Disaccharide analysis of human skin glycosaminoglycans in sun-exposed and sun-protected skin of aged people

The total amount of main disaccharide units of skin glycosaminoglycans was compared between sun-exposed (n = 12) and sun-protected skin (n = 14) of aged people using high performance liquid chromatography after labeling with 1-phenyl-3-methyl-5-pyrazolone. The total amount of main disaccharide units in sun-exposed skin was comparable to sun-protected skin presumably due to the diversity of individuals. Consequently, we compared sun-exposed skin with sun-protected skin in identical individuals (n = 6). The total amount of main disaccharide units in sun-exposed skin was significantly greater than that in sun-protected skin (P < 0.05). In addition, the ratio of delta Di-HA (hyaluronic acid, HA)/delta Di-4S (dermatan sulfate, DS) in sun-exposed skin showed a decreasing trend as compared with sun-protected skin in four of six individuals. These results are in agreement with our previous results obtained in animal experiments of photoaging, i.e., hairless mouse skin exposed to repeated UV irradiation showed an increase in total amount of main disaccharide units and a decrease in the ratio of delta Di-HA(HA)/delta Di-4S(DS). We could confirm similar changes in skin glycosaminoglycans both in human and murine photoaging supporting the appropriate rationale for using the hairless mouse as an animal model for photoaging. Again, disaccharide analysis should provide a useful method to examine the biochemical changes of skin glycosaminoglycans in human photoaging.

[A case of pulmonary dirofilariasis]

A 41-year-old man was admitted to the hospital for detailed evaluation of chronic hepatitis C. A nodular shadow (15 x 15 mm) was detected in the left middle lung field on a chest X-ray film. Roentgenologic, cytologic, and bronchial endoscopic examinations resulted in no definitive diagnosis. To rule out a malignant tumor the left lung was partially resected (S6). Histological examination of the resected specimen revealed Dirofilaria worms in a necrotic mass. In most cases of pulmonary dirofilariasis, thoracotomy is done to confirm the diagnosis. Recently, however, antibodies against Dirofilaria have been detected by immunologic methods and have been used to help make the diagnosis in some cases. A less invasive procedure, such as a reliable immunologic test or a technique for thoracoscopic resection, would be very useful in cases of this benign condition.

Abnormal excitability of the corticospinal pathway in patients with amyotrophic lateral sclerosis: a single motor unit study using transcranial magnetic stimulation

The pathophysiology of corticospinal tract degeneration in amyotrophic lateral sclerosis (ALS) was investigated by studying the effect of transcranial magnetic stimulation on discharge characteristics of single motor units during voluntary activation. The motor units were recorded from the first dorsal interosseus muscles of 12 patients with ALS, 14 healthy subjects, 12 patients with upper motor neuron lesions and 9 with pure lower motor neuron diseases. More than 100 magnetic stimuli were delivered over the scalp during minimal muscle contraction. The occurrence of motor unit discharges was plotted in a peristimulus time histogram. An increase in discharge probability at latencies of 20-30 msec, that represents monosynaptic activation (primary peak) was found in normal units. Motor units from ALS patients with short disease durations had significantly increased discharge probabilities in the primary peak (P < 0.001). Motor units from 4 ALS patients with upper motor neuron signs showed double primary peaks: an initial synchronized peak followed by a dispersed peak. The latter was ascribed to a slow corticospinal pathway, which remains undetected or is functionally insignificant in healthy subjects. We conclude that the excitabilities of the surviving corticospinal tract pathways are abnormally increased in ALS, especially in the early stage.

Peritoneal-pleural communications in hepatic hydrothorax demonstrated by thoracoscopy

To understand the mechanism of hepatic hydrothorax clearly, thoracoscopy was performed with a flexible bronchoscope. It revealed an intrathoracic influx of ascitic fluid via a bleb and two defects located in the tendinous portion of the right hemidiaphragm and confirmed the existence of transdiaphragmatic peritoneal-pleural communications.

