The prognostic significance of vascular invasion in upper urinary tract transitional cell carcinoma

The prognostic significance of vascular invasion was evaluated in a retrospective series of 30 patients with upper urinary tract cancer who underwent a potentially curative operation. Vascular invasion was found in 11 patients (36.7%). The incidence of vascular invasion was well correlated with tumor grade and stage. The incidence of metastases postoperatively was significantly higher in the patients with (72.7%) than without (21.1%) vascular invasion (p < 0.01). The survival rate of the patients with vascular invasion was significantly lower than in those without vascular invasion (p < 0.005). In multivariate Cox regression analysis the prognostic value of vascular invasion was independent of tumor stage and grade. These results indicate that vascular invasion should predict a more unfavorable outcome in patients with upper urinary tract cancer as an independent morphological indicator.

Bowel preparation for the total colonoscopy by 2,000 ml of balanced lavage solution (Golytely) and sennoside

One of disadvantages of the Golytely preparation is that examinees have to drink as much as 4,000 ml of Golytely. To overcome this disadvantage, we designed a modified preparation regimen in which examinees have to drink only 2,000 ml of Golytely by taking sennoside orally. Bowel preparation was carried out in 297 examinees by this modified method. Examinees ate their usual diet and took 36 mg of sennoside orally on the night before the examination. On the day of the examination, the examinees drank a total of 2,000 ml of Golytely. No severe complications were noted and 97% of the examinees were able to drink the dose of 2,000 ml. Subjects who had also experienced bowel preparation by the modified method of Brown were asked to compare the two regimens, and only 1% preferred Brown's method while 73% preferred bowel preparation by our Golytely method. The result of bowel preparation by this method was excellent or good in 90 to 97% of the subjects at all sites in the colon and rectum. We conclude that bowel preparation for total colonoscopy using 2,000 ml of Golytely and sennoside is superior because it is highly acceptable to the examinees and provides excellent gut irrigation.

Effect of doxycycline on the generation of reactive oxygen species: a possible mechanism of action of acne therapy with doxycycline

On the basis of a recent report that minocycline is effective in the treatment of acne inflammation by acting directly as an antioxidant on infiltrating neutrophils, we investigated whether doxycycline might also be capable of reducing the generation of reactive oxygen species, using human neutrophils and a cell-free, xanthine-xanthine oxidase system. The species investigated are superoxide radical anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH.). Doxycycline significantly reduced the levels of O2-, H2O2 and OH. generated by both systems. Our results seem to suggest that the clinical effectiveness of doxycycline in the treatment of acne inflammation is due partly to its antioxidant effect on neutrophils.

Contribution of the endothelium to intimal thickening in normocholesterolemic and hypercholesterolemic rabbits

Endothelial cell injury is considered to be a primary event in the pathogenesis of atherosclerosis. In this study, we investigated the aortic intimal lesion after balloon catheterization in hypercholesterolemic and normocholesterolemic rabbits with or without probucol, an antioxidant. After deendothelialization, the rabbits were divided into four groups: 1) a control group fed a standard diet; 2) a probucol-treated group; 3) a cholesterol-fed group; and 4) a group fed a mixed cholesterol and probucol diet. Four animals from each group were killed at 2, 4, and 8 weeks after deendothelialization. The aortic segments of nonendothelialized areas, borderline areas, and uninjured areas were histologically and immunohistochemically examined. Deendothelialized areas showed various degrees of intimal thickening, which was mainly composed of smooth muscle cells in rabbits from groups 1 and 2. The intimal thickness of group 3 was significantly larger than that of other groups in any area examined. The intimal thickness of group 4 was less than that of group 3 despite the hypercholesterolemic state in the former group. The intima of borderline areas was generally thicker than that of nonendothelialized areas. Although the borderline lesions of groups 3 and 4 contained numerous macrophages, the number of macrophages was lower in the nonendothelialized compared with the reendothelized lesion. These data indicate that endothelial cell injuries can cause intimal thickening. The regenerated endothelial covering is favorable for monocyte migration and attachment. This process, together with the proliferation of smooth muscle cells, greatly contributes to the progression of atherosclerosis, which appears to involve lipid oxidation. Probucol prevented intimal thickening to a certain degree in this experiment in the normocholesterolemic as well as the hypercholesterolemic state.

