Determination of 17-hydroxycorticosteroids in dialysate solution as a measure of adrenocortical function in hemodialysis patients

Dialysate contents of 17-hydroxycorticosteroids (17-OHCS) in hemodialysis patients were studied as a potential measure of adrenocortical function. Dialysate 17-OHCS contents after a 2-day interval of hemodialysis in 15 hemodialysis patients were determined. Dialysate 17-OHCS increased after intravenous injection of cortisol the evening prior to hemodialysis (n = 4). Dialysate 17-OHCS content was suppressed, as was plasma cortisol, after a standard dexamethasone (Dex) suppression test (n = 1). Their plasma cortisol was suppressible or nonsuppressible by an overnight Dex suppression test, as reported previously. However, basal dialysate 17-OHCS contents were not different between them, indicating that the nonsuppressible patients with overnight Dex seem not to have hypercortisolism. We conclude that determination of dialysate 17-OHCS seems a useful noninvasive technique for the evaluation of adrenocortical function in hemodialysis patients.

[Cutaneous manifestations of liver cirrhosis]

It is well recognized that liver cirrhosis may cause many characteristic skin changes. This paper deals with skin manifestations of liver cirrhosis, according to the pathological process. Portal hypertension may cause development of collateral circulation, including, visible varicose veins on the abdominal wall ("caput Medusae"). Hormonal disturbances, as the result of inability of the liver, are responsible for several vascular changes, such as, red palm, vascular spider and "paper money" skin, for gynecomastia and for loss of axillary and pubic hair. Nail changes, such as, clubbing, white nails, watch-glass deformity, flat nails and brittleness may be found in the patient with liver cirrhosis. Jaundice and melanosis are common. These skin changes are recognized as contributing to a diagnosis and estimating the stage of liver cirrhosis.

Tumor detection by radioimaging of hepatic radiozinc--correlation with metallothionein content

In order to determine if the radioimaging of the level of hepatic metallothionein (MT) is able to detect malignancy, we performed, using 45Zn, a trial to measure MT levels in the liver of experimental tumor-bearing mice and rats. The distribution of 65Zn in the livers of the mice and rats increased with s.c. transplantation of Ehrlich carcinoma and ascites hepatoma 7974F, respectively. A Sephadex G-75 elution profile of the cytosol fraction of the liver showed that the elevation of 65Zn level was due to elevation of the MT level. At 2 days after tumor transplantation in mice, the 65Zn-image demonstrated elevation of the hepatic MT level, while 67Ga-citrate, which is currently utilized, could not image the tumor at such an early period of growth. These results suggest that hepatic MT is a useful marker for the detection of malignancy at the early stage.

A sensitive enzyme-linked immunosorbent assay of serum ornithine carbamoyltransferase

Ornithine carbamoyltransferase (OCT), a urea cycle enzyme, is located almost exclusively in liver mitochondria. We designed a sensitive enzyme-linked immunosorbent assay (ELISA) of serum OCT protein using an antibody against purified bovine enzyme. OCT protein measured using this method showed a good correlation with OCT activity (r = 0.961), and was much higher in patients with liver diseases than in the controls. Measurements of serum OCT protein in 442 healthy blood donors gave the upper limit of normal range of 23 ng Eq/ml (equivalent to the bovine enzyme) for males, 8 ng Eq/ml for females, and 16 ng Eq/ml for males plus females. The values differ significantly between the sexes and depending on ages. This ELISA system is expected to be used as a pertinent liver function test.

Changes of plasma lipid and lipoproteins by rehabilitation therapy for stroke

Changes of the plasma levels of lipid by rehabilitation therapy for approximately 10 weeks were studied in 14 cases of stroke. Hypercholesterolemia or hypertriglyceridemia was present in a half cases of stroke, and HDL cholesterol was lower than the normal level in most cases before starting rehabilitation therapy. After rehabilitation therapy, hypertriglyceridemia was normalized in most cases. On the other hand, the plasma levels of cholesterol and LDL cholesterol were decreased slightly. HDL cholesterol was increased and atherogenic index was improved by rehabilitation therapy.

