[Cell proliferation and cell death (apoptosis) as indices differentiating malignant from benign gastrointestinal myogenic tumors]

We examined whether the determination of cell proliferation and cell death rates was useful in the differential diagnosis between benign and malignant myogenic tumors of gastrointestinal tract. As markers for cell proliferation and cell death, Ki-67 (MIB-1) positive rates or argyrophilic nucleolar organizer region (AgNOR) counts and apoptotic cell counts were determined in a total of 53 myogenic tumors comprising 36 leiomyomas and 17 leiomyosarcomas. Apoptotic cells were detected with the in situ nick end labeling method reported by Gavrieli in 1992 with modifications. Significant differences were observed in the Ki-67 positive rates (leiomyoma 1.8 +/- 1.4%, leiomyosarcoma 8.6 +/- 6.0%, p < 0.0001), in the mean AgNOR counts (leiomyoma 1.77 +/- 0.53, leiomyosarcomas 3.14 +/- 1.02, p < 0.0001), and in the apoptotic cell counts (median; leiomyoma 3.2, leiomyosarcoma 32.5 per 10(6) tumor cells, p < 0.005). All high grade sarcomas were picked up by the Ki-67 index of more than 7%, and almost all leiomyomas were thrown away by the AgNOR counts more than 3.0 within the low Ki-67 cases, which showed 81% of sensitivity and 97% of specificity. These results show that a combination use of Ki-67 and AgNOR is of use in the differential diagnosis between leiomyoma and leiomyosarcoma. Although a significant difference was also noted in apoptotic cell counts between these two categories, this seems not to be a practical index for the discrimination because apoptotic cell death is a rare event in gastrointestinal myogenic tumors.

[Cell proliferation and cell death (apoptosis) in epithelial tumors of the stomach--analysis of tumor tissues by the endoscopic mucosal resection]

To answer the question why some gastric cancers make elevation while others make depression in their early stage, and why polypoid cancers grow larger than their benign counterpart adenomas, the distribution of proliferating cells and apoptotic cells was compared between these lesions. Proliferating cells and apoptotic cells were detected with anti Ki-67 antibody (MIB-1) and with the in situ nick end labeling (ISNEL), respectively. A total of 62 gastric tumors, taken by the endoscopic mucosal resection method, was assessed. They consisted of 14 adenomas and 48 mucosal carcinomas (27 polypoid and 21 depressed type). Overall positive rates of Ki-67 were 27.5 +/- 9.0% in adenoma, 40.1 +/- 11.1% in polypoid cancer and 47.5 +/- 9.7% in depressed cancer. Proliferating cells were preferentially found in the cripts of metaplastic mucosa, in the middle to upper layer of adenomas, and in the whole layer including their surface of adenocarcinomas. Within cancers the polypoid type had more positive cells in the upper layer, so did the depressed type in the lower layer. ISNEL positive nuclei showed sphere, fragmented, ringed forms, or the same form as neighboring tumor nuclei. Apoptotic cells lay scattered throughout tumor glands. Apoptotic cell counts per 1000 tumor cells were 26.0 +/- 9.7 in adenoma, 36.3 +/- 32.1 in polypoid cancer, and 52.5 +/- 19.3 in depressed cancer. Depressed type cancers and a few polypoid cancers rich in non-tumor tissues showed higher numbers of apoptotic cells than adenomas and usual polypoid cancers. (ABSTRACT TRUNCATED AT 250 WORDS)

Macromolecular ionophores. 1. Chiral recognition properties of poly[(1-->6)-2,5-anhydro-D-glucitol] toward racemic amino acid ester