[Aortic arch and descending aortic replacement under deep hypothermia and circulatory arrest through left thoracotomy--case report]

Graft replacement of the transverse aortic arch and the descending thoracic aorta was done for two cases with Stanford type B aortic dissection involving the aortic arch. Cardiopulmonary bypass was established with left atrium and femoral vein for venous line and femoral artery for arterial line. Patients were cooled until their EEG activity had disappeared, then the bypass was discontinued. Lesser curvature of the transverse aortic arch was resected and graft was sutured by beveled fashion. After reinstitution of the bypass, intercostal arteries (Th8-10) were reattached to the graft and distal anastomosis was made above the diaphragma. Postoperative recovery was uneventful in both cases.

Diagnostic usefulness of dipeptidyl aminopeptidase IV monoclonal antibody in paraffin-embedded thyroid follicular tumours

Monoclonal antibodies to dipeptidyl aminopeptidase IV (DAP IV, EC 3.4.14.5) were raised and selectively applied to paraffin-embedded sections of thyroid carcinoma. Five monoclonal antibodies were found to stain paraffin sections of thyroid carcinomas. Using one of these antibodies (44-4), we studied retrospectively aberrant expression of DAP IV in thyroid carcinoma to determine whether immunohistochemical staining with DAP IV antibody is useful in pathological diagnosis. In almost all cases of thyroid follicular and papillary carcinoma, tumour cells were positive (99.0 per cent) with DAP IV, whereas the cases of follicular adenoma showed a low incidence (27.1 per cent) of positive staining. Follicular adenoma with incomplete capsular invasion had a higher positive incidence (50 per cent) than follicular adenoma without incomplete capsular invasion (9.6 per cent). In positive staining cases previously diagnosed as benign tumours, 11 benign cases reacting positively with DAP IV were rediagnosed as carcinoma after re-examination of more thyroid paraffin block sections or serial sections. These findings suggest that DAP IV monoclonal antibody is very useful in distinguishing thyroid follicular carcinoma from follicular adenoma.

Relationship between the changes in placental blood flow resistance assessed by Doppler technique and maternal serum placental aminopeptidases, which degrade vaso-active peptides, in pre-eclampsia

Our study showed that there were statistically significant correlations between the systolic and diastolic ratio (S/D) of maternal uterine or umbilical artery and the levels of maternal serum aminopeptidase activities in pre-eclampsia. Kininase I was positively correlated with the S/D ratios, whereas placental leucine aminopeptidase (P-LAP) and aminopeptidase A were negatively correlated with the S/D ratios. It is known that the increased S/D ratios reflect the increased utero-placental blood flow resistance. Since our previous study showed that placental aminopeptidases degrade vasoactive peptides such as oxytocin, angiotensin and bradykinin, which the fetus actively produces, our present study suggests that the increased vascular resistance in feto-placental circulation in pre-eclampsia is partly controlled by changes in vaso-active peptides, via degradation by placental aminopeptidases.

Effects of antithrombotic drug, Y-20811 on mural thrombus formation and intimal thickening following intimal injury

Inhibitory effect of Y-20811 on platelet thrombus formation induced by mechanical intimal injury and subsequent intimal fibrous thickening was studied. In the short term experiment, polyethylene tubing was inserted into the rabbit aorta and was drawn out one hour after with or without Y-20811 administration, then the rabbits were sacrificed. In the experiment for the quantitative analysis of platelet adhesion, 51Cr-labeled platelets were used. Radioactivities of 2cm length of the injured segment of the thoracic aorta and the proximal 2cm of the normal segment were measured. Radioactivity of the injured segment was significantly lower in rabbits treated with Y-20811 than the control ones. The mean thickness (area of thrombi/length of injured intima) and the maximal thickness of the mural thrombi in the Y-20811-treated rabbits were significantly lower than those in control rabbits. De-endothelialized area showed raised platelet thrombi in the control group and diffuse thin-layered platelet sheets in Y-20811-treated rabbits. In the long term experiment, polyethylene tubing was indwelled for 24 hours. Rabbits were sacrificed 10 days after drawing out the tubing. Through the experiment Y-20811 was injected intravenously every 24 hours. There was no significant difference between the control group and the Y-20811-treated one in both mean thickness and maximal thickness of the intimal fibromuscular thickening. The experiments indicate that Y-20811 has an inhibitory effect on platelet thrombus formation following intimal injury, but subsequent myointimal thickening is not inhibited by the drug.

