Development of a sandwich enzyme-linked immunosorbent assay for the determination of human heart type fatty acid-binding protein in plasma and urine by using two different monoclonal antibodies specific for human heart fatty acid-binding protein

We have developed a sandwich enzyme-linked immunosorbent assay (ELISA) for the determination of human heart type fatty acid-binding protein (H-FABP) in human plasma and urine using the combination of two distinct monoclonal antibodies (MAbs) directed against human H-FABP purified from human heart muscle. The total assay time of the ELISA is practically much shorter than that of the competitive enzyme immunoassay (EIA) we previously reported. The immunoreactive mass of human H-FABP was specifically measured using a horseradish peroxidase (HRPO)-labeled anti-human H-FABP MAb as an enzyme-linked MAb, and anti-human H-FABP MAb immobilized on the polystyrene microtiter plate as a solid-phase MAb, and purified human H-FABP as standard materials. The assay range of the ELISA was 0-250 ng/ml of plasma and urine. The ELISA yielded a coefficient of variation of less than 10% in inter- and intra-assays, and the good linearity was obtained in dilution test using clinical samples. Anticoagulants, except sodium fluoride and a high concentration of hemoglobin and bilirubin, did not interfere with the assay of plasma samples. A high concentration of hemoglobin, bilirubin and immunoglobulin, and contamination with seminal plasma did not interfere with the assay of urine samples. The average recovery of purified human H-FABP added to human plasma and urine samples was 98.5% and 97.0%, respectively. Myoglobin and myosin did not crossreact in the ELISA. The minimum detection limit of the ELISA was 1.25 ng/ml. The immunoreactive masses of human H-FABP in plasma and urine samples, obtained from one hundred normal healthy subjects were quantified by the sandwich ELISA. The normal mean (+/- SD) level of human H-FABP mass in plasma was 3.65 +/- 1.81 ng/ml, and that in urine was 3.20 +/- 2.70 ng/ml. In conclusion, this sandwich ELISA is a useful tool for the sensitive and precise determination of human H-FABP in human plasma and urine, and it may be used specifically for clinical investigation and diagnosis of myocardial injury.

Carcinoembryonic antigen levels in the peritoneal cavity: useful guide to peritoneal recurrence and prognosis for gastric cancer

At the time of laparotomy, peritoneal washings were collected from 155 gastric cancer patients and the levels of carcinoembryonic antigen (CEA) determined. The CEA levels in peritoneal washings were statistically independent of those in sera and could more reliably predict the presence of peritoneal metastasis than a cytologic study. Peritoneal recurrence was seen in 14 of 118 patients after curative operation. Of the 14 patients, 10 (71%) had elevated levels of CEA (100 ng/g protein) at surgery. Of these 10 cases, 2 of the tumors were classified as stage IB and 4 had no serosal invasion. Only one patient with peritoneal metastasis and a low CEA level was free from relapse more than 1 year after operation. Kaplan-Meier's analysis showed that a high CEA level in peritoneal washings was a predictor of poor prognosis in patients who underwent either curative or noncurative resection. A proportional hazards regression analysis showed that a high CEA level in peritoneal washings was statistically significant in terms of predicting a shorter interval until peritoneal recurrence (p = 0.0002) and for survival (p = 0.0001). The CEA level in peritoneal washings is therefore of value as an indicator of peritoneal recurrence and prognosis.

Coexistence of pemphigus and bullous pemphigoid

Widespread tense blisters developed on a 60-year-old Japanese man who had been diagnosed with pemphigus 11 years earlier, because of a history of pruritic erythema and erosions on his face, chest, and back, mild supra-basal layer blister formation found in a biopsy specimen, and a positive direct immunofluorescence test showing IgG deposition in the intercellular space. The histological findings showed subepidermal blister, and the immunoblot study detected 180kD bullous pemphigoid antigen. Direct immunofluorescence test revealed intercellular staining for IgG, and indirect immunofluorescence tests repeatedly demonstrated the presence of circulating antibodies to the intercellular space. From these observations, this case suggests the coexistence of pemphigus and bullous pemphigoid.

