Effects of intracoronary infusion of atrial natriuretic peptide on pacing-induced myocardial ischemia in patients with effort angina pectoris

BACKGROUND

Atrial natriuretic peptide (ANP) has been shown to dilate the coronary artery. The aim of this study was to determine whether, in patients with effort angina pectoris, intracoronary infusion of ANP attenuates pacing-induced myocardial ischemia either by dilating the stenotic lesion in a large coronary artery or by dilating collateral vessels.

METHODS

We studied six patients who had total or subtotal occlusion in one coronary artery and well-developed, angiographically visible collateral vessels (group A) and five patients who had a significant stenosis in a large coronary artery with no visible collateral vessels (group B). Their heart rate was increased by atrial pacing both before and after intracoronary infusion of ANP (0.03 microgram/kg/min for 15 min) into the donor artery of collateral vessels in group A or into the stenotic artery in group B.

RESULTS

Before ANP infusion, all patients of both groups developed an ischemic ST-segment depression (> or = 0.1 mV) and angina-like chest pain from pacing tachycardia. After ANP infusion, significant ST-segment depression was induced by rapid pacing in only one out of six patients of group A, whereas it was noted in all patients of group B (P < 0.01). After ANP infusion, chest pain developed in one out of six patients in group A, whereas it appeared in four out of five patients in group B (P < 0.05). ANP significantly dilated the angiographically normal segment of the epicardial coronary artery, but it did not significantly change the severity of the stenotic lesion in either group. ANP did not change the basal arterial pressure or heart rate, nor did it change their response to pacing tachycardia.

CONCLUSION

Infusing ANP into the donor artery of collateral vessels, but not into the artery with culprit stenotic lesion, attenuated pacing-induced myocardial ischemia. Therefore, the beneficial effects of ANP in reducing pacing-induced myocardial ischemia may result from the increase in myocardial perfusion to the ischemic area caused by dilating the collateral vessels.

Involvement of lipid peroxidation in necrosis of skin flaps and its suppression by ellagic acid

To evaluate the pathogenesis of lipid peroxidation in skin-flap necrosis and to select a novel herbal antioxidant to suppress lipid peroxidation and salvage the flaps, in vitro and in vivo experiments were instituted. In vitro studies revealed (1) the potentiality of the cutaneous microsomal system (vesicular fragment of endoplasmic reticulum) to generate oxyradicals by FeCl3 (oxidative agent), since NADPH-dependent lipid peroxidation was elevated time-dependently, (2) suppression of microsomal lipid peroxidation by herbal antioxidants (dose- and time-dependently), further supporting the theory of oxyradical-induced lipid peroxidation in the skin, and (3) that ellagic acid showed the strongest response, with curcumin, chlorogenic acid, and alpha-tocopherol (tocopherol) being moderate, and ferulic acid and gallic acid remaining weakest. Thus ellagic acid, curcumin, chlorogenic acid, and tocopherol at doses of 10, 60, 80 and 100 microM (twice I50, the dose which could inhibit lipid peroxidation by 50 percent) were chosen for in vivo assessments, respectively. In vivo studies were performed using rat back skin random flaps (70 x 15 mm and based anteriorly) and circular island flaps (20 mm in diameter and raised on superficial epigastric vessels). Control flaps were painted with a Tris-ethanol solution, and test flaps were painted with either ellagic acid, curcumin, chlorogenic acid, or tocopherol (above-mentioned doses per 250 microliters of Tris-ethanol per 300 mm2 of flap surface 1 hour before the operation and once a day for 3 postoperative days). Doses, frequency, and period of drug application were based on in vitro and in vivo pilot experiments. The results were as follows: (1) a direct and time-dependent relation was noticed between lipid peroxide levels and the rate of necrosis in both types of flap; (2) time-dependent elevation of lipid peroxide levels of skin, subcutaneous fat, and exudate of island flaps during ischemia and those of skin and subdermal fat after reperfusion indicated pre- and post-reflow states of lipid peroxidation rather than the original conception of merely reperfusion state; and (3) in good agreement with the results of in vitro experiments, ellagic acid exerted the strongest effect to suppress lipid peroxide levels of skin and to augment the viability of random flaps more than that of island flaps.(ABSTRACT TRUNCATED AT 400 WORDS)

