2+)-regulated force in skinned smooth muscle of the rabbit mesenteric artery

To help elucidate the physiological role of calponin (a thin-filament-linked regulatory protein) in smooth muscle contraction, the effects of its exogenous application were investigated on actin-activated MgAT-Pase activity in crude actomyosin from chicken gizzard, and on contraction induced by Ca(2+)-dependent and -independent means in arterial smooth muscle strips skinned by saponin or beta-escin. Calponin concentration dependently inhibited actin-activated MgATPase activity with a proportional increase in its binding to actomyosin and also attenuated Ca(2+)-induced contractions, in the presence or absence of calmodulin, in skinned arterial strips. Calponin, when phosphorylated by protein kinase C, reduced both its ability to bind to actomyosin and its inhibitory action on actomyosin MgATPase. The phosphorylated calponin also had no effect on the maximum Ca(2+)-induced contraction in skinned smooth muscle, suggesting that these actions of calponin are not nonspecific. Calponin attenuated the Ca(2+)-independent contraction observed in myosin light chain thio-phosphorylated strips, or on application of trypsin-treated myosin light chain kinase. However, calponin had no effect on maintained rigor contraction. These results suggest that in vascular smooth muscle, calponin may play a physiological role in the inhibition of Ca(2+)-regulated force, possibly through a direct action on active actin-myosin interactions.

Virulence region of plasmid pNL2001 of Salmonella enteritidis

The virulence region of the Salmonella enteritidis 55 kb plasmid pNL2001 was identified by Tn1-insertion mutagenesis, DNA hybridization studies, and Western blot analysis of proteins encoded in the virulence region of the plasmid. DNA hybridization studies showed that the pNL2001 plasmid contained a 6.4 kb SalI-EcoRI fragment homologous to the 6.4 kb SalI-EcoRI Salmonella plasmid virulence (spv) region of the S. choleraesuis 50 kb plasmid (pKDSC50). One of the 247 Tn1-insertion mutants of S. enteritidis, designated strain TA19, showed a reduced mouse lethality, and the Tn1-insertion of strain TA19 was located within this homologous 6.4 kb region, suggesting that the 6.4 kb SalI-EcoRI fragment of pNL2001 contained the spv region. Two contiguous SalI-EcoRI fragment were cloned into the expression vectors. By the 6.4 kb SalI-EcoRI fragment were cloned into the expression vectors. By Western blot analysis using four Spv peptide antisera, each specific for individual proteins encoded in the spvR, spvA, spvB and spvC genes of pKDSC50, four proteins encoded in the 6.4 kb SalI-EcoRI fragment of pNL2001 were identified. Protein SpvR with an apparent molecular mass of 32 kDa was produced from the 2.3 kb SalI-EcoRI fragment, and protein SpvA, SpvB and SpvC with apparent molecular masses of 32, 70 and 29 kDa, respectively, were produced from the 4.1 kb EcoRI-EcoRI fragment. From the 4.1 kb EcoRI::Tn1 fragment of the TA19 plasmid, proteins SpvA and SpvB were expressed, but not SpvC. It was therefore suggested that the spvC gene may contribute to the expression of virulence of S. enteritidis. Furthermore, the nucleotide sequence of the 6.4 kb SalI-EcoRI fragment encoding these four proteins was determined. Four open reading frames which encoded the four proteins with deduced molecular masses of 33,906, 28,200, 65,349 and 27,646 Da were detected. Deduced amino acid sequences of each protein showed a high degree of identity to corresponding sequences in the virulence region of S. choleraesuis, S. dublin and S. typhimurium virulence plasmids. Therefore, we confirmed that the virulence plasmids of Salmonellae including S. enteritidis share the highly conserved region responsible for virulence.