An experimental study of conductive heating using a concentric double-electrode applicator

With hyperthermia for treatment of superficial tumors in mind, a prototype applicator with two electrodes arranged concentrically on a disk was designed for efficient local heating, and a basic heating test was carried out. Frequencies as low as 200 kHz were used in order to simplify the configuration of the power device. The applicator consists of two electrodes, a circular inner electrode and another looped outer electrode, arranged concentrically. Water was passed through the applicator as a cooling mechanism; it was placed in direct contact with the target tissue to be heated and then charged with electricity. In the heating test using a phantom, oval hot spots were noted below the inner electrode. Using cooling water at 3 degrees C and 8.2 W, an isothermal line of 45 degrees C was located at a 5-mm radius circle around the central axis with 9 mm depth. A similar temperature distribution map was obtained in heating tests on the thigh muscle of a mongrel adult dog. The temperature distribution maps obtained from these tests corresponded closely with the results of theoretical analysis carried out according to the finite-element method. Since a comparatively low frequency was employed for this applicator the power device was simplified, which made adequate heating possible with low electric power. The temperature distribution map indicated that efficient local heating of superficial tumors could be achieved.

Natural co-occurrence of Fusarium toxins and aflatoxin B1 in corn for feed in north Vietnam

Natural occurrence of Fusarium mycotoxins (trichothecenes and fumonisins) and aflatoxin B1 (AFB1) were surveyed in 32 corn samples, harvested in 1993 and randomly sampled in 1994 in several districts of Hanoi, Vietnam. Corn samples were first milled into fine powder, extracted with methanol-water (3:1) and the crude extracts obtained from the same samples were used for the simultaneous analysis of the trichothecenes such as nivalenol (NIV), deoxynivalenol (DON), and T-2 toxin (T-2) by gas chromatography/mass spectrometry (GC/NS); fumonisins B1 (FB1), B2 (FB2), and B3 (FB3) by high-performance liquid chromatography (HPLC) with a flourescence detector; and AFB1 by and ELISA kit based on a monoclonal antibody. The data revealed that 14, 8, 4, 3, and 2 out of 15 corn kernel samples were positive for AFB1, FB1, FB2, FB3, and NIV with the average levels being 28, 1, 101, 276, 232, and 858 ppb, respectively, and neither DON nor T-2 were detected. As for the other 17 samples of corn powder, 13, 15, 12, 10, 4 and 2 were positive for AFB1, FB1, FB2, FB3, DON, and NIV with the average being 30, 780, 289, 176, 3, 170, and 1,365 ppb, respectively, and T-2 was not detected. Although their positive rates and levels fell in the ranges reported elsewhere, it was found for the first time that the Fusarium toxins (NIV, DON, and fumonisins) and an Aspergillus toxin (AFB1) were naturally co-contaminated in selected samples of corn produced in north Vietnam.

Hypoxia alters the energy metabolism and aggregation of washed human platelets

Washed human platelets were incubated under hypoxic and normoxic conditions to investigate the influence of oxygen deprivation on energy metabolism and aggregation. The maximum aggregation rate, oxygen consumption, lactate production, and adenine nucleotide content were measured. Hypoxic incubation decreased the oxygen burst and maximum aggregation induced by thrombin, and accelerated anaerobic glycolysis. ATP and ADP levels were preserved, but the hypoxanthine level increased in the incubation medium and the platelet AMP level and adenylate energy charge decreased compared with normoxic incubation. Thus, anaerobic glycolysis failed to compensate for impaired oxidative phosphorylation during hypoxic incubation, suggesting that oxidative energy is essential for full platelet function.

Biochemo-mechanical function of urease-loaded gels

A gel system is developed that undergoes a reversible volume phase transition in response to a small amount of urea. An N-isopropylacrylamide gel in which urease is immobilized by entrapping changes its equilibrium volume discontinuously when urea molecules are hydrolyzed by urease causing a change in pH that alters the osmotic balance of the gel triggering the phase transition. The system demonstrates a method of mechano-biochemical transformation where molecular recognition and biochemical reaction are achieved by an enzyme and the macroscopic amplification of the reaction is carried out by a gel capable of a volume phase transition. The work presented here is dedicated to Professor Allan S. Hoffman to honor his 60th birthday and his pioneering contribution to the science and technology of polymer gels, both as a scientist and as an educator.

