Reduced thyroidal uptake of inorganic iodine in liver cirrhosis

Thyroid function was investigated in patients with liver cirrhosis. 123I uptake after four hours was significantly reduced in the liver cirrhosis group (n = 19) compared with the control group (n = 16) (2.6 +/- 0.3% vs. 5.0 +/- 0.6%, mean +/- SE, p < 0.01). There was no significant difference in the blood inorganic iodine level between the two groups, and the blood 123I count after ingestion of 123I capsules was not significantly different between the two groups. The area of the thyroid was slightly smaller in the cirrhosis group. A thyroid stimulating hormone (TSH) loading test showed no significant difference in the TSH value at any time point. The serum albumin level and prothrombin time were significantly associated with the 4-hour thyroidal 123I uptake (p < 0.01, p < 0.05, respectively). We show that the thyroidal inorganic iodine uptake was reduced in patients with liver cirrhosis and this reduction correlates with the severity of liver cirrhosis. Possible mechanisms include abnormal thyroid iodine transport capacity or reduced turnover of thyroid hormones resulting in a reduction in iodine uptake in liver cirrhosis.

The induction of cardioangitis by Lactobacillus casei cell wall in mice. I. The cytokine production from murine macrophages by Lactobacillus casei cell wall extract

A single intraperitoneal injection of the water-soluble cell wall extract from Lactobacillus casei (LCWE) in mice can induce acute inflammatory heart involvement such as cardiac arteritis, similar to the heart lesions in Kawasaki disease. To clarify whether inflammatory cytokines participate in pathogenic mechanisms of LCWE-induced cardioangitis in mice, we studied in vitro cytokine production (IL-1, TNF alpha, and IL-6) from peritoneal macrophages (M phi) stimulated with LCWE in comparison with that of lipopolysaccharide (LPS). LCWE significantly activated M phi of BALB/c in production of IL-1 and TNF alpha compared with LPS. However, the magnitude of IL-6 synthesis by LCWE was approximately similar to that of LPS. These results demonstrate that the pathogenesis of LCWE- induced cardiac lesions may be associated with increased production of inflammatory cytokines.

Microsatellite instability and alterations in the hMSH2 gene in human ovarian cancer

The role of the replication error-positive (RER+) phenotype in the development of specific subtypes of sporadic ovarian carcinomas was examined by screening for the presence of microsatellite instability (MI) in 47 tumors. The overall frequency of ovarian MI was 17% only. However, MI occurred in 50% of the ovarian endometrioid-type tumors, which was significantly more often than in all the other histological subtypes combined (8%). Five of the 8 RER+ tumors exhibited most marked type I instability, possibly representing a different mechanism than for the remaining type 2 tumors. The cDNA of the mutation suppression gene hMSH2, the gene most often associated with MI, was screened for alterations in 8 MI-positive and 5 MI-negative ovarian tumors. Only 3 changes were found. Complete loss of hMSH2 mRNA expression was detected in I tumor, while another expressed only an abnormal transcript containing a deletion of exon 3. One additional RER+ serous adenocarcinoma contained a rare polymorphism with a non-conservative amino acid change. One of 8 RER+ tumors showed loss of heterozygosity at the hMSH2 loci. Genetic instability, caused in part by alterations in the hMSH2 gene, may play an important role in the sporadic endometrioid subtype of ovarian tumors. Other mutator-phenotype genes may be responsible for the remaining cases of RER+ ovarian tumors.

Geographical heterogeneity between Far East and Europe in prevalence of ypm gene encoding the novel superantigen among Yersinia pseudotuberculosis strains

Yersinia pseudotuberculosis is known to produce a novel superantigen designated Y. pseudotuberculosis-derived mitogen. In the present study, we demonstrated that there was a distinct geographical heterogeneity between the Far East (higher prevalence) and Europe (lower prevalence) in the prevalence of the ypm gene encoding the superantigen among Y. pseudotuberculosis strains.