Mathematical model of cardiovascular mechanics for diagnostic analysis and treatment of heart failure: Part 2. Analysis of vasodilator therapy and planning of optimal drug therapy

Using a mathematical model of cardiovascular mechanics, various complicated responses to vasodilator therapy for heart failure have been well accounted for through common logic: (i) the differential effects of various vasodilators on cardiac output; (ii) the opposite response of cardiac output to sodium nitroprusside in a normal state and heart failure state; (iii) the different responses of cardiac index, arterial pressure and left ventricular end-diastolic pressure to hydralazine in different types of heart failure. The response to combined vasodilator-inotropic agent therapy was simulated well by the model. The optimal therapeutic regimen was then formulated to simultaneously control the cardiac output, systemic and pulmonary arterial and venous pressures, and the degree of coronary ischaemia by multiple drug delivery, and the problem was solved using the model. We conclude that the model provides a useful basis for obtaining a guidance for more appropriate therapeutic regimen in heart failure.

Intrafamilial transmission of hepatitis C virus

The intrafamilial transmission pattern of hepatitis C virus (HCV) was examined in 118 family members of 61 index patients with type C chronic liver disease using anti-HCV antibodies and HCV RNA assay. The study subjects consisted of eight parents, 49 spouses, 50 children, eight siblings and three other relatives. The positivity rates of anti-C100, anti-JCC, second-generation anti-HCV and HCV RNA were 6.8, 12.7, 12.7 and 11.0%, respectively. Positivity in one or more anti-HCV antibody assay was detected in 3/24 (12.5%) father-child pairs, 3/17 (17.6%) mother-child pairs, 2/8 (25%) sibling pairs, 6/38 (15.8%) husband-wife pairs and 2/13 (15.4%) wife-husband pairs. In spouses, positivity for anti-HCV antibody or HCV RNA was observed after 40 years of age. None of 11 spouses married < 15 years was positive for any anti-HCV assay or HCV RNA. In spouses whose age was > 50 years and duration of marriage was > 25 years, anti-HCV or HCV RNA was frequently detected (32.0%). However, when seven pairs involving four spouses, one mother-daughter pair and two sibling pairs were subtyped, the same HCV subtypes were found in only four pairs (type II in three pairs and type III in one pair). Further, the agreement rate between anti-HCV and HCV RNA was > 90%. These results suggest that intrafamilial transmission of HCV, revealed by the subtyping method, is considered lower than the percentage of positivity for anti-HCV antibodies or HCV RNA in family members of patients with type C chronic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Changes in the gap junction of rat exocrine pancreatic cells induced by long-term ethanol ingestion

Fourteen Male Wistar rats were orally administered 20% ethanol ad libitum in place of water. After 1, 2, 3, 6 and 12 months of ethanol ingestion, the gap junctions of pancreatic acinar and ductal cells were observed by transparent electron microscopy. The result was compared with fifteen control animals. In the control, the ductal cells proved to have only small sized (0.1 micron in length) gap junction located in the apical domain as a part of junctional complex. While, in the acinar cells, not only small but large-sized gap junctions several microns in length were observed in the baso-lateral domain. After 3 months of ethanol ingestion, the gap of these two types of gap junctions was replaced with a continuous, granular structure. In addition, irregularly running gap junctions were observed after 6 months of ethanol ingestion. The functional implication of these morphological changes is not clear.