Reproductive and neurobehavioral effects of cochineal administered to mice in the diet

Mice were given the natural color additive cochineal in their food to provide dietary levels of 0 (control), 0.5, 1.0, and 2.0%, from five weeks of age in the F0 generation to nine weeks of age in the F1 generation, and selected reproductive and behavioral parameters were measured. Cochineal had few adverse effects on litter size, weight, or sex ratio. The average body weight of offspring during the lactation period was significantly decreased in higher-dosed groups of each sex. With regard to the neurobehavioral parameters, surface righting at postnatal day (PND) four was significantly affected in male offspring during the lactation period. Several parameters of movement activity in females were significantly different from controls at eight weeks of age in the F0 generation and at three weeks of age in the F1 generation. Multiple water T-maze performance of females was affected in treatment groups in the second trial at seven weeks of age in the F1 generation. The dose levels of cochineal in this study produced some adverse effects in reproductive and neurobehavioral parameters in mice.

Clinical significance of multidrug resistance and P-glycoprotein expression in patients with gastric carcinoma

Twenty-four fresh tumors of gastric carcinoma were assessed by flow cytometric detection of P-glycoprotein (P-gp) using monoclonal antibody C219. Eight patients were P-gp positive. Differentiated gastric carcinomas contained significantly higher concentrations of P-gp positive. Incidence of P-gp positive was high in advanced stage. In 16 cases estimated chemosensitivity was test assessed by thymidine incorporation assay (TIA). Seven of nine multidrug-resistant cases according to TIA were P-gp positive and all of seven nonmultidrug resistant cases were P-gp negative. Expression of P-gp and multidrug resistance were closely correlated (P < 0.01). Also, in 89 patients with operable gastric carcinoma, the relation between in vitro chemosensitivity test (TIA) and their clinicopathologic features as well as their survival lengths were studied. Thirty-one of 89 specimens from gastric carcinoma patients were multidrug resistant according to TIA. Patients in the multidrug-resistant group had a significantly poorer cumulative survival rate than those who were not multidrug resistant (P < .05). The multivariate analysis showed that multidrug resistance is a useful indicator of prognosis (P < 0.1). We suggest that multidrug-resistant cases or P-gp-positive cases of gastric carcinoma are highly malignant, and these determinations are clinically useful.

Inhibition by wortmannin of M-current in bullfrog sympathetic neurones

1. The actions of wortmannin, an inhibitor of myosin light chain kinase (MLCK), on M-type potassium current of dissociated bullfrog sympathetic neurones have been examined. 2. The amplitude of M-current was measured by whole cell recordings from cells pretreated with wortmannin (0.01-10 microM) or the wortmannin vehicle, dimethylsulphoxide (0.0001-0.1 vol%), for 30 min. Internal (recording pipette) solutions having three different pCa values (6, 7 and 8) were used for the measurements. 3. Irrespective of the pCa, M-current was not detectable when the cells were pretreated with 10 microM wortmannin. Wortmannin, 3 microM, produced 85-95% inhibition of the M-current. Pretreatment with 10-30 nM wortmannin was without effect on M-current. 4. The M-current inhibition by wortmannin at concentrations of 0.1-1 microM depended on the pCa of the internal solution. Inhibition occurred only when the calcium-rich (pCa = 6) internal solution was used. 5. Pre-treatment of the cells with wortmannin (10 microM) did not affect rapidly-inactivating A-type or delayed rectifier-type potassium currents not did it alter inwardly rectifying sodium-potassium current (IH). 6. These observations show that M-current inhibition by wortmannin has two pharmacological profiles. One is calcium-dependent and occurs at lower concentrations (0.1-1 microM), and is attributed to inhibition of MLCK by wortmannin. At higher concentrations (3-10 microM), wortmannin has an additional, calcium-independent action, inhibiting the M-current by an unknown mechanism.