The chiral recognition property of poly[(1-->6)-2,5-anhydro-3,4-di-O-alkyl-D-glucitol] (1) toward racemic RCH (CO2CH3)NH3+.PF6- (2.HPF6) has been studied using a transport system involving an aqueous source and receiving phases separated by a chloroform phase containing 1. Transport rates for aromatic guests 2a (R = Ph) and 2b (R = CH2Ph) were faster than those for aliphatic guests, 2c (R = CH(CH3)2) and 2d (R = CH2CH(CH3)2), using the polymer substituted with methyl groups (1a). The enantiomeric excess (e.e.) was 10.9% for 2a as a maximum value and decreased in the order of 2a > 2c > 2b = 2d. When the transport of 2a.HPF6 was carried out using the polymers with 3,4-di-O-methyl (1a), ethyl (1b), allyl (1c), and pentyl (1d) groups, the e.e. was 22.0% for 1d as a maximum value and increased in the order of 1a < 1b < 1c < 1d. The formation of a complex between 1a and 2a.HPF6 was confirmed by 1H and 13C NMR spectral measurements.

The effects of KBT-3022, a new anti-platelet agent, on hemorheological properties in guinea pigs

Using guinea pigs, a study was conducted on the effects of KBT-3022, a new anti-platelet agent, on hemorheological properties in various tests including blood filterability, blood viscosity, shear stress-induced red blood cell (RBC) deformability and contents of ATP and 2,3-diphosphoglycerate (2,3-DPG). Oral administration of KBT-3022 at 1 and 10 mg/kg significantly increased blood filterability, and significantly reduced blood viscosity at 10 mg/kg without changing the hematocrit, plasma fibrinogen concentration or plasma viscosity. KBT-3022 (10 mg/kg, p.o.) improved RBC deformability in response to shear stress, which was evoked by passing the blood through a thin tube. This dose of KBT-3022 also increased the contents of ATP and 2,3-DPG in RBC. These findings indicate that KBT-3022 may reduce blood viscosity as a sequel to improvement of RBC deformability through direct action on RBC. The increase in the intracellular levels of ATP and 2,3-DPG was considered to be involved in this improvement of hemorheological properties. These hemorheological effects of KBT-3022 appear to be promising for the treatment of patients with ischemic vascular disease.

[Exertional hypoxemia evaluated by pulse oximetry in patients with interstitial lung diseases]

The pattern of change in arterial oxyhemoglobin saturation (SpO2) measured by pulse oximetry (PO) during exercise, including daily activities, was studied in 23 patients with interstitial lung disease (ILD), 19 of whom had idiopathic pulmonary fibrosis, 3 collagen vascular disease, and 1 BOOP. Hypoxemia, as detected by PO appeared without dyspnea at the beginning of exertion or at a mild workload. Exercise usually induced significant changes in the same fashion first in heart rate, then in SpO2, and then in dyspnea, but stair climbing had a different pattern. Workload at the lactate threshold (LT) and symptom-limited maximal exercise (SL) in a bicyclergometer incremental exercise test correlated well with distance walked in a 10-minute walking test (10-eMD) (p < 0.01). Similarly, the degree in desaturation in each exercise test was closely correlated (p < 0.01). Exertional hypoxemia was more prominent in patients with ILD than in those with chronic pulmonary emphysema. Nevertheless, dyspne changed less per change in SpO2 in ILD patients. We conclude that prolonged monitoring of SpO2 by PO will disclose the presence of exertional desaturation in ILD patients.

[Macroscopic classification and kinetic alternations in the superficial lesion of colorectal neoplasms]

