Characterization of insulin-like growth factor II (IGF-II) and IGF binding proteins in patients with non-islet-cell tumor hypoglycemia

Insulin-like growth factor II (IGF-II) in serum and tumor extracts from five patients with non-islet-cell tumor hypoglycemia (NICTH) has been characterized. These tumors contained large quantities of IGF-II (2.4-14.2 micrograms/g tissues). The serum IGF-II levels in four of five patients were a little high and the serum IGF-I levels in five patients were low. The serum IGF-II/IGF-I ratios in these patients ranged from 24.1 to 64.2, and the values were significantly greater than those in normal subjects (1.7-7.1). When the sera were gel-filtered on a Sephacryl S-200 column under neutral conditions, the proportion of the free form of IGF-II was not increased. However, in four of five patients, an abnormal IGF-II-IGF binding protein complex was found. When serum IGF binding proteins (IGFBPs) were analyzed by Western ligand blotting, serum IGFBP-2 increased in these patients. When the tumor extracts and sera were gel-filtered on a Biogel P-60 column under acidic conditions, the majority of IGF-II in these sera was a big form of IGF-II. As compared to authentic IGF-II, insulin receptor reactivities and IGF-II receptor reactivities of tumor extracted IGF-II increased in two of three patients. These data indicate that in patients with NICTH, heterogenous IGF-II is produced in respect of size and bioactivities, and that the characteristics of IGF binding protein are altered. Thus, to find IGF-II producing tumors among extrapancreatic tumors associated with hypoglycemia, the quality of IGF-II as well as the quantity should be studied.

Responses of insulin-like growth factor binding protein-1 (IGFBP-1) and the IGFBP-3 complex to administration of insulin-like growth factor-I

The importance of insulin-like growth factor binding proteins (IGFBPs) in modulating the bioactivity of administered IGFs is poorly understood. This study examines responses of IGFBP-1 and the IGFBP-3 complex to recombinant human IGF-I. Eight fasted subjects received a single dose of 0.1-0.125 mg/kg IGF-I sc. This caused a 10-fold rise in IGFBP-1 over 6 h, falling rapidly after food intake. Peak (6-h) IGFBP-1 values were highly correlated with peak post-prandial (8-h) glucose values (r = 0.941). IGFBP-3 showed little response, decreasing slightly over the 48-h period following IGF-I. Adaptive changes in IGFBPs were studied in fed adults injected daily for 7 days with IGF-I, 0.1 mg/kg sc. Following the first injection, IGFBP-1 had a markedly blunted response compared to that in fasted subjects. However, after the seventh IGF-I injection, a 3.5-fold greater IGFBP-1 response to the same IGF-I dose was seen. Concomitantly with the increased IGFBP-1 responsiveness, mean immunoreactive IGFBP-3 and acid-labile subunit levels decreased significantly (p < 0.005), whereas IGFBP-2 detected by immunoblotting increased. Thus IGF-I administration causes changes in IGFBPs which may be important in regulating IGF-I bioavailability.

[Study of synovial lesions by MRI using gadolinium-DTPA (Gd-DTPA) in patient with early phase of rheumatoid arthritis]

To evaluate the usefulness of magnetic resonance imaging (MRI) enhanced with gadolinium-DTPA (Gd-DTPA) for the detection of the inflamed synovium and for the evaluation of the response to therapy in rheumatoid arthritis, we studied 49 patients with rheumatoid arthritis (RA) according to the 1987 revised criteria of American Rheumatism Association (ARA), 6 patients of systemic lupus erythematosus (SLE) complicated by arthritis, 3 patients of osteoarthritis (OA), 2 patients of Sjögren syndrome, 2 patients of progressive systemic sclerosis and 10 healthy volunteers as an age matched control. The 49 patients with RA were divided into three groups: (1) early phase of RA, (2) non progressing RA and (3) slowly progressing RA, and the stage classification of plain X-ray film and enhancement pattern of MR images were classified into three groups. Synovial enhancement showed a linear, band-like or diffuse pattern. Almost all cases in early phase of RA group and non progressing RA group showed a linear pattern, a band-like pattern or even no enhancement, while slowly progressing group of stage II or higher showed the diffuse pattern of enhancement in all except 2 cases. Moreover, the linear pattern, the band-like pattern or even no contrast enhancement were seen in all except 1 stage I patient, whereas 26 out of 29 patients with stage II or higher change showed diffuse contrast enhancement. Furthermore, a comparison of MR images before and after administration of DMARDs in 10 patients showed that the improvement of clinical symptoms correlated fairly well with reduction of contrast enhancement.(ABSTRACT TRUNCATED AT 250 WORDS)

