A new bioabsorbable material for rat vascular cuff anatomosis: establishment for the long-term orthotopic liver transplantation model

Rat vascular anastomosis was performed using a newly synthesized bioabsorbable material (LA-GA copolymer) cuffs and the ordinary polyethylene cuffs. The LA-GA copolymer cuff which anastomosed the portal vein and the inferior vena cava were patent and developed no collateral veins even after 6 months, keeping the transplanted liver normal. By contrast, the polyethylene cuff anastomosed portal vein was completely occluded and the collateral veins were highly developed, with the transplanted liver showing the fatty degeneration of hepatocytes and numerous regenerative nodules. It is concluded that the LA-GA copolymer cuff is a suitable material for the short and long term study of rat orthotopic liver transplantation.

Hepatoblastoma in a 2-year-old girl with trisomy 18

A very rare case of mosaic type trisomy 18 associated with hepatoblastoma is described. The patient underwent an extended right hepatic lobectomy at 2 years of age, and the resected tumor was diagnosed as a fetal type dominant hepatoblastoma. The results of chromosome analysis demonstrated that in the peripheral blood and skin, the trisomy 18 cells were 80% and 67%, respectively. On the other hand, although virtually 100% of the cells in the normal liver tissue were 46, XX, about one third of the cells were trisomy 18 in the tumor tissue. At 2 years and 9 months after the operation, the patient was generally healthy and had no evidence of recurrence.

Effect of birth season on case fatality rate of pulmonary tuberculosis: coincidence or causality?

The effects of birth season on the case fatality rate (CFR) of pulmonary tuberculosis were examined in case records of 9206 patients discharged during 1937-1965 from a national hospital for tuberculosis in Tokyo. The CFR was over 60% until 1945, then it decreased down to less than 9% after 1950. Male cases had little variation in their CFR by their birth season, while female cases had a significant variation and showed a significantly higher CFR than the male cases when they were born in January-June. The results suggest that the birth season had a significant influence on the prognosis of pulmonary tuberculosis.

[A case of inflammatory bronchial polyp associated with pulmonary and bronchial tuberculosis]

A 67-year-old man was admitted to our hospital because of cough and sputum. Chest X-ray revealed cavity and consolidation in the right upper lobe. Microscopical examination of stained specimens of sputum disclosed acid-fast bacilli (Mycobacterium tuberculosis). Cough and sputum resolved and cultures of sputum did not yield M. tuberculosis a month after administration of antituberculosis agents. However, a mass shadow in the right upper lobe was found 3 months later. Bronchofiberscopy revealed a polyp with a stalk at the orifice of right upper bronchus, which was elastic, soft in consistency, smooth surfaced, and movable. The pathological findings of the polyp showed non-specific inflammatory granulation which suggested to be inflammatory bronchial polyp. It was appeared in the healing process of bronchial tuberculosis.

[A study on the mass screening system for prostatic diseases]

Between 1984 and 1990, a mass screening for prostatic diseases was carried out on men over 55 years old in cities, towns and villages in Toyama Prefecture, Japan. The total number of subjects examined in the primary study was 1,232, which was 17.7% of the males over 55 years old in these areas. The primary study consisted of inquiry concerning urination, digital examination of the prostate, transabdominal ultrasonography, and determination of tumor markers. A secondary study was indicated for 100 subjects (8.9%) suspected to have prostatic cancer and 169 (15%) suspected to have benign prostatic hypertrophy, but only 92 (35%) of them were actually examined. Prostatic cancer was histologically diagnosed in 3 subjects (0.3%), and benign prostatic hypertrophy was established in 56 subjects (4.5%), who were referred to urologists. Though a high percentage of the population was covered by the primary study the percentage of subjects who received the secondary study among those in whom it was indicated was low. This probably was a reason for the low detection rate of prostatic cancer. An improved system is considered to be needed to increase the efficiency of mass screening for prostatic diseases.

Stimulation of the protein synthesis by fibronectin is specific for untransformed fibroblastic cells

In the preceding paper, we showed that fibronectin (FN) in solution has the ability to stimulate protein synthesis in NIH-L1 fibroblastic cells. We show here that FN stimulated protein synthesis also in other normal fibroblast cell lines, WI-38 and BALB/3T3, but did so only slightly in their transformed cell lines, L1-4NQOH10, WI-38 VA-13 and KN(7)8; and in rat hepatocytes in primary culture and rat liver epidermoid cells (GR-1) it hardly affected the synthesis. Augmentation of the protein synthesis rate was not attributable to stimulation of collagen synthesis. This stimulatory activity of FN was enhanced remarkably by proteolytic digestion of FN with trypsin.