A malignant granular cell tumor of the stomach: report of a case

We report herein what to our knowledge is the first documented case of a malignant granular cell tumor of the stomach. A 64-year-old woman was admitted to our hospital for investigation of gastric submucosal tumor. Endoscopy disclosed a large hemispherical mass located on the lesser curvature at the gastric antrum with a normal mucosal surface, and computed tomography (CT) revealed a solid tumor about 7 cm in diameter with clear margins. A laparotomy was carried out under the preoperative diagnosis of leiomyosarcoma of the stomach. A tumor was found in the gastric antrum, with extragastric extension to the hepatic hilum, and a distal partial gastrectomy was performed. However, a follow-up CT scan performed 21 months postoperatively revealed a solid tumor of about 10 cm in diameter with clear margins, situated between the liver and the transverse colon. This was subsequently diagnosed as local recurrence and a resection was carried out. Microscopic examination of both the first and second specimens showed that the tumor cells were large and polygonal, with medullary proliferation and finely granular eosinophilic cytoplasm. Mitotic figures were also present. Thus, the lesion was diagnosed as a malignant granular cell tumor of the stomach from the clinical and pathological findings.

Nucleotide sequence of the uricase gene from Bacillus sp. TB-90

The nucleotide sequence of the uricase gene from the thermophilic bacterium Bacillus sp. TB-90 was determined. The primary structure of the uricase deduced from the nucleotide sequence comprised 332 amino acids, with a total molecular mass of 37,994 Da. The molecular mass of the subunit of the uricase produced by the transformant of Escherichia coli agreed well with this value. However, the molecular mass of a subunit of the uricase produced by Bacillus sp. TB-90 was found to be 34,000 Da by SDS-PAGE. The difference between these molecular masses was attributed to processing of the C-terminal 13 amino acid residue in Bacillus sp. TB-90. Comparison of the enzymatic properties of both uricases showed that the thermostability of the uricase produced by the transformant was enhanced by about 10 degrees C in comparison to that produced by Bacillus sp. TB-90.

Expression of human metallothionein-2 in Escherichia coli: cadmium tolerance of transformed cells

A genetic approach was undertaken to investigate the physiological roles of human metallothionein-2. A constructed expression plasmid, pEXPMTII, in which human metallothionein-IIA cDNA was inserted downstream of a tryptophan-lactose promoter, was used to transform Escherichia coli JM105 strain. Cadmium-binding metallothionein was successfully expressed in E. coli in the medium containing cadmium, while copper and zinc-metallothioneins were scarcely observed in copper- or zinc-containing medium. The amino acid composition and sequence of the biosynthesized cadmium-metallothionein were analyzed. The selectivity of metals bound to metallothionein and the stability of metal-binding forms of metallothionein in E. coli were discussed. In addition, cadmium, zinc, or copper resistance of the cells expressing metallothionein was examined. Cells transformed with the plasmid pEXPMTII and cultured in a medium containing cadmium exhibited tolerance only to cadmium. It was demonstrated that human metallothionein-2 functioned for cadmium detoxification in E. coli.

Relative zinc-binding capacity of metallothionein: studies in renal cytosols from zinc-injected rats

Each rat was injected intraperitoneally once with 0.9% NaCl or zinc (10, 20, 40, or 60 mg zinc/kg b.w.). The zinc content in kidney reached a maximum level of approx. 50 microgram/g kidney, corresponding to a dose (40 mg zinc/kg b.w.). The distribution profiles of the renal cytosols of zinc-injected rats on a Sephadex G-75 column showed that most of the increased zinc was attributable to metallothionein. There was a linear relationship between the zinc contents in cytosol and metallothionein. Our results demonstrated that there was a limit of zinc accumulation in kidneys of zinc-injected rats and that 57% of the increased zinc in renal cytosols was bound to metallothionein. Our results suggest that the role of metallothionein in zinc accumulation in the kidney is similar to that of zinc accumulation in liver.

