Bone morphogenetic protein-induced muscle- and synovium-derived cartilage differentiation in vitro

Muscle- and synovium-derived mesenchymal-type cells differentiated into cartilage in response to a coating of partially purified rabbit bone morphogenetic protein (BMP) on a substratum of plastic. Observed by means of phase contrast microscopy, light microscope histochemistry, and electron microscopy, the sequence of events on a BMP-coated plastic substratum is the same as that observed on a substratum of bone matrix. The plastic eliminates the possibility of any endogenous allogeneic matrix-derived BMP contaminating the system. The differentiation of cartilage from synoviocytes and subsynovial cells resembles the pathologic process occurring in human chondromatosis.

Unstable DNA in a patient with a severe form of congenital myotonic dystrophy

Recently, an unstable DNA (expanded CTG repeat) was identified as the mutation that causes myotonic dystrophy (DM). By Southern blot analysis of DNA derived from peripheral blood, patients with congenital form of DM are shown to have greater expansion of DM specific band than is seen in the analyses of adult form of DM. We present here tissue expression of unstable DNA in an autopsied case of severe congenital form of DM. Our study revealed the largest expanding band of 19 kb was uniformly seen in various tissues from an autopsied infant with congenital form of DM.

The entry and intracellular multiplication of Francisella tularensis in cultured cells: its correlation with virulence in experimental mice

Five acriflavine agglutination test-positive (acf+) colonies and five negative (acf-) colonies were isolated from each of the four strains (Ebina, CMB2, N9, and Schu) of Francisella tularensis, and the correlation between the virulence in experimental mice and the entry and intracellular multiplication in cultured mouse fibroblast cells (L-929 cells) was examined. All of the acf- colonies derived from the Ebina and CMB2 strains were highly virulent in mice, readily entering and growing well in the cells, while all of the acf- colonies from N9 and Schu strains were of low virulence and neither entered nor grew in the cells effectively. On the other hand, regardless of their parent strains, the acf+ colonies were low virulent and most of those colonies did neither enter nor grow in L-929 cells. In addition, two acf- colonies, one from the N9 and the other from the Schu strain, gained virulence through several passages in mice, and in parallel, their entry and multiplication also improved. However, two acf+ colonies from the Ebina strain and one acf+ colony from the N9 strain showed a moderate degree of the entry and multiplication although they were all low virulent. The overall results indicate that the entry and multiplication in cells are important factors regulating the virulence of F. tularensis. The results also showed, however, that they were not sole factors to elucidate the virulence of the bacterium in mice.

The usefulness of the captopril test as a simultaneous screening for primary aldosteronism and renovascular hypertension

The usefulness of the captopril test as a simultaneous screening method for primary aldosteronism (PA) and renovascular hypertension (RVH) was evaluated in 111 patients with essential hypertension, and in 79 patients with secondary hypertension, which included 16 patients with PA and 18 with RVH. Plasma renin activity (PRA, ng/mL/h) and plasma aldosterone concentration (PAC, ng/dL) were determined before and 90 min after administration of 50 mg of captopril in the supine position on a normal NaCl diet. A cutoff point or a discriminant function in the screening was determined by discriminant analysis. A quadratic discriminant function of PRA and PAC after the captopril test identified patients with PA with a false negative rate of 6.3% (1/16), and a false positive rate of 0.6% (1/174) which was significantly lower than that of 3.4% at the basal state (P < .05). In the screening for RVH, the criterion of a postcaptopril PRA of greater than 10.6 ng/mL/h had a false negative rate of 5.6% (1/18) and a false positive rate of 15.1% (26/172). This false positive rate was also significantly lower than that using a criterion for precaptopril PRA of 2.21 ng/mL/h (P < .05). Accordingly, the captopril test was a useful method in the simultaneous screening for PA and RVH, and it may be particularly applicable in specialized hypertension clinics.

Is there any specific personality disorder or personality disorder cluster that worsens the short-term treatment outcome of major depression?

This study attempted to identify a specific personality disorder (PD) or PD cluster that independently worsens the 4-month treatment outcome of major depression under adequate antidepressant. The material of the study was 96 consecutive outpatients with major depression. For the Axis I and Axis II diagnoses, the Structured Clinical Interview for DSM-III-R (SCID) was used. In the material, the presence of any PD significantly worsened the 4-month outcome. The discriminant function analysis, conducted to identify a specific PD or PD cluster that influences the outcome, found that the number of PD from only cluster A and the number of criteria met for only schizoid PD was significantly correlated with the 4-month outcome of depression.

