[A case of multiple liver metastasis from remnant gastric cancer responding to leucovorin.5-FU+UFT therapy]

We report a case of a 67-year-old male patient who experienced multiple liver metastasis 6 months after undergoing an operation for remnant gastric cancer. The histological classification of the cancer in gastric remnant was poorly-differentiated adenocarcinoma. The patient was treated with a low dose of LV.5-FU once a week and oral UFT as an outpatient. As a result, after 3 months of the treatment, CT showed that multiple liver lesions almost disappeared, a condition that lasted about 3 years without relapse. Toxic effects due to this treatment were temporary slight liver disfunction, mild anorexia and stomatitis. This case indicates that the regimen of LV.5-FU+UFT may be effective for multiple liver metastasis from postoperative remnant gastric cancer, enabling the patient to maintain an excellent QOL (quality of life).

[Continuous intraarterial infusion of 5-fluorouracil plus leucovorin for liver metastases from colorectal cancer]

Between September 1990 and August 1994, 11 patients (pts) with liver metastases (mets) from colorectal cancer were treated with continuous hepatic arterial infusion chemotherapy of 5-fluorouracil (FU) plus leucovorin (LV). Eight pts had non-resectable liver mets (H3: 7, H2: 1), and 3 had residual small mets after resection of major mets. Drugs were administered via an extracorporeal infusion device connected to the hepatic arterial infusion port. 5-FU and LV were given through a 5- to 7-day continuous infusion at 500-750 mg/body/day and 30 mg/body/day, respectively, with a 3- to 4-week rest period. In the recent 6 pts, cisplatin was administered as a 2-hour infusion at 25 mg/body, one or two times simultaneously. Grade 2 toxicity was noted in two pts (18%). One was stomatitis and another was uncontrolled ascites in an advanced cirrhotic pt. The response rate in the 9 evaluable pts was 67% with 6 PR and no CR. The duration of the response was 5 to 9 months. One- and two-year survival rates were 75% and 22%, respectively. These results were superior to those of the intermittent bolus injection of 5-FU plus MMC (or epirubicin) in 40 pts from 1977 to 1994. These results suggest that continuous 5-FU plus LV arterial infusion is an effective regimen in pts with liver metastases from colorectal cancer. However, the infusion with an extracorporeal device limits the pts' quality of life. Further investigation is needed for a schedule that can be practiced for a longer period.

Proteus syndrome with renal involvement

We report on a case of an 11 year old girl with Proteus syndrome involving both kidneys morphologically and functionally. The patient had hemihypertrophy, scoliosis, overgrowth of lower extremities, partial macrodactyly, subcutaneous lipoma, and pigmented nevi compatible with the Proteus syndrome. She also had overgrowth of the right kidney with mildly impaired function and a small left kidney with severe dysfunction. Morphological involvement of visceral organs has previously been described; however, deteriorating renal function has not previously been reported in this syndrome.

Reduction of androgen receptor mRNA concentration by testosterone in mouse submandibular gland

In this study, we examine the effect of testosterone on the steady-state concentration of androgen receptor (AR) mRNA of mouse submandibular gland. Northern blot analysis showed the expression of an AR-specific 10-kb transcript in the submandibular glands of both sexes. Quantitative analysis was done by means of reverse transcription-polymerase chain reaction (RT-PCR) with a non-radioactive label of digoxigenin. The RT-PCR demonstrated that the steady-state of AR mRNA concentration was less in males than in females. Moreover, AR mRNA increased in the castrated male mice, while the administration of testosterone reduced the AR mRNA in female mice. In conclusion, the amount of AR mRNA in mouse submandibular gland is reduced by androgen.