To clarify relation between macroscopic appearance and the mode of tumor growth in the superficial lesion of colorectal neoplasms, we compared their colonoscopic findings with histological architecture of tumor cells. Macroscopic type was classified into the superficial elevated lesion (II a, n = 42, mean 5.14mm) and the superficial depressed lesion (n = 42, mean 3.84mm). The latter was further divided into 3 subtypes; subtype A, an irregular depression with high marginal elevation (Dep (A), n = 20); subtype B, an irregular depression with irregular marginal elevation (Dep (B), n = 7); subtype C, a clear and wide depression without marginal elevation (Dep (C), n = 15). Histological architecture was evaluated by the transmucosal growth index (TGI) of tumor cells, which is a ratio of tumor width contacting with the muscularis mucosae against that of tumor surface, and by the distribution of proliferating cells detected by Ki-67 antibody (MIB-1). In adenomas TGI increased with a degree of central depression (IIa < Dep(A) < Dep(C)). In carcinomas TGI was high irrespective of their macroscopic forms. Ki-67 labeling indices tended to increase with histological atypia. Adenomas with severe atypia showed a high labeling consistent with carcinomas. In both adenomas and carcinomas, Ki-67 positive cells were mainly noted in upper third of neoplastic glands in II a, Dep (A) and Dep (B) neoplasms. By contrast, Dep (C) neoplasms lost a preferential distribution of proliferating cells, which reached the whole neoplastic glands. These results suggest that Dep (C) adenomas and carcinomas have a unique histopathological architecture in terms of a high TGI and an enlarged distribution of proliferating cells, implying a high malignant potential.

A novel mammalian Ras GTPase-activating protein which has phospholipid-binding and Btk homology regions

We have previously purified a novel GTPase-activating protein (GAP) for Ras which is immunologically distinct from the known Ras GAPs, p120GAP and neurofibromin (M. Maekawa, S. Nakamura, and S. Hattori, J. Biol. Chem. 268:22948-22952, 1993). On the basis of the partial amino acid sequence, we have obtained a cDNA which encodes the novel Ras GAP. The predicted protein consists of 847 amino acids whose calculated molecular mass, 96,369 Da, is close to the apparent molecular mass of the novel Ras GAP, 100 kDa. The amino acid sequence shows a high degree of similarity to the entire sequence of the Drosophila melanogaster Gap1 gene. When the catalytic domain of the novel GAP was compared with that of Drosophila Gap1, p120GAP, and neurofibromin, the highest degree of similarity was again observed with Gap1. Thus, we designated this gene Gap1m, a mammalian counterpart of the Drosophila Gap1 gene. Expression of Gap1m was relatively high in brain, placenta, and kidney tissues, and it was expressed at low levels in other tissues. A recombinant protein consisting of glutathione-S-transferase and the GAP-related domain of Gap1m stimulated GTPase of normal Ras but not that of Ras having valine at the 12th residue. Expression of the same region in Saccharomyces cerevisiae suppressed the ira2- phenotype. In addition to the GAP catalytic domain, Gap1m has two domains with sequence closely related to those of the phospholipid-binding domain of synaptotagmin and a region with similarity to the unique domain of Btk tyrosine kinase. These results clearly show that Gap1m is a novel Ras GAP molecule of mammalian cells.

[A randomized controlled trail of intensive and usual community-based education for blood pressure control]

A 1.5 year community-based hypertension education program was conducted and evaluated for the feasibility and effectiveness as a program for primary prevention of cardiovascular disease. The subjects were determined to be hypertensive from cardiovascular examinations and composed of 104 untreated men and women aged 35-69 whose blood pressure levels were between 140 and 179 mmHg for systolic and/or between 90 and 109 mmHg for diastolic and who had no evidence of hypertensive end organ effects in the 1990 examination. They were randomly assigned to either an intensive education (IE) group (n = 53) or a usual education (UE) group (n = 51) and invited to education classes six months later. The IE consisted of four education classes in the first six months and another 4 classes in the next 12 months. For the UE, one class in the first 6 months and another class in the next 12 months were held. Health education was focused on reduction of sodium intake, a 30 minutes of walking, and if necessary, reduction of alcohol and sugar intake. Mean (SD) values of systolic blood pressure at the start of the education program were 144.8 (11.7) mmHg in IE and 144.5 (12.2) mmHg in UE. The respective diastolic means (SD) were 80.6 (7.8) mmHg and 80.3 (8.6) mmHg. The proportion of persons who started to receive antihypertensive medication was 8-9% in both groups at six months, and 13% in IE and 29% in UE at 1.5 years. IE showed a 6 mmHg greater reduction in mean systolic blood pressure than UE at both six months and 1.5 years. No significant difference was found in diastolic blood pressure levels over time between the two groups. Dietary improvements related to reduction of salt intake were more evident in IE than in UE. There was no significant changes in means and distributions of relative weight index and alcohol intake in either group. Subgroup analysis according to antihypertensive medication use indicated that reduction of systolic blood pressure levels was significantly larger in IE than in UE for both no medication and medication subgroups at 6 months and 1.5 years. While it was difficult to evaluate an effect of the program at 1.5 years because of the difference in the proportion of medication use between IE and UE, the results at 6 months suggest that this community-based program was effective in reducing systolic blood pressure levels.