Analysis of human and bovine milk lactoferrins by Rotofor and chromatofocusing

1. Isoelectric points of human and bovine lactoferrins were evaluated by Rotofor and chromatofocusing analysis. 2. By Rotofor, the isoelectric value of human lactoferrin fraction was determined at 8.7 and that of bovine lactoferrin at 8.8. 3. By chromatofocusing analysis, human and bovine lactoferrins showed different elution patterns. Human lactoferrin was eluted at pH 6.8-8 and bovine lactoferrin eluted at pH 8.2-8.9.

Successful treatment of life-threatening ventricular tachycardia with high-dose propranolol under extracorporeal life support and intraaortic balloon pumping

The use of propranolol is generally contraindicated in patients with congestive heart failure. However, we successfully used a continuous high-dose infusion of propranolol, in combination with the use of extracorporeal life support (ECLS) and intra-aortic balloon pumping (IABP), to treat refractory life-threatening ventricular tachycardia in a patient with postoperative congestive heart failure. The early combined use of ECLS and IABP before irreversible myocardial damage contributed to the successful outcome.

Non-selective cation channel in bullfrog taste cell membrane

Using single channel recordings of the patch clamp method, we found first that cation channels were present in the bullfrog taste cell membranes. These channels were widely distributed over the taste cell membrane. The conductance examined with inside-out patches was 30.7 +/- 5.7 pS (mean +/- S.D., n = 13). The permeability ratio of the cation channel to monovalent cations was PK:PCS:PNa = 1.18:1.00:0.70, indicating that the channels are non-selective.

Diode laser irradiation selectively diminishes slow component of axonal volleys to dorsal roots from the saphenous nerve in the rat

Ga-Al-As laser irradiation (830 nm wavelength) inhibits the action potentials in the dorsal roots elicited from the saphenous nerve of the rat. Following laser irradiation to the saphenous nerve, the amplitude of slower conduction parts of action potentials (conduction velocity < 12 m/s) were suppressed. This suppression was irradiation time dependent. After 3 min irradiation, slowest conduction velocity group (< 1.3 m/s) were totally diminished and 1.3-12 m/s group were reduced to 12-67%. In contrast, faster component (> 12 m/s) was unaffected by laser irradiation. These findings suggest that laser irradiation may selectively target fibers conducting at slow velocities which include afferent axons from nociceptors.

A change in soybean agglutinin binding patterns of bovine milk fat globule membrane glycoproteins during early lactation

Milk fat globule membrane (MFGM) glycoproteins were prepared from bovine milk at different stages of early lactation. Western blot analyses using several lectins revealed that reactivity of MFGM glycoproteins, especially 47K and 80K bands, to soybean agglutinin (SBA) remarkably increased during the lactation, while no change was observed for Ricinus communis agglutinin-I (RCA-I) binding. Sialidase treatment of MFGM glycoproteins revealed that the number of SBA-positive bands and the amount of SBA-positive oligosaccharides in these bands are increased during the lactation. Since SBA binds N-acetylgalactosamine terminated oligosaccharides, the results indicated that N-acetylgalactosaminylation of bovine MFGM glycoproteins is stimulated during the lactation.

Suicide attempts by agricultural chemicals

Forty three patients (42%) used agricultural chemicals as a method of suicide over nine and a half years (from Oct. 1981 to March 1991), and most cases were reported in June (agricultural activity) and December (year's end). The highest prevalence was inpatients in their fifties (34.9%). 58.1% of these patients who committed suicide were farmers or had no fixed occupation. Main precipitating factor was difficulties in interpersonal relationships (30.9%), and the largest number of patients (25.6%) were diagnosed as having manic-depressive psychosis, depressed type.

