Adenovirus-mediated transduction of Escherichia coli uracil phosphoribosyltransferase gene sensitizes cancer cells to low concentrations of 5-fluorouracil

5-fluorouracil (5-FU), although a widely used chemotherapeutic agent, has a limited effect in the treatment of human solid tumors due to their resistance to the cytotoxic effects of 5-FU. Escherichia coli uracil phosphoribosyltransferase (UPRT) is a pyrimidine salvage enzyme that catalyzes the synthesis of UMP from uracil and 5-phosphoribosyl-alpha-1-diphosphate. The present study demonstrates that adenovirus-mediated transduction of E. coli UPRT gene results in marked sensitization of colon, gastric, liver, and pancreas cancer cell lines to low concentration of 5-FU in vitro. The in vitro bystander effect was observed when only 10% of the hepatoma Hep3B cells were infected with UPRT-expressing adenovirus. In addition, 5-FU treatment of human hepatoma or gastric cancer xenografts in nude mice transduced with UPRT was demonstrated to result in significant in vivo antitumor effects. The adenovirus vector transduction of the UPRT gene followed by 5-FU administration is representative of a new chemosensitization strategy for cancer gene therapy.

Severe bleeding tendency in a patient with Bernard-Soulier syndrome associated with a homozygous single base pair deletion in the gene coding for the human platelet glycoprotein Ibalpha

PURPOSE

The genetic basis of Bernard-Soulier syndrome (BSS) was studied to clarify a relationship between severe clinical manifestations and gene abnormality.

PATIENT AND METHODS

A patient with BSS had a severe bleeding tendency that was sometimes life threatening. Flow cytometric analysis of the patient's and normal control platelets was performed to study which glycoprotein (GP) was impaired in glycoprotein Ib/V/IX complex. The genes encoding GPIbalpha from the patient's and control genomic DNA were amplified and directly sequenced.

RESULTS

Flow cytometric analysis revealed a defect of GPIbalpha on the surface of the patient's platelets. A homozygous single base pair deletion was identified in seven repeats of adenine at positions 1932 to 1938 in the GPIbalpha gene. This mutation, which has been previously reported, results in a frameshift and predicts a premature stop codon leading to a truncated peptide that cannot fix on the platelet membrane.

CONCLUSION

This patient's severe clinical phenotype would be explained by this mutation in the GPIbalpha gene.

Immunohistochemical localisation of regulatory neuropeptides in human circumvallate papillae

The occurrence and distribution of neuropeptide-containing nerve fibres in the human circumvallate papillae were examined by the peroxidase-antiperoxidase immunolocalisation method using surgical specimens that had not been subjected to radiotherapy, and the abundance of neuropeptide-containing fibres was expressed as the percentage of total nerve fibres demonstrated by protein gene product (PGP) 9.5 immunoreactivity for a quantitative representation of these peptidergic fibres. Substance P (SP) and calcitonin gene-related peptide (CGRP) immunoreactive (IR) nerve fibres were densely distributed in the connective tissue core of the circumvallate papillae, and some SP and CGRP-IR fibres were associated with the taste buds. A moderate number of vasoactive intestinal polypeptide (VIP)-IR fibres and a few galanin (GAL)-IR fibres were also seen in the connective tissue core and subepithelial layer. There were, however, no VIP-IR or GAL-IR fibres associated with the taste buds. Neuropeptide Y (NPY)-IR fibres were few and were associated with the blood vessels. Within the epithelium of the circumvallate papillae, no peptidergic fibres were found, although a number of PGP 9.5-IR fibres were detected. The abundance of SP, CGRP, VIP, and GAL-IR fibres expressed as the percentage of total PGP 9.5 IR fibres was 25.35+/-3.45%, 22.18+/-3.26%, 10.23+/-1.18%, and 4.12+/-1.05%, respectively. The percentage of NPY-IR fibres was below 3%. In a deeper layer of the papillae, a few VIP, GAL, and NPY-IR ganglion cells were found, and VIP immunoreactivity was detected in a few cells of the taste buds. There was no somatostatin, leucine enkephalin, or methionine enkephalin immunoreactivity in the circumvallate papillae. These results suggest that the dense SP and CGRP-IR fibres within the connective tissue core of the human circumvallate papillae may be involved in the deep sensation of the tongue.