Vascular contraction in perfused carotid arteries of cholesterol-fed rabbits

The purpose of the present study was to investigate the effects of hypercholesterolemia on sympathetic vascular responsiveness in the perfused rabbit carotid artery. Two groups of rabbit carotid arteries were evaluated for the simultaneous measurement of noradrenaline (NA) release and vasoconstrictor response induced by electric nerve stimulation and for exogenous NA-induced vasoconstriction in vitro. One group of rabbits was fed a diet containing 0.5% cholesterol for 2 weeks and the other group was fed standard rabbit chow. By scanning electron microscopy, monocytes adhering to the endothelial cells and penetrating into the subendothelium were observed. Neither endothelial denudation nor platelet adhesion could be detected. Rabbit carotid arteries were cannulated and perfused with a physiological solution at a constant flow rate. The vessels were subjected to both transmural field stimulation (TFS; 1.5-24 Hz) and exogenous NA administration. TFS caused a frequency-dependent increase in endogenous NA release with subsequent pressor responses in both groups. Exogenous NA also induced a dose-dependent pressor response, but a significant reduction was observed in the cholesterol-fed group. Methoxamine induced a similar response in both groups. It was concluded that hypercholesterolemia decreased the sensitivity of extrajunctional alpha-receptors in the perfused rabbit carotid artery.

An epidemiological study of methicillin-resistant Staphylococcus aureus (MRSA) isolated from medical staff, inpatients, and hospital environment in one ward at our hospital

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important causative microorganisms for nosocomial infections. Recently, the incidence of isolation of MRSA has been increasing every year in Japan and is, notably, much more frequently found in inpatients than in outpatients. Therefore, we have done epidemiological studies of MRSA isolated from medical staff, inpatients, and the hospital environment in one ward of our hospital. Thereafter, we examined the antibiotic susceptibility (ABPC, DMPPC, CET, CMZ, IPM, GM, MINO, OFLX, EM, CLDM, VCM), phage typing, and coagulase typing of these MRSA. MRSA were isolated more frequently from anterior nares of inpatients than from doctors and nurses. MRSA were isolated more frequently from the environment near carriers of MRSA. Coagulase type II and phage type N.T. (not typable) were the dominant types of MRSA in our hospital (69% and 61%). MRSA strains were resistant to most antibiotics with a few exceptions (VCM, IPM, CMZ, CET). The high isolation frequency of MRSA in our hospital seems to suggest that inpatients who are carrying MRSA spread MRSA throughout the hospital environment and that the anterior nares of inpatients are the major MRSA harbor.

Isolation and identification of restriction endonuclease, SelI from a cyanobacterium, Synechococcus elongatus

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[An epidemiological study of methicillin-resistant Staphylococcus aureus (MRSA) isolated from medical staffs, inpatients and hospital environments at our hospital]

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important microorganisms which is causative of the nosocomial infections. Recently the incidence of isolation of MRSA is increasing from year to year in Japan. Especially MRSA isolated from inpatients are much higher than from outpatients. Therefore we have done epidemiological studies about MRSA isolated from medical staffs, inpatients and hospital environments in our hospital. Thereafter we examined phage typing and coagulase typing of those MRSA. MRSA were isolated more frequently from anterior nares of inpatients in compare with doctors and nurses. MRSA were isolated more frequently from the environments of MRSA carriers. Coagulase type II and phage type N.T. (not typable) were dominant type of MRSA in our hospital (69% and 61%). Our studies have revealed that the isolation frequency of MRSA is very high in our hospital. It seems to suggest that inpatients who are carrying MRSA are spreading MRSA out hospital environments and medical staffs.