Epidermal growth factor contents in seminal plasma as a marker of prostatic function

Epidermal growth factor (EGF), first identified in extracts from submaxillary salivary glands of adult male mice, acts as a potent mitogen in a wide variety of cells and tissues in culture. Human EGF, a polypeptide of 53 amino acids isolated from human urine, has been identified in several biological fluids, including prostatic fluid and seminal plasma. Epidermal growth factor content in seminal plasma was measured by RIA. The EGF content in seminal fluid did not change after bilateral vasectomy and the first fraction of sample obtained by split ejaculation contained a significantly larger amount of EGF than the second fraction. Seminal EGF originates from the prostate. There was a close correlation between EGF and zinc contents in seminal fluid. The seminal fluid EGF content was lowered in patients with prostatitis and systemic androgen deficiency. The EGF content in seminal fluid seems to be a reliable indicator of prostatic function.

Fibronectin stimulates protein synthesis in cultured fibroblastic cells

Protein synthesis in mouse embryo fibroblastic (NIH-L1) cells was stimulated by addition of fibronectin (FN) to the culture medium as a soluble factor. This stimulatory activity of FN appeared only when the cells were cultured over their saturated density. A hexapeptide (GRGDSP) containing the RGDS cell attachment site of FN could not prevent the stimulation of protein synthesis. Moreover, activity of the stimulatory FN was not affected by inclusion of cytochalasin B, which is known to release FN from cell surface by disorganizing actin cytoarchitecture. These results suggest that the signaling of change in protein synthesis rate by FN may be distinct from signaling involving cell attachment and spreading.

Paracrine effect of folliculo-stellate cells on the growth factor-like action of activin A in anterior pituitary cultures

Several studies have shown that pituitary folliculo-stellate (FS) cells exhibit local functions within the pituitary gland. On the other hand, we have shown previously that activin A increases the number of FSH-producing gonadotropes in cultured rat anterior pituitary cells. In this study, we investigated whether FS cells exert an influence on the action of activin A. FS cells were prepared by culturing the dispersed rat anterior pituitary cells in media containing 15% fetal calf serum and 6 mM glutamine for 15 days. Most cells had the morphological characteristics of FS cells and S-100 protein immunoreactivity, a specific marker of FS cells. The number of FSH cells, which was higher in activin A-treated than in control cultures, was reduced to the control level by incubation with activin A plus conditioned media from FS cell-enriched cultures (FSCM). This inhibitory effect of FSCM was neutralized by a follistatin antibody, but not by anti-S-100 protein or anti-basic fibroblast growth factor. Furthermore, follistatin suppressed activin A stimulated increases in the number of FSH cells in a similar inhibitory pattern to that of FSCM. Meanwhile, the number of FSH cells was not affected by FSCM or follistatin in the absence of activin A. These results suggest that FS cells are involved in the regulation of the function and/or the morphogenesis of the FSH cell-lineage by affecting the action of activin A, and that this paracrine effect of FS cells is mediated by follistatin.

Structures of new peptide antibiotics, plusbacins A1-A4 and B1-B4

The constituent amino acids of plusbacins A1-A4 were determined to be two moles of L-trans-3-hydroxyproline and one mole each of D-threo-beta-hydroxyaspartic acid, L-threo-beta-hydroxyaspartic acid, D-allo-threonine, D-serine, D-alanine and L-arginine. In plusbacins B1-B4, one mole of L-trans-3-hydroxyproline is replaced by L-proline. The fatty acid residue of A1 and B1 was determined to be 3-hydroxy-tetradecanoic acid, for A2 and B2 to be 3-hydroxy-isopentadecanoic acid, for A3 and B3 to be 3-hydroxy-isohexadecanoic acid, and for A4 and B4 to be 3-hydroxy-hexadecanoic acid. A lactone linkage was suggested to reside between L-threo-beta-hydroxyaspartic acid and 3-hydroxy-fatty acid residues by degradation experiments. The amino acid sequences of plusbacins A2 and B2 were confirmed by Edman degradation of their deacylated products, and supported by mass spectrometric studies. From the above, structures of all components of plusbacins were concluded.

A new antitumor antibiotic product, demethylchartreusin. Isolation and biological activities

A new antitumor antibiotic, 3''-demethylchartreusin was isolated from the culture broth of Streptomyces chartreusis, as a minor component of crude chartreusin. It is structurally related to chartreusin, containing same aglycone of chartreusin, but different sugar moieties. 3''-Demethylchartreusin exhibits some potent inhibitory activities against murine tumors.