Bruton's tyrosine kinase-mediated interleukin-2 gene activation in mast cells. Dependence on the c-Jun N-terminal kinase activation pathway

Cross-linking of the high affinity IgE receptor (FcepsilonRI) on mast cells induces secretion of cytokines, including interleukin (IL)-2, through transcriptional activation of cytokine genes. Previously, defects in the gene coding for Bruton's tyrosine kinase (Btk) were shown to result in defective cytokine production in mast cells, and thereby mice carrying btk mutations exhibited diminished anaphylactic reactions in response to IgE and antigen. In this study, we provide evidence that the transcription factors involved in the IL-2 gene expression in T cells are also required for maximal activation of the IL-2 gene in FcepsilonRI-stimulated mast cells. Among them, AP-1 (Jun/Fos) and NF-AT were identified as candidate transcription factors that are regulated by Btk. Consistent with our previous data indicating that Btk regulates stress-activated protein kinases, c-Jun N-terminal kinase (JNK), c-Jun and other JNK-regulatable transcription factors are activated by FcepsilonRI cross-linking in a Btk-dependent manner. Further, FcepsilonRI-induced IL-2 gene activation is dependent on c-Jun and a component, SEK1, of its upstream activation pathway. Collectively, these data demonstrate that Btk regulates the transcription of the IL-2 gene through the JNK-regulatable transcription factors in FcepsilonRI-stimulated mast cells.

Additional possible tools for identification of proteins on one- or two-dimensional electrophoresis

Additional, essentially chemical, identification methods of proteins in polyacrylamide gel electrophoresis are described. Two cleavages of peptide bonds were used at the C-side of aspartic acid with a 0.2% pentafluoropropionic acid (PFPA) aqueous vapor at 90 degrees C for 4-16 h, and the N-side of serine/threonine with an S-ethyl trifluorothioacetate vapor at 50 degrees C for 6-24 h. The products were analyzed by mass spectrometry-peptide mass fingerprinting. A new type of C-terminal sequencing at multisites of protein was introduced. An aqueous vapor of 90% PFPA at 90 degrees C for 2-16 h provided cleavages at the C-side of aspartic acid and the N-side of serine/threonine and simultaneous successive truncation at the C-termini of the cleaved fragments. The product resulted in C-terminal sequences at multisites in proteins by mass spectrometric analysis. The following chemical deblocking methods were used. Anhydrous hydrazine vapor at -5 degrees C for 8 h deblocked the N-formyl group, and the vapor at 20 degrees C for 4 h deblocked pyrrolidone carboxylate. N-acetylserine/threonine was deblocked by aqueous vapor of 75% PFPA at 50 degrees C for 1 h, followed by reaction with p-sulfophenylisothiocyanate at pH 6.0. These methods were applied to a variety of protein spots on polyacrylamide gels. A new stepwise C-terminal sequencing of protein from polyacrylamide gels is also described.

Involvement of Bruton's tyrosine kinase in FcepsilonRI-dependent mast cell degranulation and cytokine production