[Double cancers of renal cell carcinoma and testicular seminoma: a case report]

A case of metachronous presentation of renal cell carcinoma and testicular seminoma is reported. A 48-year-old man underwent left radical nephrectomy for a renal tumor on September 4, 1991. Pathological examination revealed clear cell carcinoma with no capsular penetration. There was no evidence of distant metastases. During postoperative follow-up, he noticed a painless left testicular induration in July, 1994. Serum human chorionic gonadotropin beta subunit as a tumor marker was elevated. Left radical orchiectomy was performed on October 17, 1994. Pathological examination revealed an anaplastic seminoma localized within the testis. Chest X-ray was normal and CT of the abdomen demonstrated no evidence of retroperitoneal lymphadenopathy. The patient was diagnosed as clinical stage I left testicular seminoma. He was free of disease 8 months postoperatively. Including our case, 15 cases of clinically detected double cancers of renal cell carcinoma and testicular germ cell tumor have been reported worldwide. This is the first case of a metachronous presentation of these two cancer types preceded by renal cell carcinoma.

[Potassium channel dysfunction at the lesion site in multifocal motor neuropathy as revealed by threshold electrotonus]

Multifocal motor neuropathy presents as a treatable muscular atrophy and is characterized by persistent conduction block and fasciculations or myokymia. Although the pathological findings at the lesion site revealed perivascular demyelination with little evidence of remyelination, the mechanism of conduction block is still unknown. We explored the threshold electrotonus, which registers membrane potential changes through threshold variation, at the lesion site. The findings were consistent with focal potassium channel dysfunction, with some evidence of depolarization block. The disrupted blood-nerve barrier and lack of Schwann cell-mediated extracellular potassium regulation may predispose the membrane depolarization, thereby accounting for the conduction block and fasciculations. Sensory nerve fibers are known to have more inward rectifiers, which take up the extracellular potassium, than motor fibers, and this may explain the sparing of these fibers.

[Combined chemotherapy with 5-FU and low dose CDDP for advanced or recurrent cancer of the digestive system and home anti-cancer chemotherapy]

We have performed combined chemotherapy with 5-FU, a biochemical modulator, and low dose CDDP for advanced or recurrent cancer of the digestive system. The therapy was effective in 37% of all cases and in 45.5% and 41.6% of esophageal and gastric cancer cases, respectively. In addition, few patients developed adverse side effects including renal disorders, one of the major side effects of CDDP. Therefore, we considered home anti-cancer chemotherapy feasible. For 27 outpatients with advanced cancer of the digestive system including 15 cases of esophageal cancer, 4 cases of gastric cancer, 3 cases of colon cancer, 4 cases of pancreatic cancer and 1 case of gall bladder cancer, 4 to 6 week home adjuvant chemotherapy was performed. The regimen comprised 1 week of oral administration of 300 mg/body/day of UFT-E granules and 5 days of continuous intravenous infusion of 25 mg/body/day of CDDP using an infusor pump. During the follow-up, 3 cases of catheter obstruction, 3 cases of catheter sepsis and 1 case of pneumothorax appeared. These complications all resulted from the catheter, and safe home anti-cancer chemotherapy could be continued because 5-FU and CDDP did not cause severe side effects.

[Halothane concentration inhaled by anesthesiologists during anesthesia through face masks]

Exposure to low concentrations of anesthetics is still an important medical concern. We measured halothane concentrations in air inspired by anesthesiologists practicing inhalational anesthesia through face masks (10 cases, 200 sampling points). Halothane concentrations were 0 to 15 ppm (mean 4.89 ppm), higher than the safety level recommended by National Institute for Occupational Safety and Health (NISOH). However, these concentrations were clearly low in a room air-conditioned with vertical laminar flow providing total air exchange rate of 30 per hour (0.55 +/- 0.53 ppm, n = 40) compared to those in the rooms with horizontal laminar flow of 25 (5.98 +/- 3.80 ppm, n = 80, P < 0.001). These observations indicate the importance of ventilation systems of operating rooms for avoiding anesthetic gas exposure to anesthesiologists during inhalational anesthesia through face masks.