[Interferon treatment for chronic hepatitis C--assessment of 3 regimens in patients received more than 500MU interferon treatment and their effect predictive factors for interferon treatment using multivariate analysis with the logistic regression model]

Chronic hepatitis C patients (n = 115) were treated with interferon (IFN). Total dose employed was more than 500 MU. The response rate was assessed among the three treatment groups: 2W continuous+TIW, 4W continuous+TIW, 8W continuous+TIW. The IFN treatment effect predictive factors were also assessed. Complete response (CR) rate, CR with serum HCV-RNA disappearance rate, responders' histology activity index score changes between before and after treatment, and responders' hepatocytes HCV-RNA disappearance rate did not differ among the three treatment regimens. CR to IFN treatment was dependent on serum HCV-RNA and HCV serotype. Patients of low serum HCV-RNA and serotype II were responsive to IFN treatment.

[Analysis of DNA content in primary colorectal carcinoma and lung metastasis]

We analyzed DNA content of resected primary colorectal carcinoma and lung metastasis by flow cytometry. Of the 14 primary lesions, 5 cases showed diploid pattern, 9 cases aneuploid pattern. In contrast, 12 metastatic lung lesions of 19 showed diploid pattern and 7 lesions aneuploid pattern. DNA index of primary and metastatic lesions was 1.4 +/- 0.4 and 1.2 +/- 0.2, respectively (p = 0.08). In combination of DNA ploidy pattern between primary and metastatic lesions, there were 11 in which ploidy pattern was identical, 1 in which metastasis was aneuploid and primary was diploid, 7 in which metastasis was diploid and primary was aneuploid. Four year, survival rate from operation of metastasis was better in diploid pattern than in aneuploid pattern, but it was not significant. These results indicate that patients who have operative indication of metastasis from colorectal carcinoma have metastatic tumor which shows relatively good biological behavior (diploid tumors) and that there are heterogeneity of ploidy pattern between primary and metastatic lesions.

Cysteine protease activity of streptococcal pyrogenic exotoxin B

Streptococcal pyrogenic exotoxin B (SPE B) was purified and its protease and mitogenic activities were investigated. The apparent molecular mass of SPE B purified in the presence of iodoacetic acid was 42 kDa, whereas 29-kDa SPE B was predominant without the reagent. A polyclonal antibody raised against the 29-kDa species reacted with both species, indicating that the 42-kDa species was a precursor of the 29-kDa entity. Both the 42- and 29-kDa species enhanced [3H]thymidine incorporation into human peripheral blood mononuclear cells, whereas neither had any effect on T cell depleted mononuclear cells. The 29-kDa SPE B possessed caseinolytic activity, with an optimal pH of 8, and the activity was specifically suppressed by the antibody. A group of cysteine protease inhibitors, but no serine-, metallo-, or acidic-protease inhibitors, limited the protease activity, whereas dithiothreitol increased the activity. The DNA sequence around a putative active cysteine residue was identical among the speB genes from Streptococcus pyogenes R70, NY-5, and T19. Taken together, these results indicate that SPE B is identical to a cysteine protease, streptopain (EC 3.4.22.10).

Pulsating electromagnetic field stimulates mRNA expression of bone morphogenetic protein-2 and -4

The effects of a pulsating electromagnetic field on mRNA expression of bone morphogenetic protein-2 and -4 in chick embryonic calvaria were examined. From the onset of embryogenesis (Day 0), chick embryos were incubated in a continuously generated pulsating electromagnetic field with a peak of 3.5 milli-Tesla (mean: 2 milli-Tesla) and vibration at 15 Hz. Control chicks were incubated in a normal magnetic field. Northern-blot analysis showed that the mRNAs of bone morphogenetic protein-2 and -4 were expressed in the calvaria. Quantitative analysis of the mRNA expressions was done by means of slot-blot hybridization. The magnetic field enhanced the expressions of both mRNAs. The enhancements were more pronounced in younger chick embryos (Day 15 > Day 17), and no significant change was observed in the 19-day-old embryos. These results indicate that osteo-inductive effects of the magnetic field were mediated at least in part by bone morphogenetic protein-2 and -4.