Fatal reducing body myopathy. Ultrastructural and immunohistochemical observations

Two female infants who developed normally during infancy began to have progressive muscle hypotonia and weakness from 2 years 10 months and 2 years 3 months of ages, respectively. Both patients had rapidly progressive muscle weakness with death from respiratory failure at 4 years 11 months and 3 years 9 months, respectively. In addition to mild inflammation in their muscle biopsies, the most striking finding was the presence of numerous reducing bodies (RB) in almost all degenerating fibers. By electron microscopy, these bodies consisted of fine granular material, usually located around the degenerating nucleus. These bodies showed no immunohistochemical reaction to antibodies against structural, cytoskeletal and membrane proteins and a histone-specific antibody against nuclei and chromosomes. They were occasionally positively stained with a ubiquitin antibody. Although the origin of these bodies remains unknown, they appeared to be related to active myofibrillar degeneration, probably resulting from primary nuclear degeneration.

Long-term effects of growth hormone treatment on height in Turner syndrome: results of a 6-year multicentre study in Japan. Committee for the Treatment of Turner Syndrome

Patients with Turner syndrome have many somatic characteristics, including short stature. We report the results of a 6-year multicentre clinical trial of recombinant human growth hormone (GH) therapy in 63 patients with Turner syndrome. Twenty-six patients received GH at a dose of 0.5 IU/kg/week, while 37 received GH, 1.0 IU/kg/week, by daily subcutaneous injection. At the start of GH treatment, there was no significant difference between the two groups in chronological age, bone age, height or growth rate. Both treatment groups showed a significant growth increase during treatment. The current mean height of the 12 patients over the age of 16 treated with GH, 0.5 IU/kg/week, is 145.1 +/- 4.7 cm, and in the 16 patients treated with GH, 1.0 IU/kg/week, is 144.0 +/- 2.2 cm. In conclusion, treatment with GH does increase final height in patients with Turner syndrome. However, further studies are needed to determine the optimum age for the initiation of GH therapy, the best dose regimen and the optimal time and manner of sex and anabolic steroid use.

Decreased mitogenic and osteogenic responsiveness of calvarial osteoblasts isolated from aged rats to basic fibroblast growth factor

Osteoporosis seen in aged individuals is represented by the reduced bone mass most likely resulting from decreased bone formation by osteoblasts. To examine whether aging causes a decrease in osteoblast activity, calvarial osteoblasts were isolated from aged rats (AOB) and studied for the capacity of the cells to form mineralized bone-like nodules in comparison with that of fetal calvarial osteoblasts (FOB). There were no significant differences in basal mineralized bone-like nodule formation determined by quantifying the size of the nodules which were formed in the cultures of AOB and FOB. However, the responsiveness of AOB to growth factors was profoundly reduced. AOB showed only marginal increase in mineralized bone-like nodule formation and growth in response to basic fibroblast growth factor (bFGF). On the other hand, bFGF markedly promoted mineralized bone-like nodule formation and proliferation in FOB. These results suggest that decreased responsiveness to local osteotropic growth factors such as bFGF might account for the reduced bone formation by aged osteoblasts, which in turn leads to the loss of bone mass characteristic for senile osteoporosis.

Treatment of symptomatic AOVMs with radiosurgery

In spite of great success in the treatment cerebral AVMs with stereotactic radiosurgery, the role of this treatment modality in angiographically occult vascular malformations (AOVMs) is not recognized. Since the installation of the Gamma-knife, we have treated 20 cases of AOVMs by radiosurgery. There were 13 males and 7 females, the age ranged from 3 to 58 years with an average age of 34.0 years. Their clinical presentations at the onset were haemorrhage in 11, convulsive seizure in 7 and progressive neurological deficits in 2. Two cases had multiple lesions. Among 20 symptomatic lesions, 14 were located supratentorially, 4 in the brain stem and 2 in the cerebellar hemispheres. Following localization with MRI and dose planning, the lesions were treated by radiosurgery and the doses ranged from 15 to 20 Gy at the margins. Follow-up studies indicate a significant control of rebleeding as well as of the convulsive seizure. Imaging studies demonstrated the shrinkage of the lesion in 3 and reduced enhancement with Gadolinium-DTPA in some others. Adverse effects, chiefly related to radiation-induced oedema, occurred in 5. But they were generally mild and well controlled by medication. Thus the preliminary results indicate a certain usefulness of radiosurgery in the treatment of symptomatic AOVMs.