Metalloproteinase-mediated release of human Fas ligand

Fas ligand (FasL) is a type II integral membrane protein homologous with tumor necrosis factor (TNF). Recent studies indicate that TNF is processed to yield the soluble cytokine by metalloproteinases at the cell surface of activated macrophages and T cells. In the present study, we investigated whether FasL is also released by metalloproteinases. Treatment with hydroxamic acid inhibitors of matrix metalloproteinases specifically led to accumulation of membrane-type FasL (p40) on the surface of human FasL cDNA transfectants and activated human T cells, as estimated by surface immunofluorescence and immunoprecipitation with newly established anti-human FasL monoclonal antibodies. This surface accumulation of mFasL was associated with the decrease of soluble FasL (p27) in the supernatant as estimated by quantitative ELISA and immunoprecipitation with anti-human FasL monoclonal antibodies. These results indicate that human FasL is efficiently released from the cell surface by metalloproteinases like TNF.

Atherogenic change in the thoracic aorta of the senescence-accelerated mouse

Biochemical and histological changes in the thoracic aorta of the senescence-accelerated prone mouse were examined in comparison with those of the senescence-accelerated resistant mouse. At 3 and 5 months of age, the lipid peroxide level in the thoracic aorta was higher in the former than in the latter. At 5 months of age, levels of both total cholesterol and triglycerides in the aorta were higher in the former than in the latter, and vice versa for the level of aortic phospholipids. At 5 months of age, the prone mice showed macrophage invasion beneath the endothelial cells of the thoracic aorta, whereas the resistant ones did not.

[Migration, differentiation and integration of an immortalized neural cell line transplanted into the neonatal and adult mouse brain]

An immortalized neural cell line V1 was transplanted stereotaxically into the cerebellum and hippocampus of developing and adult mice, and the mode of migration, differentiation and arrangement of the grafted cells were examined by labeling the grafted cells with DiI (1, 1'-dioctadecyl-3, 3, 3', 3'-tetramethylindocarbocyanine perchlorate) and immunohistochemical staining. This cell line was established by transduction of the temperature-sensitive allele tsA58 of SV40 large T antigen oncogene into mouse hypothalamic cells. Grafted cells did not show any tumorigenicity for a long time. Some of the cells grafted into the neonatal cerebellum and hippocampus were arranged along the host cortical layer and showed neuronal or glial differentiation according to the grafted site. The cells grafted into adult cerebellum also showed migration and arrangement along the host cortical layer as well as morphological differentiation into glial cells in a manner similar to that of transplantation to the neonate. On the other hand, the cells grafted into the adult hippocampus made only clusters without forming an organized arrangement. These findings suggest that the grafted cells are integrated into the developmental processes of the host brain, and the mode of differentiation and arrangement of the grafted cells depends on the microenvironment of the different developmental stages of the host brain. The involvement of host blood vessels and astroglial framework in the migration and arrangement of the grafted cells was also suggested. Furthermore, these findings suggest the plasticity of the host brain in response to the grafted cells and the possibility of reconstructing the host brain with this multipotential neural cell line.

[Reflex sympathetic dystrophy: a case report]

We described an 11-year-old boy with reflex sympathetic dystrophy (RSD). He presented symptoms of allodynia and hyperesthesia in the right foot with pale color and coldness. Before the onset he had abdominal pain and a change of taste. The symptoms were resistant to physical therapy and the right foot became atrophic. Intermittent lumber epidural anesthesia by an indwelling catheter was performed for three weeks after 5 months from the onset. Improvement of symptoms did not occur during the anesthesia, but did soon after that. The pathogenesis of RSD remains unknown, although a psychological factor may have been involved in this case. RSD in childhood is usually considered to be more responsive to conservative therapy. However, some children such as our patient are resistant to conservative therapy. Recognition of RSD and early interventions such as physical therapy and psychological approach are important. In intractable cases invasive approaches such as sympathetic blockade should be also considered.