Characterization of cadherin-4 and cadherin-5 reveals new aspects of cadherins

Several properties of cadherin-4 and cadherin-5 were characterized by using the cDNA transfection approach. The proteins of both cadherins had a relative molecular mass of about 130 kDa and were present at the cell periphery, especially at cell-cell contact sites. These cadherins were easily digested with trypsin, and Ca2+ protected cadherin-4, but not cadherin-5, from the digestion. In immunoprecipitation, cadherin-4 co-precipitated with two major proteins of 105 kDa and 95 kDa, respectively. The 105 kDa and the 95 kDa proteins are likely to correspond to alpha- and beta-catenins. Cadherin-5 co-precipitated with only one major protein of 95 kDa, but seems to associate with the 105 kDa protein. On the other hand, plakoglobin or gamma-catenin did not co-precipitate well with either cadherin-4 or cadherin-5 in immunoprecipitation, but plakoglobin also appears to associated weakly with these cadherins. Cadherin-4 transfectants aggregated within 30 minutes in a cell aggregation assay, but cadherin-5 transfectants did not aggregate under the same conditions. Furthermore, the transfectants of chimeric cadherin-4 with cadherin-5 cytoplasmic domain showed cell aggregation activity comparable to that of wild-type cadherin-4 transfectants, whereas the transfectants of chimeric cadherin-5 with cadherin-4 cytoplasmic domain did not show appreciable cell aggregation, suggesting that the extracellular domains of cadherins, in conjunction with their cytoplasmic domains, play an important role in cell aggregation activity. These results show that cadherin-4 is very similar to the classical cadherins, whereas cadherin-5 is functionally as well as structurally distinct from classical cadherins.

Differential binding and activation of thyroid hormone response elements by TR alpha 1 and RXR alpha-trap heterodimers

Thyroid hormone receptor (TR) forms homo- and heterodimers on various thyroid hormone response elements (TREs). We wished to clarify the relationship of homo- and heterodimer binding to TREs and their trans-activation. We investigated binding characteristics in gel mobility shift assays using synthetic direct repeat (DR) TREs having the consensus motifs separated by different oligonucleotide gaps, and we compared binding to trans-activation mediated via the direct repeat TRE. HTR alpha 1 purified from E. coli formed a monomer and homodimer on DR-TRE +0 to +5 but binding did not closely correlate with T3-dependent trans-activation. When RXR alpha expressed in COS 1 cell was added to purified TR alpha 1 in the gel shift assays, TR/RXR heterodimers were formed, and binding of heterodimers correlated highly with the level of trans-activation. These results strongly suggest that TR/TRAP heterodimers mediate the effect of thyroid hormone on DR-TREs. We also found T3-dependent disruption of homodimer formation on DR +0 to +2 and that T3 increased heterodimer formation on these TREs.

Reduction in serum cholesterol with pravastatin improves endothelium-dependent coronary vasomotion in patients with hypercholesterolemia

BACKGROUND

This study aimed to determine if cholesterol-lowering therapy improves endothelium-dependent coronary vasomotion in patients with hypercholesterolemia.

METHODS AND RESULTS

Nine patients with hypercholesterolemia were studied before and after cholesterol-lowering therapy with pravastatin (an inhibitor of HMG-CoA reductase) for 6 +/- 3 months, which lowered serum cholesterol from 272 +/- 8 to 187 +/- 16 mg/dL (P < .01). Control patients with serum cholesterol of 218 +/- 23 mg/dL also were studied twice in a similar interval (8 +/- 2 months) with no cholesterol-lowering drugs. Acetylcholine (the endothelium-dependent vasodilator) and papaverine and nitrate (endothelium-independent vasodilators) were infused into the study coronary artery. Changes in the diameter of the epicardial coronary artery and coronary blood flow were assessed by quantitative coronary arteriography and an intracoronary Doppler catheter. In patients with hypercholesterolemia, acetylcholine-induced vasoconstriction of the epicardial artery was less (P < .05) and the acetylcholine-induced increases in coronary blood flow were greater (P < .001) after than before pravastatin. In control patients, responses of the epicardial coronary artery and coronary blood flow to acetylcholine did not change over the follow-up period. The vasomotor responses to papaverine or nitrate were similar between the two groups, and no interval changes in their responses were noted in either group.

CONCLUSIONS

These results suggest that cholesterol-lowering therapy with pravastatin may improve endothelium-dependent coronary vasomotion, which may possibly contribute to the improvement of myocardial perfusion as well as the regression of coronary atherosclerosis.