We investigated the role of Bruton's tyrosine kinase (Btk) in FcepsilonRI-dependent activation of mouse mast cells, using xid and btk null mutant mice. Unlike B cell development, mast cell development is apparently normal in these btk mutant mice. However, mast cells derived from these mice exhibited significant abnormalities in FcepsilonRI-dependent function. xid mice primed with anti-dinitrophenyl monoclonal IgE antibody exhibited mildly diminished early-phase and severely blunted late-phase anaphylactic reactions in response to antigen challenge in vivo. Consistent with this finding, cultured mast cells derived from the bone marrow cells of xid or btk null mice exhibited mild impairments in degranulation, and more profound defects in the production of several cytokines, upon FcepsilonRI cross-linking. Moreover, the transcriptional activities of these cytokine genes were severely reduced in FcepsilonRI-stimulated btk mutant mast cells. The specificity of these effects of btk mutations was confirmed by the improvement in the ability of btk mutant mast cells to degranulate and to secrete cytokines after the retroviral transfer of wild-type btk cDNA, but not of vector or kinase-dead btk cDNA. Retroviral transfer of Emt (= Itk/Tsk), Btk's closest relative, also partially improved the ability of btk mutant mast cells to secrete mediators. Taken together, these results demonstrate an important role for Btk in the full expression of FcepsilonRI signal transduction in mast cells.

Worsening of hypoxemia with nitric oxide inhalation during bronchospasm in humans

In some COPD patients, in contrast to those with ARDS, inhaled NO reportedly worsens hypoxemia. The issue examined in this study was whether inhaled NO improves or worsens hypoxemia in humans during bronchoconstriction induced by methacholine (MCh) nebulization. Five healthy subjects and six asthma patients were recruited, and during 80 ppm NO inhalation gas exchange parameters 10 min after MCh nebulization were compared with the values obtained while breathing NO-free air. During NO inhalation, the drop in PaO2 10 min after MCh, from 95.1 +/- 5.5 (baseline; mean +/- SD) to 68.9 +/- 6.2 Torr, was greater than that under the same conditions but breathing NO-free air (from 92.6 +/- 5.3 to 79.5 +/- 11.1 Torr), and the increase in AaDO2 (from 8.9 +/- 5.4 to 29.8 +/- 5.4 Torr) was greater than that during NO-free air breathing (from 8.5 +/- 7.6 to 15.4 +/- 9.2 Torr). The SaO2 dose-response reached a plateau at 5 ppm of NO. Our results show that NO inhalation worsens desaturation during bronchospasm in humans after MCh nebulization.

Substance P- and calcitonin gene-related peptide-containing nerve fibers in the nasal mucosa of chronically hypoxic rats

The distribution of substance P-immunoreactive and calcitonin gene-related peptide-immunoreactive nerve fibers in the nasal mucosa was compared between normoxic and chronically hypoxic rats (10% O2 and 3.0-4.0% CO2 for 3 months). In the normoxic nasal mucosa, substance P- and calcitonin gene-related peptide-immunoreactive nerve fibers were found within and under the epithelium and around the glands and blood vessels in the lamina propria. These immunoreactive fibers have many varicosities. In the chronically hypoxic nasal mucosa, the relative density of intra- and subepithelial substance P-immunoreactive and calcitonin gene-related peptide-immunoreactive fibers and those in the lamina propria was higher than in normoxic mucosa. The length of substance P-positive fibers within the chronically hypoxic olfactory and respiratory epithelium was 1.66 and 2.45 times higher than within the normoxic epithelium, respectively. The length of calcitonin gene-related peptide-immunostained fibers within the chronically hypoxic olfactory and respiratory epithelium was 1.56 and 1.84 times higher, respectively. Because substance P and calcitonin gene-related peptide are the predominant signal peptides of primary sensory neurons, the increased number of these fibers may represent enhanced sensory mechanisms in the hypoxic nasal mucosa. In addition, considered together with the findings in chronically hypoxic tracheal mucosa, the increased density of intraepithelial fibers containing substance P and calcitonin gene-related peptide suggests that this is a predominant feature of hypoxic adaptation throughout the upper and lower respiratory tracts.

Distribution of VIP receptors in the human submandibular gland: an immunohistochemical study

Distribution of vasoactive intestinal polypeptide (VIP)-immunoreactive nerve fibers and VIP-receptor (VIP-R)-immunoreactive sites in the human submandibular gland were examined by the peroxidase-antiperoxidase method using the specimens taken from patients that had not received radiotherapy. VIP-immunoreactive fibers were found around both serous and mucous acini, the duct system, and those around the mucous acini were more numerous than those around the serous acini. VIP-R immunoreactivity was restricted to the mucous acini and the intercalated duct segment. The serous acini, striated duct, and excretory ducts lacked VIP-R immunoreactivity. These findings suggest that the mucous acinar cells contain VIP-R, and that VIP-R-mediated VIP action is involved in regulating synthesis of viscous saliva and its release.