Human arylhydrocarbon receptor: functional expression and chromosomal assignment to 7p21

We isolated the human arylhydrocarbon receptor (AhR) cDNA from a human lung cDNA library, by using mouse AhR cDNA as a labeled probe. The nucleotide sequence of cloned human AhR cDNA is identical to the previously reported human AhR sequence [Dolwick et al. (1993), Mol. Pharmacol. 44, 911-917] from cell line HepG2. The overall amino acid identity with mouse AhR from cell line Hepa-1 is 72.5%. The human AhR expressed either in COS-7 cells or in a reticulocyte lysate in vitro translation system showed specific dioxin-binding activity and Arnt-dependent DNA-binding activity. Chromosomal localization of the AhR gene was determined to be chromosome 7p21 by fluorescent in situ hybridization and DNA blot hybridization using 23 human x mouse or Chinese hamster hybrid cell DNAs.

Increased plasma osmolality stimulates peripheral and central vasopressin release in male and female rats

It has been demonstrated that the neurohypophysial hormones can be released intrahypothalamically by the paraventricular (PVN) and supraoptic nuclei. The present experiments were undertaken to determine whether a physiological stimulus for vasopressin release, increased plasma osmolality, will stimulate the release of vasopressin by the PVN into the surrounding interstitial fluid, and whether the responses are affected by gender. Intravenous infusion of 2.5 M NaCl for 60 min (0.1 ml.kg-1.min-1) in conscious rats resulted in an increased vasopressin concentration in the dialysate from a microdialysis probe adjacent to the PVN. This response was greater in nonestrous females than in males. On the other hand, the rise in the plasma vasopressin concentration was greater in males than in nonestrous females. Mean arterial blood pressure increased and heart rate decreased, but these responses were not affected by gender. The role of centrally released vasopressin in the control of the peripheral release of vasopressin is conjectural, but both responses may be modulated by the gonadal steroid hormones.

Hemorrhage-induced vasopressin release in the paraventricular nucleus measured by in vivo microdialysis

Experiments were carried out, using the technique of in vivo microdialysis in conscious rats, to determine whether hemorrhage, a potent stimulus for the release of vasopressin from the posterior pituitary into the circulation, would also result in a local release of vasopressin from the paraventricular nucleus (PVN), and whether this release is affected by gender. Male and non-estrous female rats were prepared with a microdialysis probe adjacent to the PVN and femoral arterial and venous catheters the day before the experiment. On the day of the experiment, rats was bled either 20% or 30% of blood volume. The concentration of vasopressin in the dialysate increased significantly in the males following both hemorrhages and in the females following the 30% hemorrhage. There were no statistically significant differences in the post-hemorrhage dialysate vasopressin concentration with respect to either gender or magnitude of the hemorrhage. The plasma vasopressin concentration increased markedly in response to the hemorrhage and this response was greater in females following the 30% hemorrhage. There were no gender differences in the reduction in arterial pressure following either hemorrhage. It is concluded that physiological stimuli for the release of vasopressin into the circulation also result in intrahypothalamic release of this hormone.

Dimerization characteristics of the DNA- and steroid-binding domains of the androgen receptor

The DNA-binding domain (DBD) of the androgen, mineralocorticoid, and glucocorticoid receptors and the steroid-binding domain (SBD) of the androgen receptor (AR) were expressed separately as fusion proteins with glutathione-S-transferase (GST) in Escherichia coli. Native polyacrylamide gel electrophoresis and gel exclusion HPLC demonstrated that the GST-ARDBD fusion protein was present as a dimer. On the other hand, the GST-ARSBD fusion protein formed a high-molecular weight oligomer, which seemed to be formed by two separate interactions, i.e. GST-GST and ARSBD-ARSBD between the fusion molecules. These findings strongly suggest that ARSBD has a potent ability to form a homodimer and that ARDBD does not. GST-ARDBD specifically interacted with the glucocorticoid response elements of the mouse mammary tumor virus long terminal repeat (GREMMTV). Cleavage of the fusion protein by thrombin abolished the binding, while the nonspecific DNA-cellulose binding ability was retained. Therefore, the dimeric configuration of GST-ARDBD, even if accomplished through the interaction with the GST moiety, is needed for high-affinity binding to the response element. The binding of GST-ARDBD to GREMMTV was strongly competed by the glucocorticoid response element of rat tyrosine aminotransferase gene, followed by the androgen response element of the rat probasin gene. A palindromic thyroid response element showed no competition. Unexpectedly, no apparent different in the binding affinity to these response elements was observed among the DBDs of androgen, mineralocorticoid and glucocorticoid receptors.