Ultrastructural analysis of a human megakaryocytic leukemia cell line (CMK11-5) following prostaglandin E1 stimulation

We examined the ultrastructural changes occurring in a human megakaryocytic leukemia cell line, CMK11-5, in response to stimulation with prostaglandin E1 (PGE1). The addition of PGE1 to cultured cells dose-dependently caused vacuole enlargement, the development of cell surface projections, cell surface vacuole formation, and the release of a tracer protein (horseradish peroxidase) which had been incorporated into cytoplasmic granules. These morphological changes, which occurred parallel with [Ca2+]i mobilization in the CMK11-5 cells, were similar to those observed in CMK cells in response to stimulation with ADP, thrombin, and collagen. Our present findings suggest that PGE1 has a stimulatory effect on CMK11-5 cells through the induction of [Ca2+]i mobilization, and that the PGE1-induced transmembrane signaling system in megakaryocytes is completely different from that in platelets.

[Noninvasive assessment of left internal thoracic artery graft patency using transthoracic echocardiography]

To evaluate the utility of transthoracic echocardiography (TTE) for assessing the long-term patency of left internal thoracic artery (LITA) grafts, 36 patients who had coronary artery bypass grafting (CABG) were examined simultaneously for graft flow velocity by TTE and by graft angiogram. The flow velocity in the LITA graft was clearly visualized by TTE in 25 patients from the left supraclavicular echo view. On the basis of the angiogram, the sensitivity and specificity of TTE in the diagnosis of LITA graft patency were 71.4% and 100%, respectively. These 25 patients (mean follow-up time after CABG-29.6 months) were divided into 3 groups according to their preoperative diagnosis and the presence of grafts stenosis by angiogram as follows: APS(-), angina pectoris without graft stenosis in 15 cases; APS(+), angina pectoris with graft stenosis in 2 cases; OMI, old myocardial infarction without graft stenosis in 8 cases. The peak flow velocity D/S ratio and time velocity integral D/S ratio in the APS(-) group (2.48 +/- 0.73, 3.21 +/- 0.89) were significantly (p < 0.01) higher than those in the APS(+) group (0.30 +/- 0.23, 0.35 +/- 0.21) or in the OMI group (0.96 +/- 0.44, 0.87 +/- 0.51). Peak flow velocity D/(S+D) and time velocity integral D/(S+D) ratios in the APS(-) group (0.70 +/- 0.05, 0.75 +/- 0.06) were significantly (p < 0.01) higher than those in the APS(+) group (0.22 +/- 0.14, 0.25 +/- 0.11) or in the OMI group (0.46 +/- 0.17, 0.43 +/- 0.18).(ABSTRACT TRUNCATED AT 250 WORDS)

Oxytocin affects apical sodium conductance in rabbit cortical collecting duct

The physiological role of oxytocin (OT) in the kidney is still unclear, although autoradiographic data have shown the existence of OT receptors in the rat kidney. We examined the effect of OT in the microperfused rabbit cortical collecting duct (CCD) by using conventional cable analysis and microscope photometry. On addition of 10(-9) M OT to the bath, the lumen-negative transepithelial voltage (VT) transiently increased and the transepithelial resistance (RT) and the fractional resistance of the apical membrane (FRA) (1st phase) both decreased. After this initial change, the lumen-negative VT gradually decreased below its baseline level and RT and FRA (second phase) both increased. These electrical changes were dose dependent and were prevented by the addition of 10(-5) M amiloride to the lumen. Although responses to OT were not prevented by 10(-9) M arginine vasopressin (AVP) or 10(-6) M of a V1-receptor antagonist (OPC-21268) or V2-receptor antagonist (OPC-31260), they were inhibited by the addition of the specific OT antagonist des-Gly-NH2-[d(CH2)3,Tyr(Me),Thr]OVT. Additional studies of intracellular free calcium ([Ca2+]i) revealed that 10(-8)-10(-6) M OT caused an increase in [Ca2+]i in CCD in a dose-dependent manner. Also, pretreatment with 2 x 10(-8) M bis-(aminophenoxy)ethane-tetraacetic acid-acetoxymethyl ester, an intracellular Ca2+ chelator, abolished the electrical and [Ca2+]i responses to OT. Pretreatment with 5 x 10(-4) M 8-(4-chlorophenylthio)-adenosine 3',5'-cyclic monophosphate (CPT-cAMP) partially prevented the electrical responses to OT, thus reducing the decrease in lumen-negative VT below its basal level and the increase in RT after the 1st phase. These data show that OT affects the apical Na+ conductance of collecting duct cells through OT receptors distinct from the AVP receptors and that the effect of OT may, at least in part, be brought about by a mechanism(s) dependent on the increase in [Ca2+]i and cAMP production.