Growth hormone treatment in Turner syndrome: results of a multicentre study in Japan. The Committee for the Treatment of Turner Syndrome

Patients with Turner syndrome were treated with recombinant human growth hormone (GH) for 3 years. Sixty-eight patients received GH, 0.5 IU/kg/week, while 93 received GH, 1.0 IU/kg/week, by daily subcutaneous injection. Both treatment groups showed a statistically significant increase in growth during treatment. However, the higher dose increased height velocity to a significantly greater extent during the first and second year of treatment. The projected adult height was exceeded by 52 of 71 patients over the age of 14 years. Plasma insulin-like growth factor 1 levels were elevated and no remarkable advances in bone age were observed. There were no other significant changes in physical or laboratory parameters. No glucose intolerance was observed. These results indicate that GH treatment is useful for accelerating growth velocity in patients with Turner syndrome. However, further study will be required to find the most appropriate dose.

Hereditary hydronephrosis in C57L/MsNrs mice

Inbred C57L/MsNrs mice (66 males and 72 females) maintained at the National Institute of Health, Japan, were examined grossly for hydronephrosis. Unlike the hydronephrotic strains of mice reported so far, C57L mice showed no sex-related difference in the incidence (62% in males and 75% in females; P > 0.05) and severity of hydronephrosis. The right kidney was more severely affected than the left kidney in both sexes. Age appeared to have no influence on the incidence.

Differential distribution of a carbohydrate epitope (Y) on human salivary gland cell membranes

Monoclonal antibody 303 (mAb 303) reacts with the high molecular weight agglutinin present in human saliva. Its reactivity is periodate sensitive, and it has been shown to recognize the Y epitope. Immunogold labeling of thin sections of human parotid and submandibular glands with mAb 303 showed reactivity in secretory granules of serous acinar, intercalated and striated duct cells (Takano et al., 1988). We now report that the apical and basolateral membranes of salivary acinar and duct cells are labeled by mAb 303, but not myoepithelial cells, endothelial cells and other mesenchymal cells. Gold particles were confined to acinar and duct cell membranes even when myoepithelial cells were directly adjacent, suggesting that the epitope resides on a membrane glycoprotein and that the label does not represent secreted agglutinin bound to the cell surface. Although myoepithelial cells are thought to differentiate from epithelial stem cells, the present results indicate that substantial compositional differences exist between the membranes of myoepithelial cells and other salivary parenchymal cells. Earlier studies also showed that mAb 303 labels normal pancreatic acinar cells and certain salivary (pleomorphic adenoma) and mammary (lactating adenoma) tumors (Bogert et al., 1988). This antibody thus may be a useful reagent for characterizing the origin of exocrine gland-derived cell cultures and neoplastic cells. Further, localization studies may provide insight into the role of the Lewis blood group-related epitope in secretory cells.

Growth hormone reverses impaired wound healing in protein-malnourished rats treated with corticosteroids

Corticosteroid (CS) administration amplifies the inhibitory effect of protein malnutrition (PM) on wound healing. Abdominal surgery in protein malnourished patients receiving corticosteroids (eg, advanced malignancy, transplant recipients) may be complicated by wound dehiscence or anastomotic breakdown. Although preoperative parenteral nutrition can reduce the incidence of these complications, this is not possible in patients requiring urgent surgical intervention. In a previous report we demonstrated that postoperative growth hormone (GH) administration could restore normal wound healing in PM rats. This study evaluates the effect of GH on wound healing in PM rats treated with CS. Forty-eight female Sprague-Dawley rats weighing 180 to 210 g were divided into four groups: (1) normally nourished; (2) PM only; (3) PM + CS; and (4) PM + CS + GH. PM rats (groups 2 to 4) received 5.5% protein chow every other day for 8 weeks. Control rats (group 1) received 23.4% protein chow for the same duration. Group 3 and 4 rats received prednisolone (2 mg/kg, intramuscularly) during the last 3 weeks of PM. All animals underwent precise 5-cm midline celiotomies. Postoperatively, rats in all groups were given 23.4% protein chow. Group 3 and 4 rats continued to receive CS postoperatively. Group 4 rats were given GH (0.5 mg/d, intraperitoneally) postoperatively for 5 days. Wound testing was performed on the 6th postoperative day after removal of the sutures. A balloon inserted into the peritoneal cavity through the vagina was gradually inflated. The pressure at which the wound disrupted was recorded as the wound bursting strength.(ABSTRACT TRUNCATED AT 250 WORDS)