Cloning and nucleotide sequence of cDNA encoding Asp-hemolysin from Aspergillus fumigatus

The nucleotide sequence of a cDNA encoding Asp-hemolysin from Aspergillus fumigatus was clarified. The deduced amino acid sequence was shown to contain a set of negatively charged domains similar to portions of the cysteine-rich sequence in the ligand-binding domain of LDL-receptor. A potential signal sequence was also identified in the N-terminal domain of the deduced amino acid sequence.

cDNA cloning and interferon gamma down-regulation of proteasomal subunits X and Y

Proteasomes are the proteolytic complex responsible for major histocompatibility complex (MHC) class I-restricted antigen presentation. Interferon gamma treatment increases expression MHC-encoded LMP2 and LMP7 subunits of the proteasome and decreases expression of two proteasome subunits, named X and Y, which alters the proteolytic specificity of proteasomes. Molecular cloning of complementary DNAs encoding X and Y showed that their proteins are proteasomal subunits with high amino acid similarity to LMP7 and LMP2, respectively. Thus, interferon gamma may induce subunit replacements of X and Y by LMP7 and LMP2, respectively, producing proteasomes perhaps more appropriate for the immunological processing of endogenous antigens.

Neoadjuvant intra-arterial doxorubicin chemotherapy in combination with low dose radiotherapy for the treatment of locally advanced transitional cell carcinoma of the bladder

Between 1979 and 1990, 60 patients with locally advanced bladder cancer (stages T2 to 4NXM0) were treated with intra-arterial doxorubicin chemotherapy in combination with low dose radiotherapy and 36 (60%) achieved a complete remission. The tumor size (p < 0.01), tumor grade (p < 0.05) and clinical stage (p < 0.05) correlated significantly with the tumor response to the combined therapy. Of the 36 patients with complete remission and the 24 patients who did not achieve a complete remission 35 and 22, respectively, underwent a conservative bladder operation after treatment. Median followup was 71 months. The overall 5-year disease-free and cause-specific survival rates for the 60 patients were 49% and 72%, respectively. A significantly higher (p < 0.01) 5-year survival rate was observed in patients who achieved a complete remission (94%) than in those who did not (40%). The results suggest that intra-arterial chemotherapy plus radiotherapy is a useful regimen for patients with locally advanced bladder cancer, and bladder function may be preserved in those who achieve a complete remission.

[The effects of a novel Ca2+ channel blocker, KB-2796, on 5-HT-induced responses]

The effects of KB-2796, a new Ca(2+)-channel blocker, on 5-hydroxytryptamine (5-HT)-induced responses were investigated in comparison with those of other Ca(2+)-channel blockers such as verapamil, flunarizine, diltiazem and nimodipine. In rat cortical membrane, KB-2796 inhibited specific [3H]spiperone binding to 5-HT2 receptors in a competitive manner (Ki = 0.57 microM), but exhibited negligible affinity for radioligand binding to other 5-HT receptor subtypes such as 5-HT1, 5-HT1A, 5-HT1B, 5-HT1C and 5-HT3 at a concentration of 10 or 100 microM. KB-2796 inhibited both 5-HT-stimulated shape change and 5-HT and collagen-stimulated aggregation in rabbit platelet-rich plasma with IC50 values of 13.4 microM and 96.4 microM, respectively. KB-2796 also inhibited the 5-HT-induced increase of [Ca2+]i in washed rabbit platelets with the IC50 value of 25.7 microM. Furthermore, KB-2796 (3-30 mg/kg, p.o.) dose-dependently inhibited the 5-HT-induced paw edema in rats. In these experiments, the inhibitory effects of KB-2796 and other Ca2+ channel blockers were related to their affinities for the 5-HT2 receptor; and the potency of KB-2796 was stronger than those of diltiazem and nimodipine and almost equal to that of flunarizine, although all these inhibitors had weaker potencies than that of verapamil. These findings indicate that KB-2796 may possess antagonistic effect on the 5-HT2 receptor.