Use of the derivatizing agent 4-aminobenzoic acid 2-(diethylamino)ethyl ester for high-sensitivity detection of oligosaccharides by electrospray ionization mass spectrometry

A method for the high-sensitivity detection of oligosaccharides by electrospray ionization mass spectrometry (ESI-MS) is reported. The method involves the chemical derivatization with 4-aminobenzoic acid 2-(diethylamino)-ethyl ester (ABDEAE). This derivative, which contains a 2-(diethylamino)ethyl group, having a high proton affinity, enhances the ionization efficiency of analytes in the positive ESI mode. Experiments using maltohexaose as a model oligosaccharide revealed that derivatization with ABDEAE gave a remarkably large increase in molecular ion abundance. Using a mixture of acetonitrile, 2-methoxyethanol, 2-propanol, and water (1:1:1:1 v/v/v/v) as solvent for ESI, ABDEAE-derivatized maltohexaose could be detected at a level of 10 fmol. This represents a 5000-fold improvement in sensitivity over underivatized maltohexaose. ESI tandem mass spectrometry of the ABDEAE-derivatized maltohexaose provides structural information at the low-picomole level. In this spectrum, 1,5X' and 0,2A" series of sequence ions, arising from ring cleavage, were observed as the predominant ions.

[Matrix metalloproteinase (MMP-9) in patients with rheumatoid arthritis]

MMP-9 degrades type IV collagen, gelatin, type V collagen, and type XI collagen. We measured proMMP-9 and proMMP-9/TIMP-1 complex in sera and joint fluids by sandwich ELISA, and examined immunohistochemically the expression of these proteins in joint tissue from patients with rheumatoid arthritis (RA). ProMMP-9 was purified by the three chromatographic steps from the culture medium of HT1080 cells. Purified proMMP-9 and activated MMP-9 by APMA showed a single band of Mr92000, Mr67000, resectively on gelatin-zymography. We raised two monoclonal antibody colones 2G9, 8G7 against proMMP-9 with BALB/c mice. 2G9 and 8G7 reacted with proMMP-9 on Western blotting, and these clones reacted proMMP-9 and proMMP-9/TIMP-1 complex on sandwich ELISA, specifically. ProMMP-9 concentration in 86 sera (749.4+/-940.2 ng/ml) and 54 joint fluids (4539.9+/-7681.5 ng/ml) from patients with RA was significantly higher than those of patients with osteoarthritis and control. Immunohistochemistry with 2G9 showed that in rheumatoid synovium proMMP-9 localized in neutrophils and monocytes diffusely infiltrated the sublining layer. In addition, osteoclasts in rheumatoid subchondral bone were intensively stained. ProMMP-9 concentration in joint fluids from 39 RA patients was not correlated to stage and class of Steinbrocker and to clinical laboratorial data. But, it was positively correlated to the number of proMMP-9 positive cells in RA synovium (r=0.607) and the score of Roony's diffuse infiltrates of lymphocytes (r=0.720). Our results suggest a role of MMP-9 in joint destraction of RA throughout neutrophils and monocytes, and a regulation of this enzyme by lymphocytes.

Successful screening for early esophageal cancer in alcoholics using endoscopy and mucosa iodine staining

BACKGROUND

Epidemiologic studies have provided evidence that alcohol abuse is an important risk factor for esophageal carcinoma. However, no systematic screening program has been established yet in the early detection of esophageal cancer in high risk populations of heavy drinkers.

METHODS

A cohort of 629 male alcoholics (54 +/- 8 years old) were consecutively and systematically screened by endoscopy combined with iodine staining and targeted biopsy at the National Institute on Alcoholism (Kanagawa, Japan). For mucosal carcinomas, endoscopic esophageal mucosal resection (EEMR) was used to serve confirmatory diagnostic and therapeutic purposes.

RESULTS

Iodine-unstained lesions, distinctly demarcated, white, and 5 mm or larger in greatest dimension, were observed on the esophageal wall in 162 patients (25.8%). Thirty-six such unstained lesions in 21 of 629 patients, with an unexpectedly high rate of 3.3%, turned out to be squamous cell carcinomas of the superficial type. According to some established criteria, EEMR was performed in 17 of these patients, 3 of whom were given additional irradiation. Esophagectomy was performed in two patients, chemotherapy combined with irradiation in one, whereas still another was followed endoscopically. The cancer invasion was confined within the epithelium in eight patients, to the proper mucosal layer in nine, and to the submucosa in four. Multiple logistic regression revealed that the risks for distinct iodine-unstained lesions and superficial esophageal carcinoma increased independently for users of stronger alcoholic beverages, i.e., whiskey or shochu (odds ratio [OR] = 1.47 and 2.94, respectively) compared with lighter beverages, i.e., sake or beer and 30+ cigarettes/day (OR = 1.68 and 3.85, respectively).