Transient appearance of substance P-like immunoreactivity in the granular convoluted tubules of the male mouse submandibular gland: light- and electron-microscopic studies

The time of appearance and distribution of substance P (SP)-like immunoreactivity in the granular convoluted tubule cells of the developing male mouse submandibular glands were examined, and the subcellular localization of SP-like immunoreactivity was investiagted by electron microscopy. At 25 days of age, SP-like immunoreactivity was first detected in the supranuclear cytoplasm of the granular convoluted tubule cells, which occurred either singly or in small clusters. At 30 and 35 days of age, granular convoluted tubule cells with SP-like immunoreactivity were more numerous than in the earlier stages, as the volume ratio of the cells increased. Not all granular convoluted tubule cells demonstrated SP-like immunoreactivity. The number of cells with SP-like immunoreactivity decreased at 60 days of age, and these cells had completely disappeared at 90 days of age. Most, but not all, secretory granules in the granular convoluted tubule cells were strongly labeled with gold particles, indicating that the subcellular site of SP-like substance is in the secretory granules within the cells. The findings suggest that the physiological role of the SP-like substance secreted from the GCT cells is restricted to the early postnatal stages, and that it may be involved in the development of the oral mucosa or digestive tract as a trophic factor.

Acute mesenteric vascular occlusion: analysis of 39 patients

OBJECTIVE

To study the factors that influence mortality and long term outcome of patients with acute mesenteric vascular occlusion.

DESIGN

Retrospective study.

SETTING

University hospital, Kanazawa, Japan.

PATIENTS

Thirty-nine patients treated between 1978 and 1995 for acute mesenteric vascular occlusion.

INTERVENTIONS

34 patients underwent laparotomy. Bowel was resected in 29 patients, and primary anastomosis was done in 20. The occluded vessel was revascularised in 5 patients.

MAIN OUTCOME MEASURES

mortality, short bowel syndrome and long term survival.

RESULTS

25 patients had arterial occlusions, and 8 venous. In the remaining 6, the occluded vessel was not identified. 11 Patients developed renal failure, 11 respiratory failure, and 10 disseminated intravascular coagulation (DIC). Twelve patients died within 30 days. The factors associated with early death were acidosis and high serum amylase activity. 9 Patients developed the short bowel syndrome. Survival was 49% at 1 year, and 34% at 5 years.

CONCLUSION

Mortality was higher in patients with advanced peritonitis. Mesenteric revascularisation should be attempted to avoid the short bowel syndrome.

[A case of chronic inflammatory demyelinating polyradiculoneuropathy complicated by phrenic nerve palsy]

We report on a patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) complicated by phrenic nerve palsy. A 50-year-old man was admitted to our hospital due to dyspnea and numbness in his limbs. On admission, severe muscle atrophy, weakness, and sensory disturbance were seen in the distal part of his extremities. Deep tendon reflexes were absent in all the limbs. Routine blood examinations showed no abnormal findings except for mild hyperglycemia (fasting blood sugar 145 mg/dl). Right phrenic nerve palsy was observed on a chest roentgenogram and % vital capacity (%VC) was 56%. Cerebrospinal fluid showed elevated levels of total protein (116 mg/dl) and IgG (16.9 mg/dl). Sural nerve biopsy revealed severe loss of myelinated fibers with demyelination and onion-bulb formation. After immunoadsorption plasmapheresis, the phrenic nerve palsy improved rapidly and %VC recovered to 76%. Although phrenic nerve palsy is rare in patients with CIDP, it is important to take notice of this condition, because phrenic nerve palsy is critical when it occurs bilaterally or when it develops in patients who have suffered from respiratory diseases. Immunoadsorption plasmapheresis is one of the effective treatments for CIDP, especially in patients with serious complications such as phrenic nerve palsy.