[Prognostic factors for muscle-invasive bladder cancer treated with a combination of intra-arterial chemotherapy and low-dose radiotherapy]

Clinical and pathological factors that affect short-term responses and long-term prognosis of muscle-invasive bladder cancer were studied in 73 patients who underwent a combination of intra-arterial chemotherapy and low-dose radiotherapy. Complete Response (CR) was observed in 41 (56%) of the 73 patients. The frequency of CR was significantly different according to the sex (males 64%, females 29%; p = 0.0239), clinical stage (T2 74%, T3 64%, T4 20%; p = 0.0005), tumor size (< 3 cm 81%. > or = 3 cm 31%; p < 0.0001), and tumor grade (G3 72%, G2 41%, p = 0.0127). By multivariate analysis, a significant difference was observed only in the tumor grade. The 5-year survival rate after bladder-preserving operations (median duration of follow-up 69 months) was significantly different according to the sex (males 75.2%, females 57.1%; p = 0.0427), clinical stage (T2 86.3%, T3 82.3%, T4 33.8%; T2 vs T4, p = 0.0005; T3 vs T4, p = 0.0107), tumor size (< 3 cm 89.6%, > or = 3 cm 47.2%; p = 0.0012), and tumor response (CR 95.0%, non-CR 38.6%; p < 0.0001). By multivariate analysis, a significant difference was observed only in the tumor response. The combination therapy of intra-arterial infusion and irradiation produced excellent short-term effects and prolonged the survival of the patients. Preservation of the bladder is considered to be possible in patients who obtained CR.

[A study on the visibility of different floor levels--experiments from a stumbling point of view]

Experiments were conducted to examine the visibility of different floor levels from a stumbling point of view. The test subjects were the elderly and the young, and we compared the difference between the two. We investigated eye movement while they were scanning the different floor levels. The results were as follows: 1) The height of different floor levels and illuminance had an influence on the visibility of different floor levels. Especially, the elderly were easily influenced by them. 2) The eye movements in scanning the different floor levels did not relate to the visibility of them, but were related to the personality of the test subjects. Eye movement patterns of the elderly differed from that of the young. The elderly were scanning mainly the lower part. The eye fixation time of the elderly was longer than that of the young. From the results, it was clarified that there were the difference between the elderly and the young. We could show it by the degree of influence. For example, the influence by the change of environmental condition.

Heat shock protein produced by Helicobacter pylori

The cells of Helicobacter pylori were suspended in the medium containing 35S-methionine. After a heat shock of the cells at 42 C for 5, 10, and 30 min, the production of proteins was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. Out of many proteins produced by the cells, only 66 kDa protein production was dramatically increased by heat treatment. The N-terminal amino acid sequence of 66 kDa protein was quite similar to that of 62 kDa and 54 kDa proteins previously suggested as heat shock protein (HSP) of H. pylori based on the reaction with polyclonal and monoclonal antibodies against HSP 60 family proteins produced by other bacteria. Therefore, it was concluded that H. pylori produces the 66 kDa protein as its major heat shock protein which belongs to HSP 60 family.