[Arterial intimal thickening]

Disturbances in the integrity of the arterial endothelium are considered to be a primary event in the pathogenesis of atherosclerosis. Platelets do not adhere to the intact endothelium but with removal of the endothelium, a thrombotic response to the exposed thrombotic subendothelium occurs. With time, proliferation of smooth muscle cells occurs in the inner-most part of the media beneath the thrombus, and the proliferated smooth muscle cells migrate beyond the internal elastic lamina to invade the thrombus and organize it. A growth factor released from activated platelets (PDGF) stimulates smooth muscle cell proliferation. At the same time, the endothelium, adjacent to the thrombus, proliferates and covers the organizing thrombus from its margin. Thus, localized flat or raised intimal thickenings are formed from organization of mural thrombus or repair of intimal injury. There is much evidence that the release of platelet constituents can damage the vessel wall. Our study clearly demonstrated that material released from situ platelet-rich mural thrombi into the arterial circulation can cause endothelial damage and promote the proliferation of smooth muscle cells in the intima, downstream, and in remote segments of the arterial wall, without apparent endothelial denudation. PDGF, together with other growth factors, is also considered to be involved in smooth muscle cell proliferation in this case.

Replication of endothelial cells and smooth muscle cells induced in vivo by hypercholesterolaemia and materials released from platelet-rich white thrombus

Endothelial cell injury is considered to be the primary event in atherogenesis. In this study, we investigated the effects of hypercholesterolaemia, and substances released from platelet-rich thrombi, individually and together on endothelial cells and the wall of the rabbit in vivo. We divided 24 rabbits into four groups: I was a control group on a normal diet; II was a tubing group on a normal diet, in which polyethylene tubing was inserted into the ascending aorta; III was a group being fed a cholesterol diet; and IV was a combined group being fed a cholesterol diet with polyethylene tubing in the ascending aorta. Segments from the descending thoracic and abdominal aortas which were not injured directly by tubing were examined morphologically and for [3H] thymidine incorporation into endothelial cells and smooth muscle cells. The descending aortas of groups II, III, and IV showed various degrees of endothelial cell damage. [3H]Thymidine incorporation into endothelial cells and aortic wall was increased in groups II, III, and IV (most in group IV) as compared with group I. These data indicate that hypercholesterolaemia and substances released from activated platelets and/or white mural thrombi can cause endothelial damage which may result in endothelial and smooth muscle cell proliferation. In addition, a combination of these two factors showed an additive effect on the endothelial injury and regeneration in vivo.

Inhibition of neutrophil chemotactic factor production in comedonal bacteria by subminimal inhibitory concentrations of erythromycin

The effect of 1/10 minimal inhibitory concentrations (sub-MIC) of erythromycin (EM) on human neutrophil chemotactic factor production in comedonal bacteria, Propionibacterium acnes strains, Propionibacterium granulosum strains and coagulase-negative staphylococcus (CNS) strains was assayed using the Boyden chamber method. Sub-MIC of EM significantly suppressed neutrophil chemotactic factor production in all strains of P. acnes, P. granulosum and CNS. Our results suggest that sub-MIC of EM may have an anti-inflammatory action by reducing the inflammatory capacity of comedonal bacteria in inflammatory acne.

Effects of azelastine on neutrophil chemotaxis, phagocytosis and oxygen radical generation

The effects of azelastine, an orally active anti-allergic drug, on several inflammatory parameters of human neutrophils, including human neutrophil chemotaxis, phagocytosis and generation of reactive oxygen species (ROS), was examined. ROS generated in a cell-free, xanthine-xanthine oxidase system was also assessed. The species investigated were superoxide radical anion (O2-), hydrogen peroxide (H2O2) and hydroxyl radical (OH.). Azelastine significantly inhibited human neutrophil phagocytosis and the generation of O2-, H2O2, OH. by human neutrophils. However, the drug did not markedly affect human neutrophil chemotaxis or the ROS levels generated in the xanthine-xanthine oxidase system. The present study indicates that azelastine may exert an anti-inflammatory action by inhibiting human neutrophil phagocytosis as well as oxygen radical generation at the sites of inflammation.