Structural studies of condensation products of biogenic amines as inhibitors of tryptophan hydroxylase

The effects of condensation products of dopamine and indoleamines on the activity of tryptophan hydroxylase (TPH) were evaluated to determine the structures associated with modulation of this enzyme activity. The compounds having a catechol structure, such as 1-methyl-6,7-dihydroxy-1,2,3,4-tetrahydroisoquinoline, markedly inhibited the activity of the enzyme prepared from the rat brain. The inhibition was non-competitive in terms of both the biopterin cofactor and the substrate L-tryptophan. Substitution on the one or two positions of catechol isoquinolines did not affect the inhibitory activity towards TPH. Among these compounds, a charged substance, 1,2[N]-dimethyl-6,7-dihydroxy-isoquinolinium ion, was an extremely potent inhibitor; the Ki values were 0.88 +/- 0.17 and 0.64 +/- 0.08 microM (mean +/- S.D.) in terms of the substrate and cofactor, respectively. By contrast, the condensation products of tryptophan and tryptamine with acetaldehyde scarcely affected TPH activities. 1-Methyl-1,2,3,4-tetrahydroisoquinoline, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and 1-methyl-4-phenylpyridinium ion (MPP+) were almost inactive. These results indicated that the catechol structure recognized and combined with TPH at a binding site different from that of the substrate or cofactor and the positive charge on the dopamine-derived substance enhanced the affinity to TPH. The selective inhibition of TPH by dopamine-derived catechol isoquinolines was discussed in relationship to the interactions between catecholamines, indoleamines and their metabolites in the brain under physiological and pathological conditions.

Inhibition of tryptophan hydroxylase by dopamine and the precursor amino acids

Effects of dopamine and its precursor amino acids on the activity of tryptophan hydroxylase were examined. They inhibited the enzyme activity prepared from mastocytoma cells in terms of the biopterin cofactor and the substrate L-tryptophan. In relation to the biopterin, tryptophan hydroxylase was found to have two different kinetics, and dopamine inhibited the activity in a non-competitive way to both the components. Dopamine had the highest affinity to the enzyme, followed by L-DOPA and L-tyrosine, while D-tyrosine did not inhibit the activity. In terms of L-tryptophan, L-tyrosine, L-DOPA and dopamine inhibited the enzyme non-competitively and their affinity to the enzyme was in this order. These results indicate that the indoleamine metabolism may be regulated by catecholamines and their related amino acids in the brain.

Co-expression of epidermal growth factor-receptor and c-erb B-2 proto-oncogene product in human salivary-gland adenocarcinoma cell line HSG and the implications for HSG cell autocrine growth

The autonomous proliferation of HSG cells is mediated by an autocrine growth factor, a 46K epidermal growth factor (EGF)-like molecule. The receptor for this molecule was investigated. Immunoprecipitation and immunoblotting revealed the expression of two possible receptor molecules, EGF-R and p185erbB-2, in HSG cells. Northern blotting also revealed the co-expression of 5.6-kb EGF-R mRNA and 4.6-kb c-erb B-2 mRNA. When the purified EGF-like molecule was added to the cultures, EGF-R but not p185erbB-2 was autophosphorylated. These results suggest that, although both EGF-R and p185erbB-2 are co-expressed in HSG cells, the EGF-R is the genuine receptor for the EGF-like molecule. However, there is a possibility that p185erB-2 is involved in the signal transduction system. This possibility was examined by using specific antibodies to human EGF-R (hEGF-R), p185erbB-2, and EGF to inhibit the functions of these molecules. Addition of these three antibodies to the cultures inhibited the growth of HSG cells. The antibodies to EGF-R and p185erbB-2 also caused morphological changes such as disturbances of the plasma membrane, and some cell death. Surprisingly, the effect of the anti-p185erbB-2 antibody on growth inhibition and morphology was stronger than that of the anti-hEGF-R antibody. Thus, p185erB-2 expressed in HSG cells has an important function in the signal transduction of HSG cell growth.

