Amount of Helicobacter pylori in gastric mucus during anti-H. pylori treatment

Helicobacter pylori is present in infected patients not only on the gastric epithelial cell surface but also in gastric mucus. We developed a competitive polymerase chain reaction (cPCR) method for quantitative measurement of H. pylori in gastric mucus. The aim of this study was to determine the number of H. pylori in gastric mucus before and after anti-H. pylori treatment. Patients with duodenal ulcer were treated with lansoprazole alone (n = 11) or lansoprazole and amoxycillin (n = 12). The amount of H. pylori in gastric mucus was measured over time by a cPCR assay. Helicobacter pylori infection was also tested for using histology, culture, and the rapid urease test (RUT). Although most patients treated with lansoprazole alone had become H. pylori-negative by the end of treatment when tested by histology, RUT, and culture, a large number of H. pylori organisms were found in the gastric mucus at that time by cPCR. These patients returned to being H. pylori positive 1 to 12 months later on the basis of histology, RUT, and culture. However, cPCR results indicated eradication of H. pylori by the end of treatment in eight of the 12 patients treated with lansoprazole and amoxicillin, and these patients remained H. pylori negative on histology, RUT, culture, and cPCR 1 to 12 months later. Testing for H. pylori in gastric mucus is thus useful for precise determination of the success or failure of H. pylori eradication therapy.

Clinicopathological significance of intratubular giant macrophages in progressive glomerulonephritis

Very large macrophages, which we have termed "giant macrophages" (G-M phi), have been found in renal tubules, some containing cytoplasmic vacuoles. To elucidate their pathophysiological roles, we examined renal biopsy tissues from various primary glomerulonephritis (GN) and tubulointerstitial nephritis (TIN) using immunohistochemistry with monoclonal antibodies against M phi and other cell surface markers. Giant macrophages were absent or rare in TIN, minimal change nephrotic syndrome, and minor glomerular abnormalities, but G-M phi was plentiful in progressive glomerulonephrides such as IgA nephropathy with crescents, membranoproliferative GN, focal segmental glomerulosclerosis, and especially in crescentic GN. These G-M phi were usually seen in the lumen of renal tubules, but occasionally were found in the Bowman's spaces and glomerular tufts, and similar cells were also found in urine. Moreover, they frequently made contact with tubular epithelial cells expressing intercellular adhesion molecule-1, and the tubular epithelial cells in such lesions often had degenerative changes. Giant M phi may damage tubular epithelial cells from the luminal side. Phenotypically, G-M phi showed activated (CD71+) and mature (25F9+) characteristics along with features of M phi (CD68+), and the cytoplasm contained a great deal of lipids. The numbers of G-M phi in renal tissues closely correlated with the degree of hematuria (rho = 0.5, P < 0.001), serum creatinine value (r = 0.63, P < 0.001) in GN patients (N = 96) and with proteinuria in IgA nephropathy patients (r = 0.89, P < 0.001, N = 27). These data suggest that G-M phi are M phi that were activated and matured in certain active inflammatory sites, which flowed into tubules and then into urine. Thus, the existence of G-M phi in biopsy tissue or urine reflect the activity of GN and may have a predictive value for the progression of GN.

Combined brachytherapy and external beam radiotherapy in normal monkey brains--experimental radiation necrosis evaluated by sequential magnetic resonance imaging

Radiation-induced brain damage was evaluated using sequential magnetic resonance (MR) imaging in monkeys more than 1 year after either brachytherapy or combined brachytherapy and external beam radiotherapy (EBRT). MR images were obtained 1 week, 1 month, 3 months, and subsequently every 3 months after brachytherapy, and the volume of the lesions was measured. In all four monkeys receiving only brachytherapy and three of the four animals receiving combined brachytherapy and EBRT, MR imaging revealed only transient extensive edema 1 week after treatment and ring enhancement, which was maximal 3 months after treatment, surrounding the implantation site. In one of the four animals undergoing combined brachytherapy and EBRT, MR images obtained 9 months after treatment showed an irregularly extending enhanced lesion with edema. MR images obtained 15 months after brachytherapy in this monkey showed the lesion extended into the contralateral hemisphere through the corpus callosum. Necropsy revealed severe radiation necrosis. This animal developed a very similar MR imaging presentation to that often encountered in human brains after combined brachytherapy and EBRT.