[Kainic acid-induced generalized seizures in cats--microinjection into caudate nucleus]

Electroencephalographic and behavioral changes were observed after 2 micrograms of kainic acid (KA) injection through a chronically implanted cannula into unilateral caudate nucleus (CN) of freely moving and non-anesthetized cats. The control group showed no changes on EEG or behavior during the observation period. In KA group, from 2 to 5 minutes after KA injection, the cats showed contralateral circling. On EEG, focal spikes were elicited at the injected site of the right CN. From 15 to 25 minutes after the injection, secondarily generalized seizures were observed on EEG repeatedly. However, the behavioral change was not remarkable and only the behavioral arrest was observed during the electrographic generalized seizure. From 6 to 8 hours after injection, they showed clonic seizure of the contralateral hindlimb followed by generalized tonic-clonic convulsion. These seizures were frequent during 6 to 16 hours after injection. However, these seizures subsided within 48 hours after the injection and the cats became normal afterward. Histopathological examination revealed focal pyknosis and gliosis only at the injection site of caudate nucleus. The results suggested that an epileptogenic focus of the caudate nucleus demonstrated a rapid evolution from the focal seizure status to the secondarily generalized seizure status. This fact explains that the caudate nucleus may be a possible key structure as a relay nucleus for the secondary generalization of a focal seizure.

The majority of the marker chromosomes in Japanese patients with stigmata of Turner syndrome are derived from Y chromosomes

DNA analyses of 41 individuals with stigmata of Turner syndrome and a 45,X/46,X+mar or 46,X+mar karyotype were carried out. Southern-blot analysis employing 17 Y-specific probes were used to determine whether the marker chromosome was Y-chromosomal in origin. Of the 41 DNA samples from these patients, 23 contained detectable Y-chromosomal DNA. Points of chromosome breakage were distributed over the entire length of the Y long arm. Three individuals, who carry different portions of the Y chromosome, had developed gonadoblastoma. GBY (the gonadoblastoma locus on the Y chromosome) is mapped proximal to DYS132, midway between the 13 Yq loci that we have studied. We also used a polymerase chain reaction technique that could detect 7 loci over the length of the Y chromosome. This technique may be useful for the rapid assessment of marker chromosomes, especially for evaluating the risk of gonadoblastoma.

[Therapeutic difference by TAE between HCC with HCV-Ab and HBV-Ag]

Transarterial infusion therapy using adriamycin-Lipiodol emulsion (TAE) was used for 30 patients of HCC with HCV-Ab and 20 patients with HBV-Ag. We compared the tumor effect and prognosis in terms of several clinico-pathological factors. The response rate (PR+MR) after TAE was 43% in HCC patients with HCV-Ab and 30% in those with HBV-Ag. One-year survival rate was 89% in HCC patients with HCV-Ab and 58% in HCC patients with HBV-Ag. Thus, there was a significant difference between the two groups. No definite reasons between two groups influencing tumor effect and prognosis is obviously revealed except for portal vein invasion.

Behavior and EEG changes of unanesthetized cats after kainic acid injection into unilateral caudate nucleus

1. The microinjection of KA into the unilateral caudate nucleus induces secondarily generalized seizure. 2. The caudate nucleus considered to be one of the important relay structures in the generalization of epilepsy. 3. In this model of caudate nucleus epilepsy, cats did not show spontaneous seizure or choreic movement in the chronic stage.

[Studies on changes in low esophageal sphincter function after esophageal transection or esophago-esophagostomy in children]

An aim of the present study is to clarify the changes of esophageal function after surgical treatments of the esophageal varices or the congenital esophageal stenosis in children. Esophageal manometric studies were performed in sixteen children undergoing the esophageal transection with paraesophageal devascularization or the esophago-esophagostomy with partial esophagectomy before, within 1 month and over 7 months after the operation. The pressure of lower esophageal sphincter (LES), the length of LES, the LES relaxation test and the gastroesophageal reflux (GER) inducing test were measured. 1) Esophageal transection; The pressure dropped within 1 month and returned to the preoperative level over 11 months after the operation. Temporal deterioration of LES function was observed during the early postoperative days. However, return to the preoperative state was gained over 1 year. 2) Esophago-esophagostomy; The pressure and the length of LES were not changed after the operation. The LES function was disturbed preoperatively and moreover long postoperatively, in the case when congenital stenosis closely existed to the esophago-gastric junction. Degree of the postoperative disturbance of the LES function may be influenced by the distance to the part of the transection or the partial esophagectomy from the E-C junction.