Control of trigeminal motoneurons from the cerebellar interpositus nucleus of the guinea pig

1. Effects of stimulation of the cerebellar interpositus nucleus (IPN) on jaw reflexes and trigeminal motoneurons were studied along with the route responsible for the effects in ketamine-anesthetized guinea pigs. 2. Stimulation in the IPN evoked a bilateral, ipsilaterally dominant, short-latency reciprocal effect on jaw reflexes: a depression of the jaw-closing masseteric reflex and a facilitation of the jaw-opening digastric reflex. This reciprocal phase was followed by a non-reciprocal facilitatory phase. 3. Stimulation in the IPN evoked a short-latency, strychnine-sensitive inhibitory postsynaptic potential (IPSP) followed by a rebound depolarizing potential in the jaw-closing masseter motoneurons (MAMNs) and an excitatory postsynaptic potential (EPSP) in the jaw-opening anterior digastric motoneurons (ADMNs). The time course of the intracellular response of MAMNs to the IPN stimulation was similar to that of the IPN-induced effects on the jaw-closing reflex. In contrast, the duration of the IPN-induced EPSP in ADMNs was shorter than the IPN-induced facilitation of the jaw-opening reflex. 4. After the IPN neurons were lost by injection of kainic acid into the nucleus, the reciprocal effect of the IPN stimulation on the jaw reflexes could not be seen, even though the projection fibers from the trigeminal sensory nucleus to the IPN remained essentially intact. 5. Stimulation in the superior cerebellar peduncle (SP) induced the same reciprocal effect on the jaw reflexes as the IPN stimulation. A lesion of the SP virtually abolished the reciprocal effect on the jaw reflexes of stimulation in the IPN ipsilateral with reference to the SP lesion. 6. Transection of the brain stem at the level immediately caudal to the red nucleus did not affect the reciprocal effect of the IPN stimulation on the jaw reflexes. 7. We conclude that the IPN output bilaterally induces an inhibition of jaw-closing MAMNs and an excitation of jaw-opening ADMNs, oligosynaptically by way of a direct cerebelloreticular projection system via the SP.

[Interferon therapy of idiopathic thrombocytopenic purpura]

The authors evaluated the efficacy of a daily administration of recombinant human alpha 2a interferon (IFN), given at a dose of 300MU for 12 consecutive days, in patients with steroid-nonresponsive or -dependent idiopathic thrombocytopenic purpura (ITP). Nine patients received courses of IFN therapy. Mean platelet counts rose from 1.39 to 10.9 x 10(4)/microliters and PAIgG decreased from 151.7 to 59.7 ng/10(7) cells. The maximum rise in platelet counts occurred from 10 to 42 days (mean 19.1) after the initiation of IFN. Complete response (CR) was achieved in 3 of 13 courses (23.1%), and partial response (PR) in 8 (61.5%). One CR case continued for longer than 20 months without further treatment, but intermittent IFN therapy was necessary for the other. The increment of the platelet counts was transient in all of the partial responders. No severe side effect requiring interruption of the course of IFN was experienced. Both serum IgG and PAIgG significantly correlated with the increment of platelet counts, therefore the mechanism of IFN on ITP was presumed to be associated with the inhibition of autoantibody production. Daily administration of IFN appears to be an effective and safe treatment protocol for refractory ITP.

Isolation and characterization of new peptide antibiotics, plusbacins A1-A4 and B1-B4

New antibiotics, plusbacins A1-A4 and B1-B4, were isolated from the culture broth of a strain of Pseudomonas sp. These antibiotics were isolated as a complex by column chromatographies on Diaion HP-20 and silica gel, and then separated by HPLC. They are amphoteric in nature. The hydrochlorides are obtained as colorless powders, soluble in methanol and alkaline water. From their physico-chemical properties, these antibiotics are presumed to be acyloctapeptides containing a lactone linkage, and their differences occur in amino acid and fatty acid residues. The antibiotics are active against Gram-positive bacteria in vitro and in vivo.

[Clinical study on primary aldosteronism--localization of adrenal tumors]

Seven cases of primary aldosteronism were experienced during the 12 years in the Toyama Medical and Pharmaceutical University Hospital. The majority of cases were between 32 and 64 years old with a mean of 51 years. Two cases were male and 5 were female. Hypertension was observed in 6 cases, but one case had normal blood pressure. Hypokalemia was recognized in 6 cases. The plasma level of aldosterone was high in all cases and all the cases showed low levels of plasma renin activity. Concerning the localization of the lesions, CT scan, magnetic resonance imaging and adrenal scintigraphy revealed an accuracy rate of 100%, each. Therefore, these imaging techniques are very useful tools for identifying the locality of the adenoma. On the other hand, the accuracy rates of adrenal venous aldosterone assay and ultrasonography were 83 and 60%, respectively. The cases with rather short duration of hypertension before surgery returned to normal in blood pressure earlier after the operation than the other cases.