Effect of Helicobacter pylori infection on gastric juice pH

BACKGROUND

How Helicobacter pylori infection affects gastric acid secretion is still unclear.

METHODS

Gastric juice pH, ammonia concentration in gastric juice, serum gastrin level, and grade of gastritis in accordance with the Sydney System were determined for patients with gastric ulcer (GU) and duodenal ulcer (DU) before and after treatment with lansoprazole and amoxicillin, and results were compared with those of H. pylori-negative controls.

RESULTS

Scores for H. pylori density, atrophy, metaplasia, and activity of gastritis in the corpus were higher in patients with GU, especially those with proximally located GU, than in those with DU. Gastric juice pH was significantly higher in GU patients than in DU patients and controls. After H. pylori eradication, gastric juice pH and serum gastrin levels in both GU and DU patients were significantly decreased to control levels. In patients without eradication, no significant changes in these factors were observed.

CONCLUSIONS

These findings suggest that H. pylori infection and gastritis in the corpus suppress acid secretion and increase gastric juice pH, resulting in hypergastrinemia, and that eradication of H. pylori normalizes acid secretion and serum gastrin levels.

Proliferative potential and apoptosis in rat glioma cell lines after hyperthermia

The proliferative potential of cultured rat glioma cells (C6 and 9L) was evaluated after hyperthermia using immunohistochemical staining with bromodeoxyuridine (BrdU) and Ki-67 monoclonal antibodies. Apoptosis was assessed by in situ end-labeling of deoxyribonucleic acid breaks. Both BrdU and Ki-67 labeling indexes decreased with increasing hyperthermia time. The decrease of the Ki-67 labeling index was not as great as that of the BrdU labeling index. The number of apoptotic cells increased with time after hyperthermia. These results indicate that the antitumor effect of hyperthermia may reflect the induction of apoptosis in the cells within the cell cycle, and the resultant reduction of the proliferative potential of surviving cells, especially in the S phase.

Simultaneous determination of tetrahydrocortisol and tetrahydrocortisone in human plasma and urine by stable isotope dilution mass spectrometry

A capillary gas chromatographic-mass spectrometric method for the simultaneous determination of tetrahydrocortisol (THF, 3alpha,11beta,17alpha,21-tetrahydroxy-5beta-preg nane-20-one), allo-tetrahydrocortisol (allo-THF, 3alpha,11beta,17alpha,21-tetrahydroxy-5alpha-pre gnane-20-one) and tetrahydrocortisone (THE, 3alpha,17alpha,21-trihydroxy-5beta-pregnane-11,20-dion e) in human plasma and urine is described. [1,2,3,4,5-2H5]THF (THF-d5), allo-[1,2,3,4,5-2H5]THF (allo-THF-d5) and [1,2,3,4,5-2H5]THE (THE-d5) were used as internal standards. A double derivatization (bismethylenedioxypentafluoropropionate, BMD-PFP) made possible the separation of the three tetrahydrocorticoids with good gas chromatographic behavior. Quantitation was carried out by selected-ion monitoring of the characteristic fragment ions ([M-30]+) of the BMD-PFP derivatives of THF, allo-THF and THE. The sensitivity, specificity, precision and accuracy of the method were demonstrated to be satisfactory for measuring low concentrations of THF, allo-THF and THE in human plasma and urine.

Malignant cerebellar astrocytoma developing 15 years after radiation therapy for a medulloblastoma

A case of malignant cerebellar astrocytoma occurring 15 years after the radiation therapy for a medulloblastoma is reported. The tumor developed at the same site of irradiation after a sufficient latent period and was completely different from medulloblastoma in its histology. This tumor fulfilled the criteria of radiation-induced neoplasm. Only seven similar cases have been reported up to the present. Whole neuraxis irradiation following a gross total resection is a standard treatment for medulloblastoma, but the possibility of the development of radiation-induced tumors must be borne in mind for a long time after the radiation therapy for medulloblastoma.