CONCLUSION

Routine application of this program for these high risk individuals yielded an unusually high rate of detection of esophageal carcinoma.

Non-radioactive DNA diagnosis for the fragile X syndrome in mentally retarded Japanese males

A rapid screening test was developed to detect CGG repeat expansion of the FMR-1 gene causing the fragile X syndrome by a non-radioisotope PCR technique. A biotin-labeled primer was initially used and the biotin-labeled PCR product was detected by means of chemiluminescence. The normal PCR product of around 300 bp was not created in the abnormal FMR-1 gene sample with this method. Four positive samples were found among those from 226 mentally retarded males, but the CGG repeat expansion was shown on Southern blot analysis in only one sample. To eliminate false-positive samples, a hybridization method involving a biotin-labeled (CGG)s oligonucleotide was developed for the PCR product and the CGG repeat expansion could be detected. Finally, 256 mentally retarded males in Japan were examined and only 2 abnormal samples were detected. The prevalence of this abnormality was less than 1%, which is relatively lower than those reported previously.

Substrate modulation of morphology, growth, and tear protein production by cultured human lacrimal gland epithelial cells

Human lacrimal gland biopsies were serially incubated in chelating and enzymatic solutions. Viable single cells were evaluated for outgrowth in growth factor enriched medium using the following culture substrates: Matrigel, Type I collagen gel with or without fibroblasts, and plastic. Each epithelial outgrowth was characterized morphologically and immunohistochemically, and their growth and viability were examined by BrdU labeling and a quantitative cell viability assay. Synthesized proteins were evaluated by ELISA, SDS-PAGE, and 14C-labeled amino acid incorporation. Lacrimal gland epithelial cells plated on Matrigel formed clusters with central cavities that contained lactoferrin, mimicking acinar complexes in vivo. Cells plated on collagen gel or collagen gel containing fibroblasts formed islands or a monolayer, and lactoferrin was detected in incomplete cavities of epithelia on the latter substrate. Epithelial cells plated on plastic formed a monolayer and cellular expression of lactoferrin was weak and sporadic. Cellular release of the lactoferrin measured by ELISA supported the results of immunohistochemistry. Cells grown on plastic had the highest proliferative rate, whereas those grown on Matrigel showed the lowest proliferative rate. These results indicate that different substrates modulate lacrimal gland epithelial cell morphology, proliferative rate, and production of the tear protein lactoferrin. Matrigel promotes acinar differentiation to a greater extent than collagen gel and plastic. Incorporation of fibroblasts in collagen gel substrate promotes significant effects on growth and differentiation.

Effect of antiepileptic drugs on thyroid function

Chronic treatment with antiepileptic drugs (AED) is known to reduce serum thyroid hormone levels. Serum thyrotropin (TSH) level is unchanged despite low thyroxine (T4) level. We studied serum tri-iodothyronine (T3), T4 and TSH in 30 epileptic patients prior to discontinuation and 2, 4, 8 and 16 weeks after AED discontinuation. One AED was discontinued in each patient. Serum T3 levels were reduced consistently after AED discontinuation. Serum T4 and rT3 levels were increased, but not persistently. Serum TSH levels were unchanged. Our results suggest that during AED treatment serum T3 level was increased. This could be an increased conversion of T4 to T3. An acceleration of thyroid hormones degradation by enzyme induction is physiologically balanced by an increased conversion of T4 to T3.