Nested amplification of COL2A1 3' variable region in skeletal remains

We identified skeletal remains of a highly decomposed body by amplifying the COL2A1 3' variable region. We extracted degraded and contaminated DNA from teeth and bone fragments and amplified the hyper variable regions of COL2A1 by nested PCR. This method is 2,000 times more sensitive than the 27 cycle standard PCR. The sensitivity and specificity of the amplification was extremely improved using nested primer pairs. Using 47 cycles of total amplification by nested PCR, we were able to effectively amplify the target fragment. A total 47 cycles of dual PCR using one pair of primers was not as sensitive as nested PCR, which enabled us to amplify and detect the fragment from 5 pg of template DNA by agarose gel electrophoresis with ethidium bromide staining. We found that the hypersensitive nested PCR was suitable for the forensic identification of old, unidentifiable skeletal remains.

Association of HLA-DPB1*0501 with early-onset Graves' disease in Japanese

To investigate the association between HLA antigens and Graves' disease among Japanese, serologic typing and DPB1 genotyping using the PCR-RFLP method have been performed. HLA alleles of 106 patients with Graves' disease were determined, and the frequency of HLA-B46 was found to be significantly increased. Furthermore, the frequencies of HLA antigens were compared between two age groups: early-onset and late-onset patients (under and over 20 years, respectively). It was found that the frequency of DPB1*0501 (88.9%) was significantly increased (pc < 0.004) in the early-onset group as compared with the healthy controls (55.0%) but not in the late-onset group (60.7%). On the other hand, a significant increase of HLA-B46 was observed in the late-onset patients (pc < 0.0004). These results suggest that the genetic background of Japanese patients with early-onset Graves' disease is different from late-onset patients. Namely, the HLA-DP allele (DPB1*0501) and the HLA-B allele (B46) are primarily involved in the pathogenesis of early-onset and late-onset Graves' disease in Japanese, respectively.

[Effect of recombinant atrial natriuretic peptide (r-ANP) on ischemic and cyclosporine-induced kidney damage in rats]

Cyclosporine A (CYA) a new immunosuppressive drug, has greatly improved the outcome of solid graft transplantation. The nephrotoxicity of CYA, however, is a serious problem, and constitutes the major obstacle limiting the use of CYA as an immunosuppressive agent for renal transplantation. On the other hand, the newly described atrial natriuretic peptide (ANP) hormonal system in both humans and animals appears to play an important role in sodium and water excretion. The present study examined the nephrotoxicity of CYA and the effect of recombinant-ANP (r-ANP) on the damaged kidneys in three groups. Group 1 consisted of rats with 45 minutes warm ischemic left kidney and right nephrectomy [WI rats]; Group 2 consisted of WI rats with oral administration of CYA (100mg/kg/day) for 2 weeks [WI+CYA rats]; Group 3 consisted of WI+CYA rats with intraperitoneal administration of r-ANP (10ng/kg/day) for 2 weeks. Group 2 had lower glomerular filtration rates (GFR) and renal plasma flow (RPF) than Group 1, but Group 3 had significantly higher GFR and RPF than Group 2. Additionally, in order to demonstrate the change in renal viability among the three groups, the adenosine triphosphoric acid level (ATP) and adenylate energy charge ratio (EC) of renal parenchymal tissue were measured by high performance liquid chromatography (HPLC). Group 2 had lower ATP and EC than Group 1, and Group 3 had higher ATP and EC than Group 2. The results of this study suggest that r-ANP is efficacious on rat kidney damage induced by CYA and WIT.