[Successful low-dose etoposide therapy for a case of myelofibrosis with chronic myelogenous leukemia megakaryocytic predominance type]

A 38-year-old woman presented with ear pain and vertigo. No hepatosplenomegaly or lymphadenopathy were found, but her platelet counts markedly rose to 414 x 10(4)/microliters with an increase of megakaryocytes in the bone marrow (859/microliters). Cytogenetic assay revealed positive Ph1 chromosome and rearrangement of the break point cluster region (bcr). Although platelet counts remained under 100 x 10(4)/microliters after the administration of carboquone, a high fever and pancytopenia appeared 31 months later. Bone marrow biopsy showed marked myelofibrosis which was improved by low dose etoposide. This case was thought to be Ph1 positive ET, but it was more compatible with CML megakaryocytic predominance type according to the newly proposed "Hannover criteria for myeloproliferative disorders" and cytogenetic assay.

[High-dose cepharanthin therapy of idiopathic thrombocytopenic purpura]

Clinical efficacy of oral high-dose cepharanthin (40-60 mg/day) was evaluated in nine patients with idiopathic thrombocytopenic purpura who were unable to discontinue the administration of adrenocorticosteroids or immunosuppressive drugs. Mean platelet counts significantly (p less than 0.05) rose from 4.5 +/- 0.9 x 10(4)/microliters to 8.9 +/- 4.2 x 10(4)/microliters without any side effects. Two to five months after the initiation of this therapy, 4 patients, including 3 who could discontinue adrenocorticosteroids, kept their platelet counts over 10 x 10(4)/microliters. It was suggested that the oral administration of cepharanthin could be a beneficial and safe strategy for ITP.

Galacardins A and B, new glycopeptide antibiotics

A strain of actinomycetes identified as Saccharothrix sp. SANK 64289 was found to produce new antibiotics, galacardins A and B. Their physico-chemical properties showed that they were new members of glycopeptide antibiotics. They were structurally related to beta-avoparcin but differed from it only in sugar composition. Though beta-avoparcin does not contain galactose, galacardins A and B did contain two and one moles of galactose, respectively. They showed strong antimicrobial activity against Gram-positive bacteria and also showed excellent in vivo protective activity against Staphylococcus aureus infection in mice.

Improved serodiagnosis of non-A, non-B hepatitis by an assay detecting antibody to hepatitis C virus core antigen

We examined sequential serum samples from 12 patients with well-characterized posttransfusion non-A, non-B hepatitis who had an acute, resolving self-limited type of clinical course for the presence of antibody to the hepatitis C virus nucleocapsid (core) protein (p22) expressed by a recombinant baculovirus. These sera were simultaneously examined for antibody to the hepatitis C virus nonstructural protein (C100-3) that is presently used for blood screening worldwide. In three patients, both anti-p22 and anti-C100-3 antibodies were detected, but anti-p22 was detected much earlier. In four patients, only anti-p22 was detected. Two other patients were considered to be hepatitis C virus carriers who had been already infected with hepatitis C virus. In one patient, only anti-C100-3 was detected, and it was transient. In two patients, neither antibody was detected. Anti-p22 was detected in at least one of eight samples of transfused blood. Of the nine samples of donated blood that were positive for anti-p22, only four were positive for anti-C100-3. This new assay detecting the antibody to the p22 protein is thus useful for the serodiagnosis of non-A, non-B hepatitis in the acute phase and for blood screening.

[A case of subacute effusive-constrictive pericarditis]

A 30-year-old female with effusive-constrictive pericarditis was admitted to our hospital because of dyspnea, ascites and edema. On examination, her blood pressure was 118/94 mmHg and her pulse rate was 90 bpm. Physical examination revealed pulsus paradoxus, markedly raised venous pressure and pericardial knock sound. Chest X-ray showed marked cardiomegaly and bilateral pleural effusion. After cardiac catheterization there was elevation of mean right atrial pressure, right ventricular end-diastolic pressure, pulmonary-capillary-wedge pressure, and their pressures during diastole were approximately 30 mmHg. After successful pericardiocentesis, their diastolic pressures still remained at 15 mmHg. Additionally, pressure wave of the right ventricle showed distinct diastolic dip and plateau pattern, and that of the right atrium showed deep x and y descents. The pressure pattern suggested that not only pericardial effusion but also decreased compliance of the pericardium was the main factor contributing to the cardiac diastolic dysfunction. Histological examination of the pericardium showed diffuse lymphocyte infiltration and fibrosis. These findings strongly suggested that there might have been viral infection.