Medullary bone of piglets

The bone marrow is commonly present in the medullary cavity of long bones in most mammals at birth. In the present study, the persistence of the osseous tissue was examined in the medullary cavities of piglet bones at and after birth. Immediately after birth, medullary cavities of long bones were almost completely filled with the spongy bone. The persisted spongy bone, i.e., medullary bone was prominent in younger pigs but decreased with advance in age. By 90 days of age, the medullary bone almost disappeared to form the extended medullary cavity. During the disappearing process of the medullary bone, osteoclasts showed significant increase in size and number (p less than 0.05). In irregular and flat bones, osseous trabeculae of the medullary bone became slender with age. The extramedullary hematopoiesis in the liver and spleen was very active till 30 days of age. This may suggest that the persistence of the medullary bone narrows the medullary cavity to cause poor medullary hematopoiesis and is compensated by extramedullary hematopoiesis. The relationship among the medullary bone, extramedullary hematopoiesis and piglet anemia was discussed.

Effects of subminimal inhibitory concentrations of minocycline on neutrophil chemotactic factor production in comedonal bacteria, neutrophil phagocytosis and oxygen metabolism

Comedonal bacteria, Propionibacterium acnes, P. granulosum and coagulase-negative staphylococci (CNS) seem to play an important initiating role in the inflammatory process by producing neutrophil chemotactic factors. The attracted neutrophils, after phagocytosis, release inflammatory factors such as reactive oxygen species (ROS). We investigated the effects of minocycline at subminimal inhibitory concentrations (sub-MIC), i.e. one-tenth MIC, on the production of human neutrophil chemotactic factors in comedonal bacteria, and on several inflammatory parameters of neutrophils, including neutrophil phagocytosis and generation of ROS (O2-, H2O2, OH.). ROS generation in a cell-free, xanthine-xanthine oxidase system was also assessed. Production of neutrophil chemotactic factors in all strains of P. acnes, P. granulosum and CNS were significantly suppressed by sub-MIC minocycline. Sub-MIC minocycline effectively reduced three kinds of neutrophil-generated ROS (O2-, H2O2, OH.). However, neutrophil phagocytosis and the ROS generated in a cell-free system were not markedly changed in the presence of sub-MIC minocycline. The results suggest that sub-MIC minocycline has an anti-inflammatory effect by inhibiting the production of neutrophil chemotactic factors in comedonal bacteria as well as ROS generated by neutrophils in the inflammatory process of acne.

Effects of cepharanthin on neutrophil chemotaxis, phagocytosis, and reactive oxygen species generation

The effects of cepharanthin on inflammatory parameters such as neutrophil chemotaxis, phagocytosis and reactive oxygen species (ROS) generation, were examined. Cepharanthin significantly decreased the levels of O2-, H2O2, and OH. generated by neutrophils. H2O2 and OH. generated in a cell-free, xanthine-xanthine oxidase system were also reduced in the presence of cepharanthin. However, the drug did not affect neutrophil chemotaxis or phagocytosis. The present study indicates that cepharanthin is an effective ROS scavenger, exerting its anti-inflammatory action by reducing the potent ROS species excessively generated in tissues and organs, especially at the sites of inflammation.

Molecular analysis of a Bjerkandera adusta lignin peroxidase gene

A cDNA clone, lambda LPO-1, encoding a major lignin peroxidase from the basidiomycete Bjerkandera adusta was isolated and characterized. The nucleotide sequence of lambda LPO-1 predicts a mature protein consisting of 349 amino acids with a molecular weight of 37,225 preceded by a signal peptide of 23 amino acid residues. We have also cloned and sequenced the gene encoding lignin peroxidase from B. adusta. Comparison of these sequences reveals a lignin peroxidase gene structure consisting of 1,116 bp of protein-encoding DNA that is interrupted by four intervening sequences. The putative eukaryotic regulatory sequence, a TATA box, is present at position -75 relative to the translational initiation codon. Amino acid sequence homology between the coding regions of lambda LPO-1 and of the lignin peroxidase cDNA clone lambda ML-1 from Phanerochaete chrysosporium is 61%.