Suppression of tubulin tyrosine ligase during tumor growth

The C terminus of the tubulin alpha-subunit of most eukaryotic cells undergoes a cycle of tyrosination and detyrosination using two specific enzymes, a tubulin tyrosine ligase (TTL) and a tubulin carboxypeptidase. Although this enzyme cycle is conserved in evolution and exhibits rapid turnover, the meaning of this modification has remained elusive. We have isolated several NIH-3T3 derived clonal cell lines that lack TTL (TTL-). TTL- cells contain a unique tubulin isotype (delta2-tubulin) that can be detected with specific antibodies. When injected into nude mice, both TTL- cells and TTL- cells stably transfected with TTL cDNA form sarcomas. But in tumors formed from TTL rescued cells, TTL is systematically lost during tumor growth. A strong selection process has thus acted during tumor growth to suppress TTL activity. In accord with this result, we find suppression of TTL activity in the majority of human tumors assayed with delta2-tubulin antibody. We conclude there is a widespread loss of TTL activity during tumor growth in situ, suggesting that TTL activity may play a role in tumor cell regulation.

Increased expression of TGF-beta receptors by scleroderma fibroblasts: evidence for contribution of autocrine TGF-beta signaling to scleroderma phenotype

Scleroderma fibroblasts exhibit numerous phenotypic differences when compared with healthy skin fibroblasts. Some of these differences, in particular overexpression of collagen type I and other extracellular matrix proteins, parallel the effect of transforming growth factor-beta (TGF-beta) on dermal fibroblasts, suggesting that the scleroderma fibroblast phenotype may result from activation of autocrine TGF-beta signaling. To test this hypothesis we examined the role of TGF-beta Type I and Type II receptors in regulating collagen type I transcription. We have shown that overexpression of either Type I or Type II receptors significantly (3-4-fold) increases alpha2 (I) collagen promoter activity in transient transfection assays in dermal fibroblasts. Addition of anti-TGF-beta antibody abolished, whereas addition of plasmin enhanced, the stimulatory effect of receptor overexpression on collagen promoter activity, suggesting that this effect depends on autocrine TGF-beta. Moreover, these cotransfection experiments indicated that expression levels of TGF-beta receptors is a limiting factor in the autocrine regulation of collagen type I transcription by TGF-beta. Comparison of the TGF-beta receptor Type I and Type II mRA expression levels in scleroderma and normal fibroblasts have indicated elevated expression (2-fold) of both receptor types in scleroderma cells, which correlated with increased binding of TGF-beta. Significantly, elevated TGF-beta receptor levels correlated with elevated alpha2 (I) collagen mRNA levels. These results suggest that the elevated production of collagen type I by scleroderma fibroblasts results from overexpression of TGF-beta receptors.

Distinct effects of tetragastrin, histamine, and CCh on rat gastric mucin synthesis and contribution of NO

Although gastrin, histamine, and carbachol (CCh) accelerate gastric mucin metabolism, information about their target cells of mucin production is lacking. To clarify this, we examined the effects of these stimulants, including the possible participation of nitric oxide (NO), on mucin biosynthesis in distinct sites and layers of rat gastric mucosa. Pieces of tissue obtained from the corpus and antrum were incubated in a medium containing radioactive precursors and each stimulant, with or without NO synthase (NOS) inhibitor. Distribution of NOS was compared with that of the specific mucins by immunostaining using specific antiserum and monoclonal antibodies. In the full-thickness corpus mucosa, tetragastrin enhanced [3H]glucosamine incorporation into mucin but had no effect on [14C]threonine incorporation. Both histamine and CCh dose dependently increased3H- and14C-labeled corpus mucin. Only CCh stimulated antral mucin biosynthesis. CCh stimulation was noted in the corpus mucosa after removal of surface mucous cells, but stimulation by tetragastrin or histamine disappeared as a result of this pretreatment. Only tetragastrin-induced activation was completely blocked by the NOS inhibitor. NOS immunoreactivity was limited to surface mucous cells. Mucus-producing cells present in the different sites and layers of the gastric mucosa have distinct mechanisms for regulation of mucin biosynthesis. Gastrin-stimulated mucin biosynthesis mediated by NO is limited to surface mucous cells of rat gastric oxyntic mucosa.