Expression of laminin, type IV procollagen and 230 kDa bullous pemphigoid antigen genes by keratinocytes and fibroblasts in culture: application of the polymerase chain reaction for detection of small amounts of messenger RNA

In order to clarify whether keratinocytes and/or fibroblasts express genes encoding basement membrane zone macromolecules, we examined laminin, type IV collagen and 230 kDa bullous pemphigoid antigen (BPAG1) gene expression in keratinocytes and fibroblasts in culture. Northern transfer analysis revealed the presence of specific mRNA transcripts for alpha 1(IV) and alpha 2(IV) chains of type IV collagen as well as B1 and B2 chains of laminin in both fibroblast and keratinocyte RNA. Laminin A mRNA, however, was detected in fibroblasts but not in keratinocytes. In contrast, BPAG1 mRNA was detected in keratinocytes but not in fibroblasts using the same RNA preparations. A polymerase chain reaction (PCR) using laminin A and BPAG1-specific primers produced amplified DNAs with the predicted sizes in reverse-transcripted cDNA derived from keratinocyte and fibroblast RNA, respectively. These results provide evidence that normal human skin keratinocytes and fibroblasts express genes encoding laminin A, B1, B2, alpha 1(IV), and BPAG1 at a steady-state level. Moreover, the PCR for detecting small amounts of mRNA suggested that both keratinocytes and fibroblasts can be utilized for the analysis of DNA mutations in inherited skin diseases affecting the basement membrane zone, such as epidermolysis bullosa.

Involvement of protein kinase C in the interleukin 1 alpha-induced gene expression of matrix metalloproteinases and tissue inhibitor-1 of metalloproteinases (TIMP-1) in human uterine cervical fibroblasts

The role of protein kinase C in the interleukin 1 (IL-1)-mediated production of pro-matrix metalloproteinases (proMMPs) and tissue inhibitor-1 of metalloproteinases (TIMP-1) in human uterine cervical fibro-blasts has been investigated. IL-1 and a protein kinase C activator, 12-O-tetradecanoylphorbol 13-acetate (TPA) augmented the production of proMMP-1 (interstitial procollagenase), proMMP-3 (prostromelysin-1) and TIMP-1, but their effects were inhibited by the protein kinase C inhibitors 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H-7) and staurosporine in a dose-dependent manner. The suppressive effect of H-7 and staurosporine on the IL-1-induced production of proMMPs-1 and -3 and TIMP-1 resulted from the decrease in the steady-state levels of their mRNAs. When protein kinase C was down-regulated by treating the cells with a high level of TPA, the inductive effect of IL-1 upon proMMP-3 production was reduced considerably. These results indicate that protein kinase C mediates the IL-1-induced production of proMMPs-1 and -3 and TIMP-1 at the pretranslational level in human uterine cervical fibroblasts. On the other hand, neither IL-1 nor TPA modulated the production of proMMP-2 (progelatinase A). Both IL-1 and TPA also accelerated the production of prostaglandin E2 (PGE2) by cervical fibroblasts. However, the treatment of the cells with staurosporine in the presence of IL-1 or TPA further augmented PGE2 synthesis, suggesting that the increased synthesis of PGE2 by IL-1 treatment is mediated via signalling pathways distinct from those of proMMPs-1 and -3 and TIMP-1.

Inhibition of salt-induced gustatory responses in the frog (Rana catesbeiana) by 5'-GMP

Millimolar concentration of sodium 5'-guanylate (5'-GMP), a 'umami' substance, inhibited salt-induced gustatory neural responses, particularly tonic components, of the bullfrog when the tongue was adapted to a low salt (5 mM NaCl) solution but not when adapted to normal saline that contained 115 mM NaCl. The result suggests that 5'-GMP is a modulator of adaptation process in salt response in the bullfrog taste system.

Middle mesenteric artery: an anomalous origin of a middle colic artery

A case of anomalous mesenteric artery is reported. The artery was incidentally cannulated during angiography of a patient with a left renal tumor. It arose from the abdominal aorta between the superior and inferior mesenteric arteries. The artery then ascended directly upwards from its origin and supplied the transverse colon replacing the middle colic branch of the superior mesenteric artery. The anomaly must be a result of a anomalous concentration of unpaired visceral arteries in the developing embryo. This type of anomaly is very rare and it would be appropriate to name the artery the middle mesenteric artery.