Arthroscopy in 19 children with Perthes' disease. Pathologic changes of the synovium and the joint surface

Arthroscopy of the hip joint was performed in 19 children with Legg-Calvé-Perthes' disease. Proliferation of the synovium was pronounced both in the acetabular fossa and over the inner wall of the capsule. Hypervascularity was seen on the acetabular labrum in every stage of the disease. Microscopically, hyperplasia of the synovial lining cells was observed, but inflammatory changes in the synovial tissue were inconspicuous in the early stage of the disease. Although hypertrophy of the endothelial cells of the vessels was seen in the late stage of the disease, it was not distinct in the initial or fragmentation stages. Joint pain improved after irrigation during arthroscopy.

ANTISENSE oligonucleotides: a new tool in neuroscience

1. Recent studies have shown that gene expression can be selectively attenuated by administration of short sequences of nucleotides (oligonucleotides) that are complementary to a portion of messenger RNA coding for a particular gene product. 2. This technique is known as ANTISENSE, because the oligonucleotides are complementary to the mRNA which has the same sequence as the SENSE strand of DNA. 3. In the present review we focus, after a brief discussion of gene expression and mechanisms of action of ANTISENSE, on the methodological aspects of ANTISENSE experiments in neuroscience. In particular, we address the advantages, disadvantages and controls for the ANTISENSE technique, as well as the choice, design, mode of delivery, dose and storage of ANTISENSE oligonucleotides.

Urinary chiro-inositol excretion is an index marker of insulin sensitivity in Japanese type II diabetes

OBJECTIVE

To determine the relationship between urinary chiro-inositol excretion and insulin sensitivity in Japanese type II diabetic patients.

RESEARCH DESIGN AND METHODS

Eighteen subjects were age-matched, nonobese, type II diabetic patients. Eight subjects had impaired glucose tolerance (IGT), and 10 had normal glucose tolerance (NGT). We quantified urinary chiro-inositol excretion using gas chromatography-mass spectrometry and the insulin sensitivity index (SI), and glucose effectiveness (SG) using Bergman's modified minimal model method.

RESULTS

The urinary excretion of chiro-inositol was much lower in the diabetic patients (32.3 +/- 16.0 mumol/day, means +/- SD) than in the NGT subjects (96.0 +/- 17.6; P < 0.0001) and IGT subjects (58.9 +/- 11.6; P < 0.0001). SI was much lower in the diabetic patients (3.81 +/- 1.49) than in the NGT subjects 6.30 +/- 1.59, P < 0.0005). SG was much lower in the diabetic patients (2.14 +/- 0.56) than in the NGT subjects (3.07 +/- 0.38, P < 0.0001). There was a significant correlation between urinary chiro-inositol excretion and SI (r = 0.766), as well as a significant correlation between urinary chiro-inositol excretion and SG (r = 0.747).

[Cytokine production by human airway epithelial cells and its modulation]

There is increasing evidence that airway epithelial cells play an active role in allergic inflammation, including bronchial asthma. We showed that human airway epithelial cells in culture release GM-CSF, G-CSF, M-CSF, IL-6, and IL-8, using a serum-free culture system. These cytokines are known to modulate the bioactivities of inflammatory cells that accumulate at the site of inflammation. Among them, GM-CSF, IL-8, or both may be important because they influence the bioactivities of eosinophils, which are characteristic of allergic inflammation. Here we report on the effects of air pollutants such as suspended particulate matter and diesel exhaust particulates on release of cytokines from airway epithelial cells. All air pollutants we tested stimulated epithelial cells to release GM-CSF. These results suggest that one cause of the recent increase in the prevalence of allergic disorders is direct stimulation of airway epithelial cells by air-pollutants. Furthermore, anti-inflammatory agents such as steroids and anti-allergic drugs were found to suppress the release of GM-CSF from airway epithelial cells in vitro.