Treatment of 46 patients with Turner's syndrome with recombinant human growth hormone (YM-17798) for three years: a multicentre study

A total of 46 patients with Turner's syndrome were treated for three years with recombinant hGH. Nineteen patients received hGH at a weekly dosage of 0.5 IU.kg-1.week-1, while 27 received 1.0 IU.kg-1.week-1 by daily sc injection. Both treatment groups showed a statistically significant growth increase during treatment. The increase in height over three years' treatment, as expressed by SD score (SDS) for chronological age, did not differ significantly between patients treated with 0.5 IU and those with 1.0 IU hGH. Seventeen of 22 patients over the age of 14 had exceeded their expected adult height. Plasma IGF-1 levels were elevated and no remarkable advances in bone age were observed during the treatment in either treatment group. There were no other significant changes in physical or laboratory examinations. No glucose intolerance was observed. These results indicate that hGH treatment is useful for accelerating growth velocity in patients with Turner's syndrome. However, further study will be required to find the best treatment dosage.

[A case of extracerebral cavernous hemangioma in the middle fossa]

Authors reported an autopsy case of extracerebral cavernous hemangioma in the middle fossa and discussed the effect of irradiation therapy on it. A 72-year-old woman was admitted due to progressive deterioration of consciousness and the right hemiparesis. CT scan revealed a slightly high density mass, which was markedly heterogeneously enhanced with contrast media, in the left middle cranial fossa. Angiogram with prolonged injection demonstrated a faint tumor stain. Craniectomy and partial temporal lobectomy for decompression were performed, but the tumor could not be removed due to uncontrollable hemorrhage. Her level of consciousness further deteriorated, and in addition heart failure developed. And finally she became vegetative in spite of effective irradiation therapy of 46Gy. CT scan taken three months and seven years after the irradiation showed marked regression of the tumor. After the vegetative state for 8 years, the patient died of acute pancreatitis, and autopsy was performed. The cavernous hemangioma with markedly proliferated interstitial connective tissue and thrombosed vessels was verified by microscopical examination. Although the treatment was not successful in this patient, we confirmed that irradiation is useful in the management of the extra-axial cavernous hemangioma in the middle fossa as a pre- or postoperative adjunct therapy.

[A case report of serous cystadenoma located in pancreatic tail]

Cystadenomas of the pancreas are relatively rare compared to pseudocysts. There are two types of cystadenoma of the pancreas; mucinous and serous. Serous cystadenomas of the pancreas are very rare. We experienced a serous cystadenoma located in pancreatic tail. The patient was male, forty-one years old, and was free from any subjective symptom. The pancreatic cyst was found by abdominal ultrasonography and was difficult to differentiate serous or mucinous by computed tomography or celiac angiography preoperatively. We performed distal pancreatectomy and the cyst was revealed to be serous cystadenoma pathologically.

[A review on assessment techniques for workers' physical and mental conditions by physiological measurements]

It was only a several decades ago that physiological measurements were recognized as effective indicators of human physical and mental conditions in occupational health or ergonomics. The recent rapid progress in sensor and signal processing techniques, however, made these available for practical evaluation techniques. This paper is an overview of the accumulated techniques in several fields including experimental psychology, physiology, medical sciences, and ergonomics. The major topics described herein are as follows: 1) properties and merits of physiological measurements compared with the other techniques, 2) applicability of various physiological indicators evaluated from noninvasive, ambulatory and continuous monitoring techniques, 3) practical physiological measurements and signal processing systems which can be applied at actual workplaces and environment, 4) effective and useful evaluation techniques of physiological indicators such as ECG, blood pressure, respiratory parameters, EEG, EBP, EMG, body movements, body temperature, perspiration, eye movements, CFF and electrodermal activities. Our review of 235 published papers has shown that physiological measurements have made a significant contribution to the assessment of physical and mental workload, CNS (central nervous system) activity level and work performance. However, further studies should be made on detail mechanisms and individual variations.