Distribution of neuropeptide-containing nerve fibers in the salamander taste organs

Salamander taste organs were recognized as oval cell clusters within the dorsal surface of the tongue. A moderate number of SP, CGRP, VIP, NPY, and GAL immunoreactive nerve fibers terminated in the cell clusters, and some of them penetrated into the basal half of the cell clusters. Around the glands, VIP, NPY, and GAL fibers were numerous, and SP and CGRP fibers were less numerous. Immunoreactivity of SOM and FMRF was not detected either in the nerve fibers associated with the cell clusters or those around the glands. These findings suggest that the chemosensory mechanisms of the salamander gustatory organs are under the control of peptidergic innervation. In addition, the present study indicates that the caudate taste organs are structurally primitive but functionally mature.

Early intervention for very-low-birth-weight infants

To assess the efficacy of early intervention (EI) for very-low-birth-weight (VLBW) infants, we evaluated 62 2 year old children who were enrolled in an EI program and 48 control subjects aged 2 years. We determined the subjects' developmental quotients (DQ) and obtained information about the parents' evaluation of the children from a questionnaire sent to the parents. There was no significant difference in the DQ between the EI group and the control group. However, based on the responses to the questionnaire, subjects in the EI group showed slight, but statistically marginally significant, improvements in behavioral problems, especially a decrease in hyperkinesia, in adjusting to a circadian sleep cycle, and an improvement in language development, as compared with the control group (P < 0.1). Thus, EI for VLBW infants is considered useful to enhance some areas of development.

Early and late events in Fc epsilon RI signal transduction in human cultured mast cells

Protein tyrosine phosphorylation and other biochemical events have been shown to occur after cross-linking of Fc epsilonRI in rodent mast cells. To investigate the mechanism of Fc epsilonRI signal transduction in human mast cells, we used human cultured mast cells (HCMC) generated from cord blood cells in the presence of recombinant human stem cell factor and IL-6. We found that on cross-linking of Fc epsilonRI: 1) HCMC released histamine; 2) rapid tyrosine phosphorylation of multiple cellular substrates, including Syk, HS1, c-Cbl, ERK-1, and ERK-2, was observed; 3) intracellular Ca2+ and inositol phosphate production were increased within the first minute after Fc epsilonRI cross-linking; and 4) genistein, a tyrosine kinase inhibitor, inhibited both protein tyrosine phosphorylation and histamine release in a dose-dependent manner. These results were consistent with previous studies in rodent mast cells. In contrast, no tyrosine phosphorylation of phospholipase C gamma1 and Btk (Bruton's tyrosine kinase) were observed in our experimental conditions. These results suggest that the greater part of the early and late signaling events in HCMC is similar to those obtained with rodent mast cells and indicated that the requirement of tyrosine phosphorylation in the activation process of each of the signaling molecules might be different in HCMC and rodent mast cells. Our finding indicates that HCMC may be useful for analysis of Fc epsilonRI-mediated signal transduction in human mast cells.