Mammosomatotroph adenoma cells secrete both growth hormone and prolactin

Pituitary adenoma cells from a mammosomatotroph adenoma obtained from a 21-year-old female presenting with acromegaly and amenorrhea were investigated by sandwich cell immunoblot assay, immunohistochemistry, and electron microscopy. The new, simple technique of sandwich cell immunoblot assay could detect two hormones secreted in the same one cell, and found that 89% of mammosomatotrophs secreted both growth hormone (GH) and prolactin (PRL). Immunohistochemistry showed that the tumor cells were positive for both GH and PRL. Electron microscopy showed cells contained granules ranging in size form 150 to 500 nm. This is the first demonstration of both GH and PRL in the same mammosomatotroph cell. Sandwich cell immunoblot assay can measure the amount of secreted hormone, allowing a new approach to the investigation of mammosomatotroph adenomas.

Relative zinc-binding capacity of metallothionein in hepatic cytosols of zinc-injected rats

In order to determine the zinc-binding capacity of metallothionein in hepatic cytosols of zinc-injected rats, we examined the relationship between zinc contents in cytosols and metallothionein fraction in rat livers. Each rat was injected intraperitoneally once with 0.9 % NaCl or zinc (10, 20, 40 or 60 mg zinc/kg b.w.) and was killed 14 h after injection. The distribution profiles of the hepatic cytosols of zinc-injected rats on a Sephadex G-75 column showed that the increased zinc was attributable to the metallothionein and high molecular weight proteins. Our results demonstrated that 63% of the increased zinc in hepatic cytosols of zinc-injected rats was bound to metallothionein and that 23% of the increased zinc was bound to high molecular weight proteins. These results suggest that the mechanisms of zinc accumulation in rat liver are different from those of cadmium accumulation.

[Fournier's gangrene in a patient with perirectal abscess: a case report]

A case of an 81-year-old man with Fournier's gangrene was reported. The patient visited our hospital complaining of scrotal swelling and redness. Perirectal abscess was found and ultrasound study revealed thickness of scrotal skin and normal testes. The patient was immediately treated with antibiotics, incision and debridement of the scrotal skin. The lesion healed 8 weeks later.

Relative zinc-binding capacity of metallothionein in hepatic cytosols of zinc-injected rats

In order to determine the zinc-binding capacity of metallothionein in hepatic cytosols of zinc-injected rats, we examined the relationship between zinc contents in cytosols and metallothionein fraction in rat livers. Each rat was injected intraperitoneally once with 0.9% NaCl or zinc (10, 20, 40 or 60 mg zinc/kg b.w.) and was killed 14 h after injection. The distribution profiles of the hepatic cytosols of zinc-injected rats on a Sephadex G-75 column showed that the increased zinc was attributable to the metallothionein and high molecular weight proteins. Our results demonstrated that 63% of the increased zinc in hepatic cytosols of zinc-injected rats was bound to metallothionein and that 23% of the increased zinc was bound to high molecular weight proteins. These results suggest that the mechanisms of zinc accumulation in rat liver are different from those of cadmium accumulation.

Oxidative and nonoxidative mechanisms of site-specific DNA cleavage induced by copper-containing metallothioneins

DNA cleavage induced by metallothionein (MT) containing copper was investigated by a DNA sequencing technique. Reconstituted Cd7-MT showed no ability to cause DNA cleavage. Commercially available rabbit MT I caused DNA cleavage, suggesting that DNA cleavage is due to the metal contained in commercial Mt. Cu2Cd5-MT and Cu12-MT were prepared by the treatment of commercial rabbit MT I with [Cu(CH3CN)4]CIO4. Cu12-MT frequently induced an alteration of thymine residues, especially in the 5'-GTC-3' sequence, and piperidine treatment led to chain cleavage at the thymine residues. The site specificity was similar to that obtained with Cu(I) plus H2O2. H2O2 enhanced DNA cleavage induced by Cu12-MT. Catalase and a Cu(I)-specific chelating agent, bathocuproine, inhibited DNA cleavage. These results suggest that Cu(I) and H2O2 have important roles in the production of active species causing DNA cleavage. Commercial MT and Cu2Cd5-MT induced DNA cleavage much less than Cu12-MT, but gave particularly specific DNA cleavage. Cu2Cd5-MT induced cleavage specifically at the central guanine residue of the 5'-GGT-3' sequence. A similar cleavage pattern was obtained with commercial MT. No effect of piperidine treatment suggests that the DNA cleavage might not be due to base damage and/or liberation. The DNA cleavage was inhibited efficiently by EDTA, but not by bathocuproine and catalase. Experiments with DNA ligands, albumin, and denatured DNA suggest that commercial MT and Cu2Cd5-MT induce nonoxidative cleavage of the deoxyribose phosphate backbone through its DNA recognition. These two types of cleavage mechanisms are discussed in relation to the possible role of Cu-MT in carcinogenesis.