Immunohistochemical study of human advanced glycosylation end-products (AGE) in chronic renal failure

In patients with diabetic renal failure plasma advanced glycosylation end-products (AGE) levels are reported to be elevated and dialyzer of continuous ambulatory peritoneal dialysis (CAPD) is usually used with a high glucose concentration. Here, an immunohistochemical study on human AGE accumulation in vascular beds and peritonea of patients with chronic renal failure (CRF) or those on CAPD was undertaken. Further, the influence of aging was studied using AGE-specific monoclonal antibody. 1. AGE accumulation was observed in radial arterial walls (from vascular intima to smooth muscle layer) of diabetic patients with CRF. Even in some non-diabetic patients with CRF (n = 3/6), especially in those with a long history of CRF and dialysis treatment, similar positive staining was seen in vascular walls. No AGE staining was observed in any renal tissue of age-matched control subjects including tissue from patients with acute renal failure. 2. Although AGE accumulation was not seen in the peritonea of CRF patients with no prior CAPD therapy, it was seen in the mesothelial layers and in adjacent coarse connective tissues of peritonea from patients on CAPD (n = 6), even from as early as only 3 months of CAPD therapy. 3. AGE accumulation was observed in the vascular bed of the non-diabetic aged kidney with normal function, but not in that of the young kidney. Thus, AGE accumulation in the vascular bed may depend on the degree and term of renal impairment and on aging in addition to diabetes. AGE accumulation in the peritonea became positive following CAPD treatment, indicating that it might affect the efficiency of CAPD.

Hemoglobin augmentation of interleukin-1 beta-induced production of nitric oxide in smooth-muscle cells

The roles of hemoglobin (Hb) in the pathogenesis of cerebral vasospasm remain a matter of discussion. Hemoglobin is known to be released from extravasated red blood cells in a variety of pathological conditions, including subarachnoid hemorrhage. These conditions are often accompanied by infiltration of inflammatory cells and an associated release of multiple cytokines. Certain of these cytokines, including interleukin-1 beta (IL-1 beta), are capable of increasing nitric oxide (NO) production via the inducible form of nitric oxide synthase (NOS), and excessive NO production under these conditions may contribute to cellular dysfunction. This study further examines these questions by investigating the effects of Hb on the induction of NOS by IL-1 beta. The effects of Hb on IL-1 beta-induced NO production were examined in cultured smooth-muscle cells of rat aorta (RA-SMC's). Production of NO was estimated from the accumulation of nitrite, an oxidative product of NO, in the culture medium. The synthesis of NO was induced by IL-1 beta in a concentration-dependent manner. This activation of NO production was inhibited by: 1) a general inhibitor of NOS (N omega-nitro-L-arginine); 2) a protein synthesis inhibitor (cycloheximide); and 3) two selective inhibitors of the inducible form of NOS (hydrocortisone and aminoguanidine). These results suggest that IL-1 beta promotes the expression of the inducible form of NOS in RA-SMC's. The effects of Hb on NO production were tested by adding purified human Hb to the culture medium of the cells in both the presence and absence of IL-1 beta. Nitrite accumulation was slightly but significantly increased by Hb in the absence of IL-1 beta. In contrast, Hb markedly augmented nitrite accumulation induced by IL-1 beta. This augmentation persisted even after the removal of Hb from the culture medium. The number of cells was not affected by Hb or IL-1 beta. The findings demonstrate that Hb can modify cytokine-induced production of NO in RA-SMC's by increasing the inducible form of NOS. These observations suggest that Hb can also modify the action of inflammatory cells by facilitating NO production in target cells.