Ultrasonographic follow-up study of small pancreatic cysts of unknown etiology

The aim of the present project was to evaluate the prognosis of small and asymptomatic cysts of the pancreas which were diagnosed as being nonneoplastic by endoscopic ultrasonography. Eighty-two patients with such cysts had been subjected to ultrasonographic examination every 6 months. Results of follow-up for 3 or more years were obtained in 31 patients. The cysts disappeared in 4 patients and enlarged in 1 patient. The others did not show any morphological changes. The enlarged cyst turned out to be a retention cyst after surgical resection. Our endoscopic ultrasonographic criteria were effective for small nonneoplastic cysts of the pancreas, and most of these cysts appeared to be nonprogressive.

Detection of Epstein-Barr virus DNA and EBV-determined nuclear antigen in angioimmunoblastic lymphadenopathy with dysproteinemia type T cell lymphoma

Six cases of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD)-like T cell lymphoma were analyzed by immunohistochemical staining, polymerase chain reaction (PCR) and Southern blot analysis. Five cases out of six showed gene rearrangements of the T cell receptor beta chain, indicating the existence of a clonal T cell proliferation. Epstein-Barr virus (EBV) DNA was detected in all six AILD type cases by PCR amplifying the sequence located in the internal repeat I, and confirmed by Southern blot hybridization, using a BamHI-W fragment as a probe. Detection of the EBV genome occurred more frequently as compared with other types of lymphoid disorders. Furthermore, EBV determined nuclear antigen (EBNA) was detected in UCHL-1 (CD45RO, pan-T cell marker) positive cells by immunostaining. These results suggest that a significant number of AILD type cases are T cell origin lymphomas and EBV infection may be relevant to the biological features of this type of lymphoma.

Granuloma formation in the liver of Balb/c mice intoxicated with carbon tetrachloride

Hepatic granulomas induced by a single or several subcutaneous injections of carbon tetrachloride (CCl4) in Balb/c mice were examined electronmicroscopically and immunocytochemically. Stellate cells (fat-storing cells; lipocytes; Ito cells) were identified by the detection of cytoplasmic desmin, while T-lymphocytes and monocytes/macrophages were identified with monoclonal antibodies Thy 1.2 and MOMA-2, respectively. Following pericentral necrosis induced with CCl4, clear foci containing lymphocytes, monocytes, macrophages and perisinusoidal stellate cells occurred in the surrounding hepatic parenchyma on day 5. These clear foci developed to granulomas with increasing numbers of macrophages and stellate cells. Mitotic and apoptotic figures in randomly distributed macrophages, and direct contacts between macrophages and stellate cells were frequently seen within the granulomas. The stellate cells were characterized by a well-developed granular endoplasmic reticulum and Golgi complex. Collagen fibrils were closely applied to the stellate cells and connective tissue septa extended between neighboring granulomas and/or the pericentral necrotic areas after several injections of CCl4. CCl4-induced hepatic granulomas provide a model for investigating paracrine and/or autocrine modulation within a well-organized microenvironment during progressive hepatic inflammation and fibrosis.

Intravenous injection of adenosine triphosphate for assessing sinus node dysfunction in patients with sick sinus syndrome

The clinical value of rapid intravenous injection of adenosine triphosphate (ATP, Adephos Kowa # L3, CAS 56-65-5) for assessing sinus node function was examined in 5 patients with sick sinus syndrome (SSS) and 6 normal controls. All patients with SSS showed cardiac pauses longer than 3 s on a 24-h Holter ECG monitoring. First, after prophylactic insertion of a temporary pacemaker in the right ventricle, overdrive suppression test was conducted using the standard technique, and sinus node recovery time (SNRT) was observed to evaluate the sinus node function. Then, 10 min later, 10 mg of ATP was rapidly injected intravenously, and body surface and intracavitary ECG were continuously recorded until the basal state was regained. The rapid injection of ATP resulted in a slight inhibition of sinus node automaticity in normal subjects, but marked inhibition was in patients with SSS associated with suppression of AV conduction. The longest post ATP atrial cycle (AA interval in the intracavitary ECG showed a close inverse relationship with SNRT corrected for basal sinus length (CSNRT), according to the following formula: longest AA interval (ms) = 3.32 x CSRT (ms) +254.4 (r = 0.91, p < 0.001). The results suggest that rapid intravenous injection is a useful tool for the diagnosis of SSS.