Activated protein C resistance: molecular mechanisms

Activated protein C (APC) resistance is usually associated with a single DNA mutation predicting replacement of Arg506 by Gln in factor V (FV). Studies using synthetic peptides suggest that FV residues 493-506 provide factor Xa (FXa) and protein S binding sites. Biochemical studies were performed to test the hypothesis that the Arg506Gln FV mutation causes APC resistance and to define the nature of the resistance of Gln506-FVa to APC. Purified Gln506-FV conveyed APC resistance to FV-deficient plasma in APTT and FXa-1-stage assays. Purified Gln506-FVa, generated either by thrombin or by FXa, was resistant to APC. Nonetheless, Gln506-FVa was not completely resistant to APC since it was inactivated by APC approximately 10-fold slower than normal Arg506-FVa, probably due to cleavage at Arg306. This reduced but significant susceptibility of Gln506-FVa to APC inactivation may help explain why APC resistance, especially for heterozygotes, is a relatively moderate risk factor for venous thrombosis. Cardiolipin promotes APC anticoagulant activity better than FXa coagulant activity, and antibodies from some antiphospholipid antibody syndrome patients downregulate APC activity. Thus, acquired APC resistance may contribute to pathogenesis of thrombosis in the antiphospholipid antibody syndrome.

Acetylcholinesterase-positive afferent axons in mucosa of urinary bladder of adult cats: retrograde tracing and degeneration studies

Acetylcholinesterase (AchE)-positive afferent axons in the mucosa of the cat urinary bladder were examined in the present experiments. Small-sized dorsal root ganglion cells containing AchE enzyme activity were labelled by injection of retrograde tracer (wheat germ agglutinin conjugated to enzymatically inactive horseradish peroxidase gold complex) into the bladder mucosa of adult cats. Results show that 48.9% (90/184) of the labelled ganglion cells possessed AchE enzyme activity. Following unilateral dorsal root ganglionectomy (L2-5, S1-3), a total of 6619 unmyelinated axon terminals were examined in the bladder mucosa, including 691 degenerating axon terminals. Percentages (8.;6-16.1%) of degenerating axon terminals in the ganglionectomized animals (1, 2, 3, 10 and 21 days post-operated) were significantly higher than those of controls (3.1%) and the 60-day post-operated animals (3.2%). Approximately one-half (47.9%) of the degenerating axon terminals observed in the 1-21 day post-operated animals were AchE-positive. Further examination also disclosed that the population of the intact (not affected by ganglionectomy) AchE-positive axon terminals at 60 days (59.3%) was significantly greater than that of controls (45.6%). The AchE-positive terminals containing few synaptic vesicles were significantly increased in number in the 60 day post-operated cats. In conclusion the present study demonstrates that one half of afferent axons in the mucosa were AchE-positive. The increase in AchE-positive afferent axon terminals containing few synaptic vesicles may be derived from contralateral dorsal root ganglia resulting from sprouting following dorsal root ganglionectomy.

Generation of novel rapamycin structures by microbial manipulations

A new rapamycin producing culture was isolated and designated as Actinoplanes sp. N902-109. The addition of a cytochrome P-450 inhibitor and precursor feeding using this culture, and biotransformation approaches generated new rapamycin analogs with modifications at C-4, C-9, C-16, C-27, C-28 and/or C-39. The immunosuppressive activity of the resulting analogs was established in the mixed lymphocyte reaction assay.