Six cases of heterochronous gastrointestinal cancer preceded by breast cancer

Among 432 women with primary breast cancer, six (1.4%) were diagnosed as having gastrointestinal cancer more than six months after operation for the breast cancer. This paper presents these six cases. The patients ranged from 56 to 78 years of age at the time of breast cancer surgery, and the interval after surgery until diagnosis of the second cancer ranged from 7 months to 5 years 1 month. The second cancer was gastric cancer in 3, esophageal cancer in 2, and hepatic cancer in 1. All of the 6 patients had received postoperative adjuvant chemotherapy for breast cancer. The most frequent histological type of breast cancer was solid-tubular carcinoma (3 patients). Three patients died, due to the second cancer, 4 days, 2 months, and 6 months, respectively, after diagnosis of the second cancer, and the other patients are alive 2, 3, and 4 years after diagnosis. The Japanese literature regarding multiple cancer among breast cancer patients is reviewed. It is concluded that care should be taken to examine breast cancer patients with gastrointestinal symptoms, which are likely to be dismissed as a side effect of postoperative chemotherapy.

Structure of azurin from Achromobacter xylosoxidans NCIB11015 at 2.5 A resolution

The crystal structure of azurin from a denitrifying bacterium, Achromobacter xylosoxidans NCIB11015, has been refined at 2.5 A resolution using diffraction data obtained by means of synchrotron radiation at KEK. Crystals suitable for X-ray experiment were obtained by the macro-seeding method and an intensity data were obtained on imaging plates mounted on a Weissenberg camera (Rmerge = 0.09). The initial model was obtained by the molecular replacement method using the structure of azurin from Alcaligenes denitrificans NCTC8582 as a starting model. The structure was refined by molecular dynamics optimization and the restrained least-squares method to a crystallographic R-value of 0.205. However, the current model gave an electron-density of the side-chain regions of several residues close to the N-terminus quite different from those expected from the amino acid sequences reported. Very recently, two kinds of azurins (Az-I and Az-II) were isolated from this bacterium by a slightly modified purification method and have been characterized and found to have different CD spectra. On analysis of amino acid sequences around the N-terminus, the second azurin (Az-II) was proved to be a new type of azurin in this bacterium. It was consequently revealed that the current model corresponds to a new type of azurin because of the complete agreement between the electron-density and the amino acid sequence of the newly determined 20 residues from the N-terminus. Determination of the whole amino acid sequence of this azurin and further refinement are in progress.

Immunohistochemical analysis of cyclin D1 protein in hematopoietic neoplasms with special reference to mantle cell lymphoma

Immunohistochemical expression of PRAD1/cyclin D1 protein has been investigated in 106 tissue specimens of 104 cases of lymphoma, non-neoplastic lymphoid disorders and other hematologic malignancies by employing the monoclonal antibody 5D4 with formalin-fixed paraffin-embedded sections, using the microwave oven heating method. Positive neoplastic cells were found in 60 (74%) of 81 cases of non-Hodgkin's lymphoma. The positivity pattern was nuclear in 17 (85%) of 20 cases of mantle cell lymphoma in which cytoplasmic staining was also seen. This pattern of cyclin D1 positivity was in contrast to the negative staining of normal reactive mantle zones. In the other cases, positivity appeared to lie within the cell cytoplasm without nuclear staining, and most of the nodal follicular and diffuse B-cell lymphomas variously expressed PRAD1/cyclin D1. In contrast, the reaction was absent in a significant number of T-cell and extranodal B-cell lymphomas. Immunolocalization of PRAD1/cyclin D1 expression appears to be a useful diagnostic adjunct to discriminate mantle cell lymphoma from other non-Hodgkin's lymphomas.

[Coronary artery bypass with free arterial grafts]

Between October 1988 and October 1993, we experienced 15 cases of free arterial grafting for coronary artery bypass (11 men, 4 women: age range from 42 to 75 years). The bypass grafts were used 11 right internal thoracic artery (RITA), 4 right gastroepiploic artery (RGEA), and 1 left internal thoracic artery (LITA). There were no surgical complications by using free arterial graft. The patency rate at one month after operation was good (86.7%, 13/15 anastomoses). Sites of proximal anastomosis were ascending aorta in all patient. These results indicated that free arterial graft is usefull for multiple coronary artery bypass by arterial graft.