Temperature-dependent change of serological specificity of Candida albicans NIH A-207 cells cultured in yeast extract-added Sabouraud liquid medium: disappearance of surface antigenic factors 4, 5, and 6 at high temperature

The cells of Candida albicans NIH A-207 strain (A-strain) cultivated in YSLM at high temperatures (37 and 40 degrees C) did not undergo agglutination with the factor sera 4, 5, and 6 in a commercially available factor serum kit, 'Candida Check', and formed a grape-like shape. The mannans isolated from the cells had lost their reactivity against the factor sera in ELISA. It was also revealed by 1H NMR analysis that the mannans contained neither a phosphate group nor a beta-1,2-linked mannopyranose unit, although these mannans increased the non-reducing terminal alpha-1,3-linked mannopyranose unit. The cells and the mannans prepared by cultivation at such high temperatures followed by 27 degrees C in the same medium entirely recovered the reactivity with the factor sera.

[Research on the correlation between DNA recombinational mutation and cancer malignancy in human colon cancers]

The mutagenicity of quercetin, a flavonoid, was examined by means of DNA fingerprint analysis using the Pc-1 and Pc-2 minisatellite probes that efficiently detect mutations due to recombination. Treatment of FM3A and BMT-11 tumor cells with 55 microM quercetin resulted in gain and loss of bands in the fingerprints in both cell lines. The frequencies of the clones having undergone mutation were 9/26 and 2/11, using Pc-1 probe, respectively, in the two lines. These results seem to provide a molecular basis for the phenotypic variations of BMT-11 tumor cells induced by quercetin, giving direct evidence of genetic instability of the tumor cells. Moreover, we examined for a possible correlation between frequencies of DNA recombinational mutations and cancer malignancy in human colon cancers. DNA of four human colon cancer tissues and corresponding peripheral blood cells were prepared, respectively, and examined by DNA fingerprint analysis using hPc-1 polymorphic minisatellite probe. These four specimens exhibited no extra-bands resulting from recombination and/or DNA slippage at present. We would explain how the prognosis of cancer patients is related to frequencies of DNA recombinational mutation.

Augmentation of 5-fluorouracil cytotoxicity by epidermal growth factor in a newly established human signet-ring cell carcinoma of the stomach in culture

A cell line designated TSG6 was established from a signet-ring cell gastric carcinoma developed in a 57-year-old female patient. The TSG6 cells had well preserved the features of signet-ring cell carcinoma based on morphology. The cells exhibited both epidermal growth factor (EGF) and epidermal growth factor receptor (EGFR) immunoreactivities, and also secreted EGF. Moreover, the growth of TSG6 cells was stimulated in the presence of exogenous EGF. These results suggest that the possible presence of an EGF/EGFR autocrine growth mechanism is expressed in the TSG6 cells. The simultaneous treatment with EGF and 5-fluorouracil (5-FU) produced a nearly 2.4-fold enhancement of 5-FU cytotoxicity against TSG6 cells. A bromodeoxyuridine/DNA flow cytometry analysis revealed that EGF augmented 5-FU cytotoxicity by inducing the accumulation of S phase cells which might be more susceptible to 5-FU. Moreover, we found that the incorporation of 5-FU into the TSG6 cells was increased with the addition of EGF. These data indicate that EGF may be a potent agent as a biological response modifier for 5-FU against the tumors which express the EGF/EGFR autocrine mechanism, and that the TSG6 cell line is useful in furthering our understanding of the interaction between anticancer drugs and EGF.

Dislocation and subluxation during femoral lengthening

Femoral lengthening by callus distraction was performed on 26 femurs of 18 patients with various disorders between 1988 and 1992. Age at surgery ranged from 6 to 17 years (13 years on average). The amount of lengthening varied from 2 to 7.5 cm (mean 5 cm). Follow-up evaluation of femoral-head displacement was based on the change of center-edge (CE) angle. The hips were divided into two groups based on the preoperative CE angle; one group consisted of 14 hips with a CE angle > 20 degrees and the other group consisted of 12 hips with an angle of < or = 20 degrees. In the first group, none of the hips deteriorated; however, five of 12 hips in the second group did deteriorate. One hip developed complete dislocation and the other four showed a decrease in the CE angle. Four of five deteriorated hips had a history of congenital dislocation of the hip and the other had multiple epiphyseal dysplasia. In cases in which the CE angle is < or = 20 degrees preoperatively, bony procedures such as innominate osteotomy should precede femoral elongation.