[A case of myelodysplastic syndrome who died of septic pulmonary embolism]

A case of myelodysplastic syndrome (MDS) complicated by septic pulmonary embolism is reported. A 61-year-old female who had been followed for refractory anemia with excess of blasts suddenly died of acute respiratory failure. An autopsy revealed massive pulmonary emboli with gram-positive cocci gathered in the emboli and alveolar spaces. Staphylococcus aureus was also detected through a blood culture from the right atrium. We speculate that pulmonary embolism was the result of septicemia induced by the immunosuppressive condition associated with MDS.

Arteriovenous malformation with auricular hypertrophy

We report a case of arteriovenous malformation (AVM) restricted to the auricle fed by the external carotid artery. The patient showed severe hypertrophy of the left auricle, remarkably spreading throughout the auricle. At first, we chose to surgically ligate the superficial temporal artery. After the operation, however, pulsation recurred, and we ligated the external carotid artery at an inframandibular site in a second operation. Two months after surgery, plasty of the left auricle was performed at the patient's request.

Activated protein C resistance: molecular mechanisms based on studies using purified Gln506-factor V

Gln506-factor V (FV) was purified from plasma of an individual homozygous for an Arg506Gln mutation in FV that is associated with activated protein C (APC) resistance. Purified Gln506-FV, as well as Gln506-FVa generated by either thrombin or FXa, conveyed APC resistance to FV-deficient plasma in coagulation assays. Clotting assay studies also suggested that APC resistance does not involve any abnormality in FV-APC-cofactor activity. In purified reaction mixtures, Gln506-FVa in comparison to normal FVa showed reduced susceptibility to APC, because it was inactivated approximately 10-fold slower than normal Arg506-FVa. It was previously reported that inactivation of normal FVa by APC involves an initial cleavage at Arg506 followed by phospholipid-dependent cleavage at Arg306. Immunoblot and amino acid sequence analyses showed that the 102-kD heavy chain of Gln506-FVa was cleaved at Arg306 during inactivation by APC in a phospholipid-dependent reaction. This reduced but measurable susceptibility of Gln506-FVa to APC inactivation may help explain why APC resistance is a mild risk factor for thrombosis because APC can inactivate both normal FVa and variant Gln506-FVa. In summary, this study shows that purified Gln506-FV can account for APC resistance of plasma because Gln506-FVa, whether generated by thrombin or FXa, is relatively resistant to APC.

Dopamine responsiveness of human prolactinoma cells as determined by the reverse hemolytic plaque assay

The responsiveness in vivo to dopamine of prolactin (PRL) secretion in patients with prolactinoma was compared with that in vitro of single cells obtained from the same prolactinomas by surgical operations. Six patients with prolactinoma showing various degrees of hyperprolactinemia were challenged by bromocriptine suppression test (2.5 mg, peroral) before operation. Bromocriptine administration caused a decrease in the serum PRL concentration ranging 24-95% and there was no correlation between the basal PRL level and bromocriptine-induced inhibition. Monodispersed pituitary cells obtained from the prolactinomas by operation were subjected to a reverse hemolytic plaque assay for PRL to determine PRL secretion at the single cell level under basal conditions as well as in response to dopamine. The percentage of plaque-forming cells under basal conditions ranged 15-55% among the prolactinomas. The percentage of plaque-forming cells and plaque area were decreased in a dose-dependent manner by 10(-7) - 10(-5) M dopamine for the pituitary cells obtained from some adenomas but not for those from other adenomas. When the inhibition rates in vitro due to 10(-5) M dopamine in these two parameters were compared with the inhibition rate in vivo in the serum PRL concentration due to bromocriptine, it was found that there was a significant correlation between them. These results show that the reverse hemolytic plaque assay can be used to determine in vitro responsiveness to dopamine of PRL secretion from single prolactinoma cells.(ABSTRACT TRUNCATED AT 250 WORDS)