[New membrane filter (PORETEC) method for ocular diagnostic cytopathology]

We describe a new membrane filter (PORETEC) technique for processing cytopathologic fluid specimens. This procedure provides excellent cytologic preparations because there is no background staining and only a small amount of fluid specimen is necessary, as there is little cell loss. We compared the number of cells collected by the membrane filter technique with that collected by cytocentrifugation using conjunctival brush cytology specimens from 6 subjects. The number of cells obtained by the new method was significantly higher than that obtained by the cytocentrifugation technique. This method was very useful for ocular fluid specimens such as aqueous humor, vitreous specimens, and scrapings from the cornea and conjunctiva. We showed some examples of these specimens including immunocytochemical staining done by this method. We confirm that this is valuable for diagnostic cytopathologic study of various fluid specimens in ophthalmology.

Epidermal growth factor receptor levels in reproductive organs of female mice exposed neonatally to diethylstilbestrol

Binding of epidermal growth factor (EGF) to membrane preparations of vagina, uterus, ovary, oviduct, and liver was examined in mice treated neonatally with diethylstilbestrol (DES) and compared with that in untreated mice. Binding in the vagina (12.5 +/- 0.73 fmol/mg protein) was somewhat higher than in the uterus (8.0 +/- 0.34 fmol/mg protein). Level of specific binding was of the order: liver (18.4 +/- 1.09 and 16.0 +/- 1.53 fmol/mg protein) > vagina (12.5 +/- 0.73 and 8.2 +/- 0.57 fmol/mg protein) > uterus (8.0 +/- 0.34 and 6.8 +/- 0.56 fmol/mg protein) > ovary (6.8 +/- 0.36 and 8.0 +/- 1.05 fmol/mg protein) > oviduct (2.1 +/- 0.32 and 1.7 +/- 0.05 fmol/mg protein) in control and neonatally DES-exposed mice, respectively. Thus, neonatal DES exposure significantly lowered the binding site level only in the vagina, without modifying the binding affinity (Kd = 5.4 x 10(-9) M in controls vs 4.6 x 10(-9) M in DES-exposed mice). Reduction of EGF receptor level in the vagina correlates with ovary-independent persistent proliferation and keratinization of the vagina induced by neonatal DES exposure. EGF receptors were immunohistochemically demonstrated in epithelial cells of vagina, uterus, and oviduct and in stromal cells in uterus and oviduct using a polyclonal antibody to human EGF receptor protein.

Labetalol in hypertension during the third trimester of pregnancy: its antihypertensive effect and pharmacokinetic-dynamic analysis

The hypotensive effect, kinetics, and concentration-response relationship of labetalol, alpha beta- and alpha 1-adrenoceptor blocking drug, were studied in seven women with a moderate-to-severe hypertension (averaged diastolic blood pressure [DBP] of 100 to 120 mm Hg measured during a 1- to 2-day hospitalization period) during the third trimester of pregnancy who received the oral twice-daily doses of 150 to 450 mg. These dosages were individually selected by attaining a therapeutic goal of DBP < or = 100 mm Hg or systolic blood pressure (SBP)/DBP reduction of > 30/15 mm Hg, as compared with the pretreatment value, at any time during the 12-hour dosing interval for a 3- to 5-day dosage escalation period. Labetalol concentrations in plasma were measured by a high-performance liquid chromatography with fluorescence detection, and the plasma drug concentration-response relationship was analyzed by a sigmoidal Emax model. Labetalol decreased significantly (P < 0.05 to 0.01) the pretreatment SBP/DBP (166.3 +/- 5.2/110.3 +/- 3.0 mm Hg, mean +/- SEM) without any recognizable side-effects during the twice-daily dosing period in the mothers. Peaked concentrations occurred at 1 hour postdose in all patients. The elimination half-lives ranged from 4.3 to 6.9 hours, and the apparent oral clearance from 31.9 to 73.3 mL/min/kg. The pharmacodynamic parameters (Emax and EC50) analyzed by the Emax model revealed a 3- to 5-fold interindividual variability. The gestational ages at delivery ranged from 34 to 37 weeks, and the birth weights were < 2000 g in 6 of the 7 neonates. Four neonates developed respiratory distress syndrome after delivery, and one infant died of pulmonary hypoplasia 3 months later. The results indicate that 1) labetalol orally administered in a twice-daily regimen as done in this study is an effective antihypertensive drug in women with hypertension during late pregnancy, and 2) interindividual variability in the kinetic factor (e.g., oral clearance) as well as that in the pharmacodynamic factor (e.g., EC50) appear to be related to the overall variability in the hypotensive responsiveness to the drug. However, whether labetalol and/or hypertension per se would have been related to the fetal outcome remains unanswered from the present study.