[Changes in right ventricular function with unilateral pulmonary artery occlusion test for pre-operative evaluation prior to lung resection]

We measured the right ventricular ejection fraction (RVEF) before and during unilateral pulmonary artery occlusion test (UPAO) by thermodilution method. We also measured the right ventricular end-diastolic volume index (RVEDVI), right ventricular end-systolic volume index (RVESVI), and right ventricular stroke volume index (RVSVI). RVEF and RVSVI were significantly decreased by UPAO (p less than 0.05), but there were no obvious changes in RVEDVI and RVESVI. Some cases showed only a small decrease in RVEF by UPAO, even though their total pulmonary vascular resistance indices were over 700 dyne.sec.cm-5/m2 during UPAO. On the other hand, some cases had a decreased in RVEF of more than 10% by UPAO, even though their total pulmonary vascular resistance indices were under 400 dyne.sec.cm-5/m2 during UPAO. We consider that it is important to measure right ventricular functions such as RVEF together with pulmonary vascular hemodynamics in the pre-operative evaluation of cases of lung resection.

Seminal plasma transferrin concentration: relationship with seminal parameters and plasma hormone levels

Seminal plasma transferrin concentrations were determined in 155 infertile male patients and in 15 pregnancy-proven fertile males (control group); then the relationship between these concentrations and seminal parameters and plasma hormone levels was investigated. The concentrations of seminal plasma transferrin in patients with a sperm concentration below 20 x 10(6)/ml were significantly lower than those in the control group (p < 0.01). There was no significant difference in seminal plasma transferrin concentration between patients with a sperm concentration of 40 x 10(6)/ml or more and the control patients. A positive correlation was observed between sperm concentration and seminal transferrin content (r = 0.56; p < 0.05). However, correlations between seminal transferrin concentration and sperm motility and between seminal plasma transferrin content and sperm morphology did not show any significance, nor did the seminal transferrin content correlate with plasma LH, FSH, prolactin or testosterone levels. It, therefore, seems that while transferrin is indicative of certain physiopathological conditions in the germ cells, this protein is not a distinctive marker of the fertility potential of an individual.

The role of enhanced mitochondrial phosphorylation in rat liver transplantation

The effects of organ preservation on mitochondrial oxidative phosphorylation activity, adenylate hepatic energy charge, cytochrome content, and redox state of NAD+/NADH couple in rat liver transplantation were compared between a nonpreservation group and a preservation group with grafts preserved for 12 hr in Euro-Collin's solution. At 3 hr after transplantation, the energy charge in the preservation group decreased to 0.60 +/- 0.02 from the control value of 0.86 +/- 0.01, accompanied by a reduction of intramitochondrial redox state of NAD+/NADH couple. In contrast, in the nonpreservation group, the decrease in energy charge was minimally decreased to 0.79 +/- 0.04 due to the compensatory enhancement of mitochondrial oxidative phosphorylation activity. These results suggest that an enhanced mitochondrial ATP synthesis and a reduced intramitochondrial redox state are important factors affecting survival following rat liver transplantation.

[Application of laser in the treatment of spontaneous pneumothorax and emphysema]

From August 1990 to August 1991, sixteen patients with bullae or blebs (pneumothorax 9, giant bullae 5, bullous emphysema 2) were treated by CO2 laser ablation under limited thoracotomy. We found the irradiation of bullae or blebs by CO2 laser quite effective in eliminating these bullous lesions which were often multiple and inoperable by conventional methods. Histological examination revealed the wall of bullae where CO2 laser was applied became thick with dense fibrous tissues and degenerated collagen fibers which, however, were not disrupted. The procedure was safe and we were able to operate patients with disabling emphysema. Because CO2 laser can penetrate only 0.2-0.3 mm of tissue thickness, it is suitable for the ablation of bullous lesions which have thin walls and rapidly shrink and collapse by irradiation leaving thick walled scar tissues. Removing multiple bullae and blebs in patients with bullous emphysema can improve gas exchange by reducing dead spaces and elevating the diaphragm which is often flat and downward displaced because of hyperinflation in these patients. We are planning to incorporate thoracoscopy for this operation to make the procedure less invasive.