Most bovine milk fat globule membrane glycoproteins contain asparagine-linked sugar chains with GalNAc beta 1-->4GlcNAc groups

N-Acetylgalactosamine is usually not a constitutive monosaccharide of Asn-linked sugar chains. Our previous study showed that the Asn-linked sugar chains of bovine CD36 prepared from milk fat globule membranes (MFGM) contain this unique monosaccharide as the GalNAc beta 1-->4GlcNAc group [Nakata et al. (1993) Biochemistry 32, 4369-4383]. Western blot analysis of bovine MFGM glycoproteins with Wistaria floribunda agglutinin (WFA), which binds oligosaccharides terminating with either an alpha- or beta-N-acetylgalactosamine residue, showed that WFA binding is observed for most of the protein bands as detected with Coomassie Brilliant Blue staining. However, no WFA binding was observed for protein bands after treatment of MFGM glycoproteins with N-glycanase. Structural analyses of the sugar chains released by hydrazinolysis from the MFGM glycoproteins by sequential exoglycosidase digestion and by methylation analysis revealed that oligosaccharides, which bound to a WFA-agarose column, are bi-, tri-, and tetraantennary complex-type and hybrid-type sugar chains with the GalNAc beta 1-->4GlcNAc group in their outer chain moieties, while oligosaccharides, which passed through the column, were of high-mannose-type, hybrid-type, and complex-type, of which the latter two groups contained the Gal beta 1-->4GlcNAc groups. These results indicated that many bovine MFGM glycoproteins contain Asn-linked sugar chains with the GalNAc beta 1-->4GlcNAc group.

Clinical significance of DNA measurements in small cell lung cancer

BACKGROUND

Little is known about the relationship between DNA histogram data and the clinical course of small cell lung cancer (SCLC).

METHODS

The ability of tumor nuclear DNA histograms as measured by cytofluorometry to predict chemotherapeutic responsiveness and propensity for metastases was assessed in 36 patients with SCLC. Histograms were classified into four types: A, mono-mode and euploid; B, mono-mode but not euploid (A + B being monoclonal patterns); C, poly-mode; and D, no mode (C + D being polyclonal patterns). The grade was classified into low (DNA content, smaller than 8C) and high (greater than 8C) by dispersion degrees about each type.

RESULTS

The relative rate of response to chemotherapy was A (100%) is greater than B (82%) is greater than C (38%) is greater than D (17%) (A and D, P < 0.05; B and D, P < 0.01; A + B and C + D, P < 0.01) and closely related to type. Metastasis rates were significantly different between high (81%) and low (7%) grade (P < 0.01) and closely related to grade (sensitivity, 81%; specificity, 93%). Peripheral SCLC had a significantly lower response rate (20%) than did proximal SCLC (65%) (P < 0.01). In DNA histograms, the proportion of C + D (more heterogeneous than A+B) was significantly higher (80%) in peripheral SCLC (P < 0.01).

CONCLUSIONS

Nuclear DNA measurements may be potentially useful for predicting distant metastases and response to chemotherapy. The heterogeneity and possibility of resistance to chemotherapy of peripheral SCLC may tend to be higher than those of proximal SCLC.

[Serum levels of soluble ICAM-1 in asthmatic patients]

Serum soluble intercellular adhesion molecule-1 (sICAM-1) levels were measured in 54 asthmatic patients and 32 healthy subjects by sandwich enzyme-linked immunosorbent assay. Serum sICAM-1 levels in the asthmatic patients not undergoing steroid therapy were significantly higher than those in the healthy subjects and those in the asthmatic patients undergoing steroid therapy (p < 0.01 and p < 0.001, respectively). Serum sICAM-1 levels in the asthmatic patients during attack were not significantly different from those in the patients in remission. We studied changes in serum ICAM-1 levels in 13 asthmatic patients in remission and during attack and found that serum ICAM-1 levels during attack were significantly higher than those in remission (p < 0.05). The origin of serum soluble ICAM-1 in asthmatic patients still remains unclear, but the up-regulated expression of ICAM-1 on the endothelium of the respiratory tract may contribute to the recruitment of eosinophils, neutrophils and lymphocytes to the airway in bronchial asthma.