Membranoproliferative glomerulonephritis in the aged and its possible causal relationship with CD8+CD57+ lymphocytes

Membranoproliferative glomerulonephritis (MPGN) is a chronic progressive glomerulonephritis that occurs primarily in patients under the age of 30, and is rare in the elderly. We report eight aged patients with MPGN associated with CD8+CD57+ lymphocytosis. All eight patients showed a significant increase in CD8+CD57+ lymphocytes with a significant decrease in the ratio of CD4+ cells to CD8+ cells. Infiltration of CD8+CD57+ lymphocytes was observed within capillary lumens to various degrees according to the severity of endocapillary proliferation in each case. Expression of endothelial-leukocyte adhesion molecule-1 was observed in a focal and segmental manner on glomerular endothelial cells and on the endothelium of arterioles and arteries in kidney tissue in four cases in which a pronounced endocapillary proliferation was simultaneously seen. These findings suggest that cell-mediated cytotoxic mechanisms against glomerular endothelial cells may be involved in the pathogenesis of MPGN in the aged.

Preventive effect of erythromycin on experimental bleomycin-induced acute lung injury in rats

BACKGROUND

Erythromycin has been reported to have an inhibitory effect on chronic inflammatory airway disease and chronic infiltration of neutrophils into the airway. Bleomycin (BLM) often induces interstitial lung fibrosis following acute lung injury. A study was undertaken to investigate the effects of erythromycin (EM) on experimental bleomycin-induced acute lung injury in rats.

METHODS

Bleomycin-induced lung injury was assessed by light microscopic examination, measurement of neutrophil elastase activity and of the interleukin 8 (IL-8) content in bronchoalveolar lavage (BAL) fluid. The potential inhibitory effect of erythromycin was assessed by overall comparison of erythromycin untreated (BLM alone), concurrently treated (BLM + EM), and pretreated (BLM + pre-EM) groups.

RESULTS

The neutrophil count and concentration of neutrophil-derived elastase in BAL fluid were significantly different in the three groups. The morphological changes of lung injury were also less extensive in rats pretreated with erythromycin. However, these protective effects were not marked in the group concurrently treated with erythromycin. Moreover, the concentration of IL-8 in the BAL fluid tended to be less in the erythromycin treated groups; however, there were no significant differences between the bleomycin-treated groups.

CONCLUSION

Erythromycin exhibits a prophylactic effect on acute lung injury induced by intratracheal administration of bleomycin, which is possibly associated with a downregulation of neutrophil-derived elastase.

Stable isotope methodology for kinetic studies of interconversion of cortisol and cortisone in a human subject

Oral administration of 5 mg each of deuterium-labeled cortisol ([1,1,19,19,19-2H5]cortisol, cortisol-d5) and cortisone-d5 ([1,1,19,19,19-2H5]cortisone) to a human subject on two different occasions four weeks apart provided a useful means of characterizing the kinetics of the interconversion of cortisol and cortisone. From the data on plasma concentration measurements of cortisol-d5, cortisone-d5, cortisone-5, endogenous cortisol and endogenous cortisone by gas chromatography-mass spectrometry, it was demonstrated that (1) the plasma concentration ratio of cortisone-d5 to cortisol-d5 approached a plateau 4-5 h following either the cortisol-d5 or cortisone-d5 administration and the plateau values for the cortisone-d5 and cortisol-d5 administration were almost identical (about 0.43) and (2) dosing with only 5 mg of the deuterium-labeled steroids suppressed the plasma concentrations of endogenous cortisol and cortisone.