Marked hypocholesterolemia in a case with adrenal adenoma--enhanced catabolism of low density lipoprotein (LDL) via the LDL receptors of tumor cells

A 16-yr-old girl was hospitalized because of amenorrhea and virilism, and was diagnosed with an adrenal tumor on the right side. Her serum androgen levels were markedly elevated, and severe hypocholesterolemia (total cholesterol, 0.59 mmol/L) was observed. After resection of the tumor, her serum cholesterol level dramatically rose to normal, suggesting a role of this tumor in her marked hypocholesterolemia. To investigate the mechanism of hypocholesterolemia in this case, we examined the effects of dehydroepiandrosterone and dehydroepiandrosterone sulfate on the low density lipoprotein (LDL) receptor activity of fibroblasts. These hormones did not have any effect on LDL receptor activity. Northern blot analysis demonstrated that the LDL receptor messenger ribonucleic acid level of this tumor tissue was increased about 8-fold compared with that of normal adrenal cortex. The LDL receptor activity of the cultured cells established from this tumor was 2-fold higher than that of Hep G2 cells. Furthermore, the LDL receptor activity could not be down-regulated by an excessive dose of 25-hydroxycholesterol. These results suggest that increased LDL receptor activity and unrestricted uptake of LDL by the adrenal tumor may have caused the marked hypocholesterolemia in this patient.

[Effect of intravaginal administration of cisplatin (CDDP) suppositories to uterine cervical cancer--blood and tissue concentrations and the therapeutic effects]

Four patients with cervical cancer (squamous cell carcinoma: two cases of stage Ib, one of stage IIa, adenocarcinoma: one of stage Ib), were treated preoperatively by intravaginal administration of CDDP (20 mg) suppositories with pessary 7 times every other day. The uptake, distribution and antitumor effect of CDDP were investigated. Results were as follows. 1) Serum total platinum (Pt) concentration varied between individual patients. Cmax profile (0.17-0.57 micrograms/ml) of Pt was observed at 12 hours after the total dose of 140 mg administration in all patients. 2) The tissue Pt concentration showed high values in the cervix (average 55.4 micrograms/g), followed by the vagina (13.13), endometrium (3.17), uterine wall (0.64), ovary (0.57), lymph node group: parametrial (1.14), obturator (0.34), inguinal (0.28), external iliac (0.51), internal iliac (0.42) and common iliac (0.54). Para-aortic node value was too low to detect. 3) Colposcopic findings were disappearance of bleeding and reduction of tumor outgrowth. Microscopic findings were degeneration and necrosis of cancer nest from the surface to about 2 mm depth of the cervix. In conclusion, it may be necessary to improve CDDP penetration from the tumor surface for effective local chemotherapy.

Radiosurgery of the metastatic brain tumours with gamma-knife

The results of treatment of metastatic brain tumours by radiosurgery are reported. Twenty cases including lung (11), colon (5), breast (1), ovary (1), liver cancer (1) and malignant melanoma (1) were involved. Seven cases had single and 13 had multiple brain metastases. In total 55 lesions were evaluated after radiosurgery with the gamma-knife. Following localization with MR1 and dose planning, radiosurgery with marginal doses between 12 to 25 Gy (mean 18.9 Gy) was delivered. In the follow-up studies with MRI after 3 months, 29 out of 55 (52.7%) lesions showed significant shrinkage. In contrast 25 showed either no change (17) or central necrosis (8), and one was enlarged. Thus the tumour control at 3 months was 98.2%, and subsequently 96.6% at 6 months. Clinical symptoms and signs were improved in most cases, but were aggravated in four cases either by tumour recurrence or by radiation-induced oedema. Although the tumours treated with radiosurgery were well controlled, tumour recurrence in another sites occurred in 4 case, of which 3 were treated by 2nd radiosurgery with 2 successful tumour control. Complications were generally mild and transient. In summary stereotactic radiosurgery is valuable new treatment not only for solitary metastases, but also for multiple or recurrent ones.