[Studies on aspoxicillin for its transfer to the skin]

To evaluate the usefulness of aspoxicillin (ASPC) in the field of plastic and reconstructive surgery, we examined its transfer to the skin. 1. After intravenous drip infusion of ASPC for 1 hour at a dose of 2 g in 13 adults and at 1 g in 2 children, the mean serum ASPC concentration 1 hour after termination of the infusion was 70.46 +/- 28.05 micrograms/ml. The mean concentration in the skin tissue 1 hour after infusion in 15 patients was 32.45 +/- 18.47 micrograms/g. The rate of transfer to the skin 1 hour after infusion in the 15 patients was 52.9 +/- 29.7%. 2. The ASPC concentrations in skin tissues and the rates of its transfer to the skin did not differ significantly between 5 patients with facial surgery and 10 with surgery in the trunk or limbs. 3. To prevent postoperative infections, ASPC was intravenously drip infused twice daily for 2 approximately 3 days after operation at a dose of 2 g in adults and 1 g in children. No postoperative infection occurred in any patient, suggesting the effectiveness of this drug. In addition, no side effects or abnormalities in clinical examination values were observed.

[Two cases of MERRF (myoclonus epilepsy associated with ragged red fibers) showing different clinical features in the same family]

A 73-year-old woman (patient 1) developed progressive mental deterioration at age 63, and seizures at age 70. On examination, she showed severe dementia, tonic clonic convulsion, hypotonia and muscular wasting. There was neither myoclonus nor cerebellar ataxia. Brain CT revealed a low density area in the right occipital lobe. A 44-year-old man (son of the patient 1) developed unsteady gait at age 15, muscle twitching at age 18 and then noticed speech disturbance at age 35. He had no history of convulsive seizure. Neurological examination showed cerebellar ataxia, myoclonus in the extremities and mild muscular weakness. His intelligence was normal. Brain CT showed moderate atrophy of the pons and the cerebellum. Both cases showed the same mitochondrial DNA mutation as reported previously in patients with MERRF. However, the clinical features, the age of onset and the brain CT findings were totally different between these 2 cases. In the progress of mitochondrial genetic analysis, atypical forms in MERRF like the patient 1 would increase in number, and the wide variation of clinical symptoms should be considered.

Role of vasopressin, the renin-angiotensin system and sex in Dahl salt-sensitive hypertension

OBJECTIVE

To determine the roles of vasopressin, the renin-angiotensin system and sex in the pathogenesis of salt-sensitive hypertension in the Dahl rat.

DESIGN

The effects of 12 days' treatment with a non-peptide, orally effective V1 antagonist (OPC-21,268) and captopril, individually or together, were compared in male and female Dahl salt-sensitive rats after 10 days on a high-salt diet.

METHODS

OPC-21,268 was given in the food, and captopril was administered with osmotic pumps implanted subcutaneously.

RESULTS

Systolic blood pressure (SBP) reached a higher level in untreated males than in untreated females. V1 blockade in males prevented any further increase in SBP during the first week of treatment, but SBP rose thereafter towards the levels found in the untreated males. In females OPC-21,268 had no effect. In males captopril prevented any further increase in SBP. There was no effect of captopril in females during the first week of treatment, but SBP fell to pretreatment levels during the second week. Combined treatment with OPC-21,268 and captopril in males had a smaller antihypertensive effect than either drug alone. In females combined treatment prevented any further increase in SBP.

CONCLUSIONS

These findings suggest that both vasopressin and the renin-angiotensin system contribute to the pathogenesis of Dahl salt-sensitive hypertension, but that other factors, possibly including the sympathetic nervous system, are also involved. Sex also affects the severity of this form of hypertension and influences the relative roles of vasopressin and the renin-angiotensin system. It is likely that the gonadal steroid hormones modulate the activity of the pathogenetic factors in this form of hypertension at a central or peripheral level.