Effects of insulin-like growth factor I or human growth hormone in fasted rats

To study the effect of insulin-like growth factor I (IGF-I) treatment on growth and metabolism in fasted rats and compare it with the effect of human growth hormone (hGH), we infused 120 micrograms/ml IGF-I continuously or injected 200 micrograms hGH twice a day in fasted rats. After a 3 1/2-day administration of IGF-I in fasted rats, the body weights, kidney, spleen and adrenal gland weights were greater than those for untreated fasted rats (control). The body weights and the organ weights in hGH treated rats did not differ from those in control rats. Serum IGF-I levels in control, hGH treated and IGF-I treated rats were 64.0 +/- 6.1, 107.5 +/- 6.9 and 129.8 +/- 6.3 ng/ml, respectively, which were significantly different from each other. Blood urea nitrogen (BUN) levels were 13.9 +/- 1.1 ng/ml in IGF-I treated rats, which were significantly lower than those of control rats. Human GH treatment did not change BUN but affected nonesterified fatty acid (NEFA) and triglyceride. In IGF-I treated rats three-day urinary excretion of nitrogen and creatine were 163.5 +/- 14.6 mg and 9.53 +/- 1.53 mg, which were significantly less than those in control rats. These data indicate that IGF-I infusion inhibits body weight loss and catabolism in fasted rats and might be a useful therapy in catabolic conditions.

[Felty's syndrome]

Felty's syndrome is a variant of rheumatoid arthritis with a triad of leukopenia, splenomegaly and typical rheumatoid arthritis, and often accompanies the other extraarticular symptoms, such as subcutaneous nodules, lymphadenopathy, anemia, thrombocytopenia, leg ulcers, fever and weight loss. In addition to the decreased number of leukocyte, impaired functions of leukocytes were also revealed. These changes were considered as the cause of repeated infections, which was the major cause of death in Felty's syndrome. Splenectomy is not fully effective for leukopenia and for the repeated infection. Glucocorticoid therapy can increase leukocyte count, at least tentatively. It has been reported that gold was effective for leukopenia, repeated infection and skin ulcer. However, the definitive way of treatment of this syndrome based on the pathogenesis of this syndrome, remains to be established.

[Effect of anticonvulsants upon experimental limbic seizure status and regional cerebral blood flow in the hippocampus]

Continuous monitoring of regional cerebral blood flow (rCBF) of the hippocampus was made during limbic seizure status in cats by means of a heat clearance method with a calibration method by an electrolytic hydrogen clearance method. A stereotaxic operation was made under Nembutal anesthesia. Local anesthetics were applied to the painful area. Femoral artery and vein were cannulated and served for arterial blood pressure monitoring and drug injection, respectively. Tracheostomy was made and ventilated artificially. A double cannula was inserted to the amygdala and fixed to the skull with a dental cement. Electrodes for heat clearance method, electrolytic hydrogen clearance method and EEG recording were inserted to the dorsal hippocampus. Limbic seizure status was induced by kainic acid microinjection (2 ug) into amygdala via implanted cannula. Baseline rCBF was measured in each cats. Continuous monitoring of rCBF was made before and after intravenous administration of anticonvulsants such as zonisamide (ZNS), valproic acid (VPA), diazepam (DZP), phenobarbital (PB) and phenitoin (PHT). Physiological saline (PHS) was injected for controls. Injection of DZP resulted in strong seizure suppression with decrease of arterial blood pressure and hippocampal rCBF. Intravenous PB demonstrated analogous action with DZP with a mild anticonvulsant effect. Intravenous ZNS or VPA resulted in inhibition of seizure propagation from limbic system to cortex. However, these drugs augmented rCBF of the hippocampus more than 2 hours after administration. PHT and PHS demonstrated no anticonvulsant effect nor rCBF change in the present study.

Effects of activin A and somatostatin on intact FSH secretion and intracellular Ca2+ concentration in human FSH-secreting pituitary adenoma cells

Activin A stimulated synthesis and secretion of intact FSH in dispersed human FSH-secreting adenoma cells. Significant stimulation was observed after 24 hr. Activin A caused an increase in Ca2+ concentration ([Ca2+]i). This response occurred soon after the activin A action. These effects were blocked in Ca(2+)-deficient medium and by nitrendipine (5 microM). Somatostatin inhibited the activin A-induced intact FSH secretion and the [Ca2+]i response. These findings indicated that Ca2+ influx through voltage-gated Ca2+ channel was involved in the activin A induced synthesis and secretion of intact FSH.