Effects of prolonged administration of perfluorooctanoic acid on hepatic activities of enzymes which detoxify peroxide and xenobiotic in the rat

Male and female rats were fed a diet containing 0.01% (w/w) perfluorooctanoic acid (PFOA) for 2 or 26 weeks, and the effects on enzymes that participate in the metabolism of peroxides and xenobiotics in liver were studied. Elevated activity of peroxisomal beta-oxidation persisted throughout the treatment of male rats with PFOA for 26 weeks. The activity of glutathione (GSH) peroxidase towards hydrogen peroxide was depressed significantly by the prolonged administration. The long-term treatment of male rats with PFOA decreased the activity of GSH peroxidase towards cumene hydroperoxide and increased the activity of microsomal NADPH-dependent lipid peroxidation. The activities of GSH reductase and hepatic content of GSH remained unchanged. There was no difference in the content of conjugated dienes in microsomal lipid between male rats exposed to PFOA for 26 weeks and age-matched control. The activities of GSH S-transferase towards 1-chloro-2,4-dinitrobenzene and 1,2-dichloro-4-nitrobenzene were depressed by the short-term administration of PFOA to male rats, and this inhibition became pronounced during the prolonged treatment. Microsomal cytochrome P450 was induced by the short-term treatment of male rats with PFOA, and elevated levels persisted throughout the treatment for 26 weeks. Upon the administration of PFOA to male rats for 2 weeks, the activity of 7-ethoxycoumarin O-deethylase was increased markedly, whereas the activities of either aniline p-hydroxylase or aminopyrine N-demethylase were unchanged. Although an age-dependent decrease was observed in the activity of 7-ethoxycoumarin O-deethylase, the activity in male rats treated with PFOA for 26 weeks was higher than that of age-matched control, to the same extent as was observed with the short-term treatment. The prolonged administration of PFOA to male rats caused a significant increase in the activity of both aniline p-hydroxylase and aminopyrine N-demethylase. Little changes were found in the same parameters tested in female rats even after the prolonged administration of PFOA.

The murine decorin. Complete cDNA cloning, genomic organization, chromosomal assignment, and expression during organogenesis and tissue differentiation

Decorin, a proteoglycan known to interact with collagen and growth factors, may play key roles during ontogenesis, tissue remodeling, and cancer. We have deciphered the complete protein sequence of the murine decorin by cDNA cloning, elucidated its gene structure and chromosomal location, and investigated its expression in the developing embryo. The decorin protein and the gene were highly conserved vis à vis the human counterpart; however, the murine gene lacked a leader exon, exon Ib, which was found only in the human. Using interspecific backcrossing, we assigned the gene to chromosome 10 just proximally to the Steel gene locus. In situ hybridization studies of developing mouse embryos showed a distinct pattern of expression with a progressive increase of decorin mRNA during ontogenesis. At early stages (day 11 postconception), decorin was detectable only in the floor plate region. Subsequently (days 13-16 postconception), decorin expression was especially prominent in the meninges and mesothelial linings of pericardium, pleura, and coelomic cavity, as well as in the dermis and subepithelial layers of the intestine and urinary bladder. In contrast, the major parenchymal organs were only weakly positive for decorin mRNA. These findings suggest that decorin may play a role in epithelial/mesenchymal interactions during organ development and shaping.