Comparison of effects of nicardipine and trichlormethiazide on insulin sensitivity in hypertensive patients

We performed a randomized, crossover study comparing the effects of nicardipine and trichlormethiazide on insulin sensitivity in 8 untreated essential hypertensive patients. They were treated either with nicardipine or trichlormethiazide for 12 weeks, after which they were treated with the alternative drug for a further 12 weeks. Insulin sensitivity was determined by the hyperinsulinemic euglycemic clamp technique. Nicardipine had no adverse effect on insulin sensitivity. Trichlormethiazide decreased insulin sensitivity index by 12%. As nicardipine does not have an adverse effect on insulin sensitivity, it should be preferred in patients who have a proven metabolic abnormality.

Helicobacter pylori induces inflammation in mouse urinary bladder and pelvis

Helicobacter pylori was transurethrally inoculated into the mouse urinary tract. The organism established infection and induced inflammation in the urinary bladder and pelvis. During the infection, urinary pH was elevated, probably due to the production of NH3 by bacterial urease. H. pylori was recovered from the urinary bladder, kidney and urine of the infected mice. Histopathologically, severe neutrophil infiltration was observed in the mucosal layer of both organs. H. pylori was detected on the surface of the epithelial cells. These results indicate that low pH and bacterial flora were not essential factors in establishing the mucosal infection with H. pylori. This experimental system is useful to investigate the pathogenicity of H. pylori in mucosal organs.

[Perioperative alterations in polymorphonuclear leukocyte function mediated by protein kinase C]

To characterize the perioperative alterations in polymorphonuclear leukocytes (PMN) function mediated by protein kinase C, we studied twenty six patients undergoing gastrointestinal surgery. Seventeen patients with thoracic esophageal cancer were underwent total thoracic esophagectomy through a right thoracotomy (severe surgical stress group). Nine patients underwent cholecystectomy (slight surgical stress group). Measurement of O2- production capacity was used as a reflection of the activity of NADPH oxidase, and the activity of myeloperoxidase-H2O2-halide system was evaluated using luminol-dependent chemiluminescence. O2- production stimulated by phorbol 12-myristate 13-acetate (PMA) was suppressed, reaching a minimum on POD 3. On the other hand, luminol dependent chemiluminescence increased significantly after surgery, reached a maximum on POD 3. These alterations were more remarkable in the severely stressed patients. These results suggest that postoperative PMN signal transduction mechanisms, mediated by protein kinase C, may activate myeloperoxidase-H2-O2-halide system but suppress NADPH oxidase system dependently of the degree of surgical stress, revealing a differential effect of protein kinase C activation on PMN microbicidal activity.

Defense effects of a traditional Chinese medicine (sho-saiko-to) against metabolic disorders during endotoxemia; approached from the behavior of the calcium ion

The present study was carried out as an approach from intracellular Ca2+ to clarify the preventive effects of a traditional Chinese medicine, Sho-saiko-to (Kampo prescription, TJ-9), against various metabolic disorders during endotoxemia. In this experiment, we estimated the cytosolic-free Ca2+ concentration ([Ca2+]i) in liver single cells using a photonic microscope system. The [Ca2+]i in a single liver cell of endotoxin (6 mg/kg, i.p.)-injected mice was greater at 18 h post-intoxication than that in the control, whereas the administration of endotoxinin to TJ-9 (500 mg/kg/d, p.o.)-pretreated mice resulted in a markedly lower level of [Ca2+]i than that in endotoxin-treated mice. In the mice pretreated with TJ-9, the CA(2+)-ATPase activity in liver plasma membrane 18 h after endotoxin injection was markedly increased as compared to that in the endotoxin-treated mice. By contrast, the Ca(2+)-ATPase activity in liver mitochondria was lower in endotoxemic mice pretreated with TJ-9 than in mice given endotoxin alone. State 3 respiration and the respiratory control index (RCI), which are the parameters of mitochondrial function, were 41% and 35% lower, respectively, in the liver of mice given endotoxin than those levels in the control. However, the levels of state 3 and RCI in endotoxin-TJ-9-treated mice were markedly increased as compared to those of the endotoxin-treated mice. These findings suggest the protective effect of TJ-9 in the damage of liver mitochondrial function in endotoxin-poisoned mice.(ABSTRACT TRUNCATED AT 250 WORDS)