[Pagetoid spread of intratubular germ cell neoplasia into rete testis forming tumor-like mass]

Intratubular germ cell neoplasia (ITGCN) is the preinvasive phase of testicular germ cell tumors. ITGCN can spread into the rete testis in a pagetoid manner, but there are very few published data about this phenomenon. Furthermore, the tumor-like mass formed by ITGCN with pagetoid spread into the rete testis has not been documented to date, and the present case is the first to be reported. A tumor-like mass was found close to the superior pole of the left testis in a 39-year-old male and was unrelated to the epididymis. Three other nodules of seminoma surrounded by fibroconnective tissue existed next to the mass. Histological sections revealed ITGCN which was characterized by the presence of large and polygonal germ cells exhibiting clear cytoplasm with distinct cell borders. The cytoplasm was rich in glycogen and the cell membrane was immunohistochemically positive for placental alkaline phosphatase. The nuclei had less coarse chromatin than that of seminoma. ITGCN cells spread in between the lining epithelium of the rete and the basement membrane. This characteristic spread was consistent with pagetoid spread into the rete testis.

[The immunoreactivity studies of the idiopathic inflammatory myopathy over the past three years in our laboratory]

Biopsied skeletal muscles from patients with inflammatory myopathy (6 cases of polymyositis (PM), 2 cases of dermatomyositis (DM), 5 cases of collagen disease with polymyositis and a case of allergic granulomatous angitis) were examined by comparing immunostained infiltrated cells at perivascular, perimysial and the endomysial sites as well as examining the histochemical findings on serial frozen sections from cases examined by our laboratory over the past three years. CD68 was used for macrophage, L26 for B lymphocytes, CD4 and CD8 for T lymphocytes. Expression of HLA-ABC was examined for Class I antigen and HLA-DR for Class II antigen on the muscle fibers. Many macrophages and CD8-positive T lymphocytes had infiltrated the endomysium in PM. Many CD4-positive T lymphocytes and L26-positive B lymphocytes had infiltrated perivascular sites in DM. These results were almost the same as those in many other reports. HLA-ABC was positive on the muscle sarcolemma in all cases. However, the expression of HLA-DR was not identical in all cases. It is useful to determine the diagnosis and consider a pathogenesis of inflammatory muscle diseases to analyze the infiltrated cells and the site of infiltration even in case showing few of infiltrating cells and necrotic fibers.

Therapeutic effects of water-soluble echinocandin compounds on Pneumocystis pneumonia in mice

The therapeutic effectiveness of water-soluble echinocandin compounds obtained from Coleophoma empetri F-11899, which has a strong inhibitory effect on the growth of fungi, was examined in nude mice with experimental Pneumocystis pneumonia. The studies demonstrated the potential usefulness of the compounds.

Determination of naringin and naringenin in human urine by high-performance liquid chromatography utilizing solid-phase extraction

An HPLC method for determining a flavonoid naringin and its metabolite, naringenin, in human urine is presented for application to the pharmacokinetic study of naringin. Isocratic reversed-phase HPLC was employed for the quantitative analysis by using hesperidin for naringin or hesperetin for naringenin as internal standard and solid-phase extraction using a strong anion exchanger, Sep-Pak Accell QMA cartridge. The HPLC assay was carried out using an Inertsil ODS-2 column (250 x 4.6 mm I.D., 5 microm particle size). The mobile phases were acetonitrile-0.1 M ammonium acetate-acetic acid (18:81:1, v/v; pH 4.7) for naringin and acetonitrile-0.1 M ammonium acetate-triethylamine (25:75:0.05; v/v; pH 8.0) for naringenin. The flow-rate was 1.0 ml min(-1). The analyses were performed by monitoring the wavelength of maximum UV absorbance at 282 nm for naringin and at 324 nm for naringenin. The lower limits of quantification were ca. 25 ng/ml for naringin and naringenin with R.S.D. less than 10%. The lower limits of detection (defined as a signal-to-noise ratio of about 3) were approximately 5 ng for naringin and 1 ng for naringenin. A preliminary experiment to investigate the urinary excretion of naringin, naringenin and naringenin glucuronides after oral administration of 500 mg of naringin to a healthy volunteer demonstrated that the present method was suitable for determining naringin and naringenin in human urine.