Insulin-induced activation of glycerol-3-phosphate acyltransferase by a chiro-inositol-containing insulin mediator is defective in adipocytes of insulin-resistant, type II diabetic, Goto-Kakizaki rats

Type II diabetic Goto-Kakizaki (GK) rats were insulin-resistant in euglycemic-hyperinsulinemic clamp studies. We therefore examined insulin signaling systems in control Wistar and diabetic GK rats. Glycerol-3-phosphate acyltransferase (G3PAT), which is activated by headgroup mediators released from glycosyl-phosphatidylinositol (GPI), was activated by insulin in intact and cell-free adipocyte preparations of control, but not diabetic, rats. A specific chiro-inositol-containing inositol phosphoglycan (IPG) mediator, prepared from beef liver, bypassed this defect and comparably activated G3PAT in cell-free adipocyte preparations of both diabetic GK and control rats. A myo-inositol-containing IPG mediator did not activate G3PAT. Relative to control adipocytes, labeling of GPI by [3H]glucosamine was diminished by 50% and insulin failed to stimulate GPI hydrolysis in GK adipocytes. In contrast to GPI-dependent G3PAT activation, insulin-stimulated hexose transport was intact in adipocytes and soleus and gastrocnemius muscles of the GK rat, as was insulin-induced activation of mitogen-activated protein kinase and protein kinase C. We conclude that (i) chiro-inositol-containing IPG mediator activates G3PAT during insulin action, (ii) diabetic GK rats have a defect in synthesizing or releasing functional chiro-inositol-containing IPG, and (iii) defective IPG-regulated intracellular glucose metabolism contributes importantly to insulin resistance in diabetic GK rats.

Pseudorotation in the D2O trimer

Far-infrared spectra of Ar/D2O supersonic expansions have been recorded between 39 and 44 cm-1, in which a c-type band centered at 41.1 cm-1 was observed. This new band, attributed to the cyclic water trimer, has the same ground state rotational constants as the (D20)3 98 cm-1 a-type band reported by Liu et al. [J. Am. Chem. Soc. 116 (1994) 3507]. Fits of the observed far-infrared band positions to an effective one-dimensional potential require a substantially larger pseudorotation barrier or effective moment of inertia than predicted theoretically. Estimated frequencies of unobserved transitions in the pseudorotation manifolds of (D2O)3 and (H20)3 are presented as a guide to future experimental searches.

[Rapidly progressive outer retinal necrosis in a patient with acquired immunodeficiency syndrome]

We report a case of rapidly progressive varicella zoster virus retinitis, which is distinct from acute retinal necrosis syndrome. The patient was a 52-year-old male and suffered acquired immunodeficiency syndrome. Two months after the varicella zoster dermatitis in the distribution of the first division of the left trigeminal nerve, pseudodendritic keratitis and iridocyclitis were observed in the left eye. After 5 weeks, multifocal and patchy white exudates were observed in the peripheral deeper layer of the retina in the left eye, but retinal vasculitis in the exudative lesions was slight. Despite systemic administration of acyclovir, white exudates progressed confluently from the periphery to the post pole of the retina and reached the macula in 10 weeks. Eight weeks after the observation of lesions in the left eye, we found the same lesions in the right eye. After the white exudative lesions disappeared, the retina became atrophic and the retinal vessels were narrowed, but no retinal detachment was observed. Recently, Foster and associates described the rapidly progressive outer retinal necrosis as a new entity of varicella zoster virus retinitis in AIDS patients. We think our case was very similar to the rapidly progressive outer retinal necrosis. This case shows that we must carefully follow up the rapidly progressive outer retinal necrosis in the AIDS patients with a varicella zoster dermatitis.

Effects of danazol on thrombopoiesis in rats

A synthetic analog of ethinyltestosterone, Danazol, has been used clinically for the treatment of immune thrombocytopenia. We investigated the effects of Danazol on thrombopoiesis in normal rats. Though 4-week treatment by Danazol slightly enhanced the DNA synthesizing enzyme activities and the number of S-phase cells in bone marrow and spleen, the number of megakaryocytes and thrombocytes were not increased in bone marrow and peripheral blood, respectively. These findings suggest that Danazol treatment will not induce thrombosis with thrombocytosis in normal human beings and animals.

How heat treatment and thermal cycling affect wear of composite resin inlays

A three-bodied in vitro localized wear test investigated the effect of additional heat treatment and thermocycling on localized wear of light-cured composite resin inlays. In only one material did the thermocycling heat treatment have an appreciative positive effect on wear resistance.