Surgery for synchronous double cancer in the hypopharynx and thoracic esophagus

Problems involved in the surgical treatment of synchronous double cancer comprising hypopharyngeal and thoracic esophageal cancers were considered from the aspects of the radicality of treatment and the quality of life following surgery. Advanced esophageal cancers were treated by resection with lymph node dissection via right thoracotomy, and early cancers by transhiatal esophagectomy or endoscopic mucosal resection. When the entire thoracic esophagus was extirpated, the gastric tube was usually used for reconstruction. When the hypopharyngeal cancer extended to the higher oropharynx or when resection of the tongue was combined, complex reconstruction was undertaken using free grafting with a combination of the gastric tube and the jejunum or a flap such as a forearm flap or rectus abdominis musculocutaneous flap. Since endoscopic esophageal mucosal resection allows the preservation of the thoracic esophagus, the hypopharyngeal cervical esophagus was reconstructed using a free jejunal graft. Although surgical treatment provided no sufficient improvement in prognosis, postoperative quality of life was satisfactory.

Effect of tea (Camellia sinensis L.) on lipid peroxidation in rat liver and kidney: a comparison of green and black tea feeding

The antioxidant effects in the liver and kidney obtained from rat fed diets containing 3% green or black tea leaf powder, which were prepared from the same lot tea leaves, were studied using the tissue slice-antioxidant evaluation method with two lipid peroxidation inducers. After 50 d on the diets, liver slices prepared from green and black tea-supplemented rats showed significant inhibitory effects against tert-butyl hydroperoxide-induced lipid peroxidation. These effects, however, were not proportional to the amounts of (-)-epicatechins and antioxidant vitamins in the tea leaves. In the kidney, the antioxidant effect was observed only in the green tea-fed group. A similar antioxidant effect on the kidney was observed after oral administration of a major tea polyphenol, (-)-epigallocatechin gallate (50 mg/kg body weight for 7 d). Liver slices from black tea-fed rats also inhibited bromotrichloromethane-induced lipid peroxidation. These results demonstrated that dietary green and black tea had antioxidant effects on tissue lipid peroxidation ex vivo.

Sequence analysis of the gene for a novel superantigen produced by Yersinia pseudotuberculosis and expression of the recombinant protein

We previously reported that the Gram-negative bacterium Yersinia pseudotuberculosis produces a superantigen (YPM, Y. pseudotuberculosis-derived mitogen) that expands T cells bearing V betas 3, 9, 13.1, and 13.2 in an MHC class II-dependent manner. Based on the previously determined N-terminal 23 amino acids of YPM (T-D-Y-D-N-T-L-N-S-I-P-S-L-R-I-P-N-I-A-T-Y-T-G- (one-letter code)), we cloned the ypm gene and analyzed the nucleotide sequence. The gene encodes a 151-amino acid protein with a 20-amino acid signal peptide at its N terminus. The recombinant YPM expressed by the cloned gene exerted a mitogenic activity on human PBMC at a concentration of approximately 1 pg/ml. T cells bearing V beta 13.3 were preferentially expanded as well as T cells bearing the same V beta repertoires stimulated by native YPM. T cells were stimulated by the recombinant YPM in the presence of either fixed or unfixed HLA class II-transfected mouse fibroblasts. Furthermore, sequence diversity in the junctional region of the TCR beta-chain containing the V beta 3 element could be observed after stimulation by the recombinant YPM. These results indicate that YPM belongs to the category of superantigens and should be included as a novel member. The amino acid sequence of the mature protein showed no significant homology to other superantigens derived from Gram-positive bacteria such as Staphylococcus aureus and Streptococcus pyogenes. This observation, together with the substantially smaller m.w. suggest that ypm must have evolved from a different ancestral gene.