The POU gene ceh-18 promotes gonadal sheath cell differentiation and function required for meiotic maturation and ovulation in Caenorhabditis elegans

In Caenorhabditis elegans, specialized contractile myoepithelial cells of the somatic gonad, the gonadal sheath cells, are closely apposed to oocytes and are required for normal meiotic maturation and ovulation. Previously we found that mutations in the ceh-18 gene, which encodes a POU-class homeoprotein expressed in sheath cells, result in oocyte defects. To determine the basis for these oocyte defects, we have used time-lapse video Nomarski microscopy to observe meiotic maturation, ovulation, and early embryogenesis in ceh-18 mutants. In ceh-18 mutants sheath cell contractions are weaker, less frequent, and uncoordinated throughout the sequence of ovulation events, and ovulation is defective. Defective ovulation can result in the formation of endomitotic oocytes in the gonad, the formation of haploid embryos, and reversals in embryonic polarity. ceh-18 mutant oocytes exhibit defects prior to nuclear envelope breakdown, suggesting that they are physiologically different from the wild type. We observed delays in meiotic maturation, as well as maturation out of the normal spatial and temporal sequence, suggesting that proximal sheath cells directly or indirectly promote and spatially restrict meiotic maturation. Analysis of sheath cell differentiation in ceh-18 mutants using antibodies to proteins of the contractile apparatus reveals that although contractile proteins are expressed, the sheath cells appear disorganized. Transmission electron microscopy reveals that ceh-18 mutant sheath cells are morphologically irregular and only loosely cover oocytes. Taken together, these observations indicate that ceh-18 is a crucial determinant of sheath cell differentiation, a function required for normal meiotic maturation and ovulation.

Effect of adjuvant iridium-192 brachytherapy on the survival of patients with malignant gliomas

The effect of iridium-192 brachytherapy (BRTX) on the survival of patients with malignant gliomas was evaluated in 83 patients with malignant gliomas (42 astrocytoma grade III, 41 glioblastoma multiforme) over a period of 8.5 years. Fifty patients (Group 1) received only standard external beam radiotherapy (EBRT) (mean dose 51.5 +/- 12.4 Gy in 2.0 Gy fractions), and 33 patients (Group 2) received EBRT (mean dose 51.0 +/- 10.8 Gy) combined with BRTX (mean dose 50.2 +/- 13.2 Gy, dose rate of 0.3-0.4 Gy/hr). The median survival periods for patients in Groups 1 and 2 were 12.2 and 23.7 months, respectively (p = 0.0145). The median survival for 17 patients in Group 2 with glioblastoma multiforme was 21.9 months. Using BRTX as an adjuvant to EBRT appeared to confer survival benefits compared to only EBRT (p = 0.0284). Univariate and multivariate analysis identified the variables of histological diagnosis, location, Karnofsky performance status, and BRTX as relevant risk factors for survival time (p < 0.05 for each factor). Among these factors, BRTX was the most important for prolonging survival (p = 0.0015). Adjuvant iridium-192 BRTX and conventional EBRT appears to greatly improve the survival time of patients with malignant gliomas compared to only EBRT and may be the treatment of choice in selected patients with tumors located in deep-seated or eloquent areas.

[Stereotactic brachytherapy for clival chordoma]

There has recently been interest in the use of high-dose radiation with methods such as radiosurgery and brachytherapy for skull base tumors. Brachytherapy is believed to be effective for clival chordomas, but technical difficulties exist in stereotactic insertion of catheters into the clivus. We assessed the usefulness following improvement of implantation techniques in three patients with clival chordomas. All tumors were larger than 50 mm in diameter. Removable iridium-192 sources were held in catheters which were implanted through a transnasal approach under general anesthesia using a CT-guided stereotactic system in one patient and a CRW stereotactic system adapted to a magnetic resonance imaging (MRI) scanner in 2 patients. The implantation array was designed based on results of stereotactic 3-D MRI scanning, and coordinates were calculated for stereotactic implantation through twist drill holes. These catheters were introduced through the nares and directed into the clival chordoma under endoscopic visualization and X-ray fluoroscopy. No complications such as CSF liquorrhea, hemorrhage or infection were observed. Brachytherapy with a total dose of 43.2-58.0 Gy at the tumor periphery was administered for 7 to 10 days, and serial follow-up imaging studies demonstrated reduction in tumor size in two patients and no tumor growth in the other. Our results suggested that stereotactic brachytherapy is potentially useful for the control of clival chordomas and that computer-guided transnasal stereotactic insertion enables implantation of catheters less invasively and more accurately than does X-ray fluoroscopic guidance alone.