Early and late events in Fc epsilon RI signal transduction in human cultured mast cells

Protein tyrosine phosphorylation and other biochemical events have been shown to occur after cross-linking of Fc epsilonRI in rodent mast cells. To investigate the mechanism of Fc epsilonRI signal transduction in human mast cells, we used human cultured mast cells (HCMC) generated from cord blood cells in the presence of recombinant human stem cell factor and IL-6. We found that on cross-linking of Fc epsilonRI: 1) HCMC released histamine; 2) rapid tyrosine phosphorylation of multiple cellular substrates, including Syk, HS1, c-Cbl, ERK-1, and ERK-2, was observed; 3) intracellular Ca2+ and inositol phosphate production were increased within the first minute after Fc epsilonRI cross-linking; and 4) genistein, a tyrosine kinase inhibitor, inhibited both protein tyrosine phosphorylation and histamine release in a dose-dependent manner. These results were consistent with previous studies in rodent mast cells. In contrast, no tyrosine phosphorylation of phospholipase C gamma1 and Btk (Bruton's tyrosine kinase) were observed in our experimental conditions. These results suggest that the greater part of the early and late signaling events in HCMC is similar to those obtained with rodent mast cells and indicated that the requirement of tyrosine phosphorylation in the activation process of each of the signaling molecules might be different in HCMC and rodent mast cells. Our finding indicates that HCMC may be useful for analysis of Fc epsilonRI-mediated signal transduction in human mast cells.

Sharing positive experiences in making changes in work and life in a local district in Vietnam

A series of research and training programmes were undertaken in a rural district in the Mekong Delta area in Vietnam so as to facilitate positive changes in the work and life under the initiatives of the local people. As in other parts of the area, it was amid rapid changes in life-style under the shift toward a market economy. Field research relying on direct observation methods were carried out in various rice field jobs and local small enterprises for understanding the improvement potentials in the work and lives of the local people. To strengthen the local improvement initiatives, participatory training programmes were developed and practiced. In the training programmes, joint walk-through observations using an action checklist were stressed. The results were discussed in small groups and meetings. Interactive communications between the local people, while visiting their own houses and workplaces, took place. Based on these field research results, various positive changes were successfully implemented. They included a wide range of improvements such as more efficient work methods, safer use of technologies, hygienic housing conditions, and improved household plans. Our experiences demonstrated that practical approaches relying on local initiatives could facilitate the implementation of positive changes in the local socio-cultural settings.

[Neurotransmitter-mediated regulatory mechanisms of axoplasmic transport--acetylcholine and adrenaline]

It has not been known whether or not the axoplasmic transport depends on regulatory influences mediated by neurotransmitters. The video-enhanced microscope technique has made it possible to visualize the real-time movement of micro-particles along axons and thus to observe its quick response to external signals. Using this technique, the effects of acetylcholine (ACh) and adrenaline on the axoplasmic transport in cultured cervical ganglion (SCG) cells were examined. Application of ACh inhibited the transport in both anterograde and retrograde directions. This effect was mimicked by the muscarinic receptor agonist arecoline, but not by the nicotinic receptor agonist nicotine. The response to ACh was inhibited by QNX (3-quinuclidinyl-xanthine-9-carboxylate), a muscarinic receptor antagonist. Immunocytochemistry and in situ hybridization with anti-muscarinic receptor subtypes compounds demonstrated the expression of m2 receptors on the SCG cell. Islet-activation protein (IAP), a G-protein inhibitor, completely blocked the suppressive effect of ACh. The protein kinase A (PKA) inhibitor KT-5720 induced a similar effect to that of ACh. In contrast to the effect of ACh, adrenaline increased both anterograde and retrograde transport. The beta 2-receptor agonist (albuterol), but not alpha-receptor agonists (phenylphrine and clonidine) or beta 1-receptor agonist (dobutamine), mimicked the effect of adrenaline. The beta 2-receptor antagonist butoxamine abolished the facilitatory response to adrenaline. Dibutyryl cyclic AMP, a membrane permeable cAMP, and forskolin, an activator of adenylyl cyclase, induced a similiar effect to that of adrenaline. These results suggest that 1) ACh, acting through m2-receptors, activates Gi-protein and thus inhibits cAMP synthesis, 2) adrenaline, acting through beta 2-receptors, increases intracellular cAMP concentration, and 3) these changes in cyclic AMP levels inhibit or enhance the activity of PKA to phosphorylate proteins related to the axoplasmic transport.