Ileal duplication cyst associated with heterotopic pancreas: report of a case and literature review

A rare case of solitary ileal duplication cyst accompanied by heterotopic pancreas in the terminal ileum is presented. An 8 year old boy with an ovoid shaped, elastic soft and pendant-growing ileal duplication cyst associated with aberrant pancreatic tissue but not communicating with the lumen of the ileum, underwent an adhesiotomy for a small intestinal adhesion that caused bowel obstruction. The obstructive state of the intestine seemed to be caused by an inflammation of the duplication cyst which was 4.5 x 2.7 x 2.5 cm and oval in shape. Excision of the cyst and the heterotopic pancreas was curative. The histological findings were identical to heterotopic pancreas accompanied by ileal duplication without any clinical features of heterotopic pancreas. A review of the literature is presented along with the author's experience in a case of ileal duplication cyst associated with heterotopic pancreas located in the ileum.

A design for decision making: construction and connection of knowledge bases for a diagnostic system in medicine

We describe the process of organizing medical knowledge into knowledge bases and designing one architecture for a decision support system in clinical psychiatry. We define a set of knowledge bases that we regard as the necessary and sufficient structures to represent the medical knowledge to provide clinical consultations: disease profiles; frames with semantic relations to represent clinical findings; production rules with probabilities, to relate findings with diagnoses; a hierarchical classification tree, to represent disease categories; heuristic questions, to narrow the diagnostic hypotheses; and diagnostic criteria to conclude the clinical investigation. We propose one new architecture for a support system connecting these knowledge bases in a particular way to simulate medical clinical reasoning.

Morphological study of the teeth of Ambystoma maculatum, Salamandra salamandra and Aneides lugubris: fine structure and chemistry of enamel

The functional teeth of adult salamander (Caudata): Ambystoma maculatum, Salamandra salamandra and Aneides lugubris were prepared for transmission electron microscopy and electron microprobe analysis of the elements and trace elements of the enamel layer. The arrangement of enamel crystals in these species is variable. The outer part of the enamel layer in which hydroxyapatite elements (Ca, P) and trace elements (e.g., F, Fe, Mg) are concentrated, is most mineralized. The concentration of trace elements are arrangement of crystals in the enamel layer differed in these species, may be related to the pattern of mineralization of enamel.

Urinary active kallikrein excretion and diabetic renal impairments in streptozotocin-treated rats

To assess possible roles of the renal kallikrein-kinin system in the development of renal impairments in diabetes mellitus, we determined daily excretion of urinary total and active kallikrein in uninephrectomized Wistar-Kyoto rats made diabetic by streptozotocin (45 mg/kg) as a bolus injection. We also evaluated the effect of captopril (50 mg/kg/day) administered orally on the development of diabetic renal impairments in the streptozotocin-treated rats. Active kallikrein was determined by its kininogenase activity, and generated kinins were radioimmunologically measured. Total kallikrein was also determined by measuring kininogenase activity after inactive kallikrein had been activated with trypsin (200 micrograms/ml). Urinary active kallikrein excretion was significantly reduced in streptozotocin-treated rats whereas urinary total kallikrein excretion was unchanged, resulting in the decreased ratio of active to total kallikrein compared to that in the controls. These reductions were preceded by the increased excretion of urine protein measured as an index of renal impairments. The administration of captopril for 12 weeks attenuated the development of diabetic renal impairments evaluated by urine protein excretion in streptozotocin-treated rats, although it did not induce significant changes in urinary total and active kallikrein excretion, and the ratio of active to total kallikrein. Thus the results of this study indicate that the renal kallikrein-kinin system might not play major roles in the development of diabetic renal impairments in the rat, although the pathophysiological relevance of impaired activation of renal kallikrein system to the development of diabetic renal impairments remains to be determined. In addition, they suggest that the renoprotective effects of captopril may be independent of the activation of renal kallikrein system in streptozotocin-treated rats.