Construction of a Two-Dimensional Ultra-Small-Angle X-ray Scattering Apparatus

A two-dimensional ultra-small-angle X-ray scattering (USAXS) apparatus was constructed using a rotating-anode X-ray generator and a Bonse–Hart camera. In this camera, two sets of two channel-cut single crystals were used to collimate the X-ray beam in both the horizontal and the vertical planes. The measured intensity profile of the direct beam showed a high small-angle resolution in all directions on the detector plane. The full width at half-maximum was 17′′, indicating that the apparatus can be applied to structural analysis in the range up to 2 μm, even for directionally oriented samples. One- and two-dimensional USAXS profiles from colloidal silica powder agreed well with each other, showing that the desmearing procedure adopted in the previous one-dimensional USAXS experiments were justified.

Evaluation of intracerebral grafting of dopamine-secreting PC12 cells into allogeneic and xenogeneic brain

The PC12 phenochromocytoma tumor cell line is derived from a rat adrenal medullary tumor and secretes dopamine. We have previously reported that grafted microencapsulated PC12 cells using agarose and poly (styrene sulfonic acid) survived in the xenogeneic brain without immunosuppression. To investigate whether unencapsulated PC12 cells form a tumor and how they provoke immunological reaction, PC12 cell suspension was implanted into the striatum of Sprague-Dawley rat (allogeneic graft) or guinea pig (xenogeneic graft) and histological analysis using Nissl stain and immunocytochemical analysis using antityrosine hydroxylase (TH) antibody were performed 1, 2, and 4 wk after transplantation. Host animals were not immunosuppressed. PC12 cells formed a mass 1 and 2 wk after transplantation both in allogeneic and xenogeneic brain. These grafted PC12 cells were immunoreactive to anti-TH antibody. Four weeks after transplantation, however, grafted PC12 cells in the allogeneic brain were only found within the restricted area near the site of implantation. In the xenogeneic brain, only the trace of grafted PC12 cells were found around the site of implantation 4 wk after transplantation. In both allogeneic and xenogeneic animals, a number of lymphocytes were found in and around the grafts at all period investigated. These findings indicate that PC12 cells could survive in the allogeneic or xenogeneic brain for 2 wk and were ultimately rejected by immunological reaction by 4 wk after transplantation. Implantation of encapsulated PC12 cells in the allogeneic or xenogeneic brain is considered a safe and effective method for delivering dopamine into the brain because PC12 cells will not form a tumor in the long-term even if capsules are damaged in some reason.

Induction of resistance to etoposide and adriamycin in a human glioma cell line treated with antisense oligodeoxynucleotide complementary to the messenger ribonucleic acid of deoxyribonucleic acid topoisomerase II alpha

Acquisition of resistance to anticancer agents is a serious problem for cancer chemotherapy. The present study analyzed the relationship between expression of the alpha isoform of deoxyribonucleic acid (DNA) topoisomerase II (topo II alpha) and chemosensitivity to topo II inhibitors by modulating the level of topo II alpha expression. A phosphorothioate analogue of an 18-nucleotide oligomer which is complementary to the translation initiation site of the human topo II alpha messenger ribonucleic acid sequence was used to suppress the expression of topo II alpha in a human glioma cell line (U373MG). The topo II alpha activity of the treated cells was reduced to 1/3 of untreated cells in a decatenation assay using kinetoplast DNA. Antisense oligoDNA-treated cells showed mild resistance to the topo II inhibitors, etoposide and adriamycin, of about 2.0 fold and 1.5 fold, respectively, compared to control cells. Only partial reduction in the activity of topo II alpha in the glioma cell line can cause a measurable resistance to topo II inhibitors, implying that the degree of topo II expression is correlated with chemosensitivity to topo II inhibitors.