Sarcomatoid carcinoma of the ureter: a case report

We report a case of sarcomatoid carcinoma of the ureter in a 60-year-old woman who presented at our hospital with right flank pain. She had undergone total ovariectomy and radiation therapy for ovarian cancer at the age of 40 years. A diagnosis of ureteral tumor (cTsN0M0) led to radical right nephroureterectomy and partial cystectomy. Microscopic examination showed a tumor that contained areas of both sarcoma and transitional cell carcinoma. The carcinomatous tissues were blended into the sarcomatous areas and there was a transitional zone between the 2 components. Immunohistochemical examination showed that the spindle cells were positive for cytokeratin, so the final diagnosis was sarcomatoid carcinoma of the ureter. The patient has remained well without any evidence of recurrence for 5 months since the operation. There is no effective adjunctive therapy, so constant careful monitoring will be necessary. Sarcomatoid carcinoma of the ureter is a rare tumor and this is only the sixth case reported in Japan.

Discordant splenic uptake of Tc-99m colloid and Tc-99m denatured RBC in candidiasis-endocrinopathy syndrome

We report discordant splenic uptake of Tc-99m colloid and Tc-99m heat-denatured red blood cells (RBC) which occurred in a 21-year-old female with candidiasis-endocrinopathy syndrome. Tc-99m colloid liver-spleen imaging showed no splenic uptake, suggesting the presence of functional asplenia. A subsequent Tc-99m heat-denatured RBC study clearly revealed a small spleen with preserved sequestrating function. These results may demonstrate that the qualitative dissociation of splenic functions in processing colloid and denatured RBC in functional asplenia: the sequestration function remains while the reticuloendothelial system is impaired.

Comparison of cilostazol with warfarin as antithrombotic therapy after femoro-popliteal bypass surgery using an ePTFE graft

BACKGROUND

Cilostazol (6-[4-(1-cyclohexyl-1H-tetrazol-5-yl)butoxy]-3,4- dihydro-2(1H)-quinolinone) is a new antiplatelet agent with a vasodilating action. The purpose of this study was comparison of cilostazol with warfarin as antithrombotic therapy after femoro-popliteal bypass surgery using an expanded polytetrafluorethylene (ePTFE) graft.

EXPERIMENTAL DESIGN

This report is a retrospective study and the patients were followed up for five years.

SETTING

Outpatients of university hospital.

METHODS

Sixteen arteriosclerosis obliterans patients, who were diagnosed as having only superficial femoral artery stenosis or occlusion, underwent femoro-popliteal (above the knee) bypass using an ePTFE graft 6 mm in diameter. Cilostazol (150-200 mg/day) was administered to 6 cases (9 bypasses), and warfarin (prothrombin time was controlled to 15-25%.) was administered to 10 cases (14 bypasses).

RESULTS

No clinically characteristic differences were found between the two groups. The cumulative 1-, 3-, and 5-year primary and secondary graft patency rates were 69% and 80%, 69% and 80%, and, 69% and 80% in the cilostazol group, vs 61% and 91%, 51% and 91%, and, 51% and 91% in the warfarin group, respectively. These differences were not significant (p < 0.05). No hemorrhage complications were observed in the cilostazol group. The management of cilostazol administration was safe and simple.

CONCLUSIONS

Although the number of cases was small in this study, cilostazol was considered to be as effective as warfarin and suitable for the postoperative antithrombotic therapy after the ePTFE bypass surgery.

A case of prostate cancer presenting as a symptomatic abdominal mass

An 80-year-old man presented to our hospital complaining of an abdominal mass. On physical examination, a hard fist-sized mass was noted in the right lower abdomen. Needle biopsy of the prostate and abdominal mass showed moderately differentiated adenocarcinoma. The chest roentgenogram revealed multiple lung metastases. Clinical diagnosis was T3N3M1, stage D2. Serum prostate specific antigen (PSA) level (8,600 ng/ml) normalized after 3 months of anti-androgen therapy. Lung metastases disappeared after 11 months, while the abdominal mass was reduced to 25% of the pretreatment size after followup of 30 months.