[Two patients with far advanced gastric cancer responding to combination chemotherapy with 5-FU and CDDP]

Combination chemotherapy with 5-FU and CDDP was given to two patients with far advanced gastric cancer. One patient was associated with metastases of lung, liver, pancreas and Virchow and periaortic lymph nodes, and the other was associated with metastases of periaortic lymph nodes and malignant ascitis. The regimen consisted of 5-FU 1,000 mg/m2 (day 1-5, continuous infusion) and CDDP 100 mg/m2 (day 3, 1 hr drip infusion). The interval was from the 6th to the 21st day. The response to chemotherapy showed shrinking of primary gastric lesions and metastases of liver, pancreas and periaortic lymph nodes, and disappearance of Virchow lymph nodes and malignant ascitis. Adverse reactions were thrombocytopenia (Grade 4), leukocytopenia (Grade 3), stomatitis (Grade 1, 3), vomiting (Grade 1, 2) and peripheral neuropathy (Grade 3). This therapy is thought to be effective against far advanced gastric cancer.

[A case of successful surgical treatment of recrudescent stanford type A aortic dissection after early thrombogenic closure and reduction of dissecting lumen]

A 51-year-old woman was admitted with acute chest and back pain. A CT scan (2 hours after onset) was demonstrated acute type A aortic dissection. The dissecting lumen was already closed with thrombus. A DSA was performed. It showed no intimal tear and a normal aortic figure. Repeat CT (5 hours after onset) was performed. It showed reduction of dissecting lumen compared with previous CT. Although medical treatment was continued, she recomplained intermittent slight chest and back pain. On the sixteenth day after her admission, repeat CT revealed recrudescent dissection and opened dissecting lumen of ascending aorta. Graft replacement was successfully performed using circulatory arrest and retrograde cerebral perfusion. She was discharged in good health.

Effect of fish oil on the development of AOM-induced glutathione S-transferase placental form positive hepatocellular foci in male F344 rats

Omega-3 fatty acids, which are contained in fish oils and certain vegetable oils in contrast to corn oil or safflower oil rich in omega-6 fatty acids (linoteic acid), have been reported to reduce the carcinogenesis in several organs. In this study, the modifying effect of menhaden fish oil was investigated on the occurrence of azoxymethane (AOM)-induced glutathione S-transferase placental form (GST-P) positive hepatocellular foci, recognized preneoplastic lesions in the liver, in male F344 rats. Starting at five weeks of age, groups of animals were fed ad libitum a semipurified diet containing 5% corn oil (low fat). At seven weeks of age, all animals except the vehicle-treated groups were injected subcutaneously with AOM (15 mg/kg body wt, 1x/wk for 2 wks). Four days after the second injection, groups of animals were fed the diets containing 4% menhaden oil + 1% corn oil (low fish oil diet), 22.5% menhaden oil + 1% corn oil (high fish oil diet), and 5% corn oil. Thirty-four weeks after AOM injections, all animals were necropsied. Livers were sectioned and performed immunohistochemical staining of GST-P for quantitative analysis of enzyme altered foci of the liver. The results demonstrate that the density and the unit area of AOM-induced enzyme altered foci in the liver were significantly lower in the high fish oil group (0.60 +/- 0.08/cm2, 3.0 +/- 0.4 x 10(-4)) than in the 5% corn oil group (2.71 +/- 0.33/cm2, 16.6 +/- 2.6 x 10(-4)) and the low fish oil group (1.66 +/- 0.33/cm2, 11.1 +/- 1.9 x 10(-4)).(ABSTRACT TRUNCATED AT 250 WORDS)