Structural study of the sugar chains of human leukocyte common antigen CD45

The leukocyte cell surface glycoprotein CD45 is a protein tyrosine phosphatase and is involved in signal transduction mediated by the T cell antigen receptor. The asparagine-linked sugar chains were released as oligosaccharides from purified CD45 by hydrazinolysis. Approximately 6 mol of sugar chains was released from 1 mol of CD45. These sugar chains were converted to radioactive oligosaccharides by reduction with NaB3H4 and separated into neutral and acidic fractions by paper electrophoresis. All of the acidic oligosaccharides were converted to neutral ones by digestion with sialidase, indicating that they are sialyl derivatives. Binding of the sialylated oligosaccharides to an SNA-agarose column as well as methylation analysis revealed that the oligosaccharides have only alpha-2,6-linked sialic acid residues. The neutral and sialidase-treated acidic oligosaccharides were fractionated by serial lectin column chromatography followed by Bio-Gel P-4 column chromatography. Structural studies of each oligosaccharide by sequential exo- and endoglycosidase digestion and by methylation analysis revealed that CD45 contains mainly bi-, tri-, and tetraantennary complex-type sugar chains. About 46% of the tetraantennary complex-type sugar chains had the poly(N-acetyllactosamine) groups and 18% of the 2,4-branched triantennary complex-type sugar chains had the fucosyl N-acetyllactosamine group. A portion of the bi- and 2,4-branched triantennary complex-type sugar chains were bisected. In addition to these sugar chains, a small amount of high mannose-type and hybrid-type sugar chains were detected.

Determination of human immunoglobulin A and secretory immunoglobulin A in bronchoalveolar lavage fluids by solid phase enzyme immunoassay

Solid phase enzyme immunoassay methods for the determination of secretory immunoglobulin A (IgA) and the total amount of serum and secretory IgA in bronchoalveolar lavage fluids (BALF) were developed. The solid phase was prepared by immobilizing rabbit anti-human IgA. Horseradish peroxidase-conjugated goat anti-secretory component or horseradish peroxidase-conjugated goat anti-human IgA (Fc) were used as labeled antibodies. The minimum detectable amounts of secretory IgA and total IgA were 2 and 0.5 ng/well, respectively. These assay methods were successfully applied to the determination of secretory and total IgA levels in BALF samples obtained from 44 subjects including healthy non-smokers, smokers and patients with the following lung diseases: idiopathic pulmonary fibrosis, sarcoidosis and hypersensitivity pneumonitis. The secretory and total IgA levels in BALF collected from healthy non-smokers (n = 9) were 10.5 +/- 3.6 and 25.4 +/- 15.5 (S.D.) micrograms/ml, respectively. In healthy smokers, the secretory IgA concentration was significantly decreased and in idiopathic pulmonary fibrosis, the total IgA was increased. These results indicate that the quantitation of secretory and total IgA may be useful for the investigation of lung disease.

[Bladder cancer associated with growth hormone-producing pituitary tumor: a case report]

A case of bladder cancer associated with a growth hormone (GH) producing pituitary tumor is reported. A 67-year-old male underwent hypophysectomy for a GH producing pituitary tumor, 31 months earlier. Although the serum GH decreased postoperatively, recurrence of pituitary tumor with increased serum GH was found and followed by a neurosurgeon. He was referred to our department for asymptomatic gross hematuria. Cystoscopy revealed a papillary pedunculated tumor. Under the diagnosis of superficial bladder tumor, transurethral resection (TUR) was performed. Pathological examination showed transitional cell carcinoma. As the bladder cancer recurred with a high level of serum GH seven months later, TUR was repeated. We reviewed and discussed the relationship between GH or GH producing tumor and bladder cancer.