Sequence analysis of the gene for a novel superantigen produced by Yersinia pseudotuberculosis and expression of the recombinant protein

We previously reported that the Gram-negative bacterium Yersinia pseudotuberculosis produces a superantigen (YPM, Y. pseudotuberculosis-derived mitogen) that expands T cells bearing V betas 3, 9, 13.1, and 13.2 in an MHC class II-dependent manner. Based on the previously determined N-terminal 23 amino acids of YPM (T-D-Y-D-N-T-L-N-S-I-P-S-L-R-I-P-N-I-A-T-Y-T-G- (one-letter code)), we cloned the ypm gene and analyzed the nucleotide sequence. The gene encodes a 151-amino acid protein with a 20-amino acid signal peptide at its N terminus. The recombinant YPM expressed by the cloned gene exerted a mitogenic activity on human PBMC at a concentration of approximately 1 pg/ml. T cells bearing V beta 13.3 were preferentially expanded as well as T cells bearing the same V beta repertoires stimulated by native YPM. T cells were stimulated by the recombinant YPM in the presence of either fixed or unfixed HLA class II-transfected mouse fibroblasts. Furthermore, sequence diversity in the junctional region of the TCR beta-chain containing the V beta 3 element could be observed after stimulation by the recombinant YPM. These results indicate that YPM belongs to the category of superantigens and should be included as a novel member. The amino acid sequence of the mature protein showed no significant homology to other superantigens derived from Gram-positive bacteria such as Staphylococcus aureus and Streptococcus pyogenes. This observation, together with the substantially smaller m.w. suggest that ypm must have evolved from a different ancestral gene.

Characterization of a highly toxic, large molecular size heat-stable enterotoxin produced by a clinical isolate of Yersinia enterocolitica

A novel heat-stable enterotoxin (ST) designated as Y-STc was purified to homogeneity from the culture supernatant of a pathogenic strain of Yersinia enterocolitica serotype O3 and its amino acid sequence was determined. The mature Y-STc was found to consist of 53 amino acid residues, which includes the putative pro-sequence. The molecular weight of Y-STc was 5638 and constituted the largest molecular size in the family of currently known STs. The minimum effective dose of purified Y-STc in the suckling mouse assay was 0.6 ng (0.0 pmol), indicating that, despite the long sequence, Y-STc is the most toxic in the ST family.

Diagnosis and treatment of metachronous cancers in the esophagus and the head and neck region

The esophagus and the head and neck region, both having the squamous epithelium, are thought to be subject to the same carcinogenic factors. This report discusses the diagnosis and treatment of secondary cancer detected following the treatment of primary cancer in 21 patients who had metachronous cancer comprising esophageal cancer and head and neck cancer. The secondary cancer was already advanced when detected despite the fact that almost all patients were followed up regularly at the outpatient clinic of the facility where the primary cancer was treated. Although surgical treatment of the secondary cancer was similar to that of the usual primary cancer, the prognosis for the former was poor, indicating that the prognosis tends to be determined by the disease stage of the secondary cancer. Early detection of the secondary cancer requires esophagoscopy using the iodine dye method or close examination of the head and neck region at an otolaryngologic outpatient clinic at the time of treatment of the primary cancer and thereafter at 6- to 12-month intervals.

Peptide ligands for integrin alpha v beta 3 selected from random phage display libraries

The integrin alpha v beta 3 binds promiscuously to cell-adhesive proteins: vitronectin, fibronectin, and several others containing the RGD motif. We have explored molecular recognition by alpha v beta 3 through selection of ligands from large random libraries of peptides displayed on phage. Ligands bound by alpha beta 3 consisted primarily of RGD peptides; however, these peptides showed considerable heterogeneity with respect to the identities of amino acids flanking RGD. The tolerance of alpha v beta 3 for RGD peptides of diverse composition is consistent with its role in vivo as a versatile receptor for RGD-containing extracellular matrix proteins. Peptide ligands for alpha v beta 3 also included a novel binding sequence, identical to a tetrapeptide found in vitronectin, which is a candidate for a synergistic site in this adhesive protein that may act in concert with RGD to promote molecular recognition.

Carbamazepine-induced thrombocytopenia and carbamazepine-10,11-epoxide: a case report

The case of a patient who developed thrombocytopenia during treatment with carbamazepine (CBZ) is described. The platelet count recovered soon after discontinuation of CBZ, Lymphocyte stimulation test with carbamazepine-10, 11-epoxide (CBZ-10, 11-EPOX), a major metabolite of CBZ, was positive, although with CBZ it was negative. These findings suggest that CBZ-10, 11-EPOX was possibly causative in the pathogenesis of CBZ-induced thrombocytopenia in this case.