[Pharmacokinetic study of intraperitoneally administered plachitin for non-curative gastrointestinal cancer]

Plachitin is a chemical compound of cis-diammine-dichloroplatinum (CDDP) and chitin. Pharmacokinetics and adverse effects of Plachitin for intraperitoneal chemotherapy (IP) were studied in 11 patients who suffered from non-curative gastrointestinal cancers in comparison with 4 patients who underwent IP of CDDP. Five patients were given 300 mg (100 mg as CDDP) of Plachitin which was cotton type on the residual cancer mass (Group A). Six patients were given IP 300 mg of Plachitin particles (Group B). As the control group, 4 patients were given IP 100 mg of CDDP (Group C). The platinum concentrations of serum, urine and intraperitoneal discharge were observed during 3-4 weeks after the treatments and calculated as the CDDP concentration. The serum CDDP levels were below 0.1 micrograms/ml for 4 weeks in Group A and B. In Group A, urine concentrations of CDDP were significantly lower than in Group B and C at 3 and 5 days after the treatment statistically (p > 0.05). But at 14 days after treatment, the urine concentration of CDDP in Group A was higher than in Group C. In Group A and B, the CDDP concentrations of intraabdominal discharge was lower than in Group C statistically (p > 0.05). Nausea was observed only in one patient of Group B and other adverse effects which contained renal sufficiency were not recognized in the three groups. Thus, Plachitin was considered an effective and safe agent for intraperitoneal chemotherapy.

Vertebral slip in lumbar spondylolysis and spondylolisthesis. Long-term follow-up of 22 adult patients

We studied the aetiology of vertebral slip in a long-term follow-up of 22 adult patients with isthmic spondylolysis or spondylolisthesis of L5. Of the 18 with spondylolysis without slip, 13 showed no slip after ten years, but five developed displacement of over 5%. All four patients with spondylolisthesis showed progression of the slip. We found that the vertical thickness of the transverse process of L5 was significantly greater (p < 0.01) in the 13 patients with no slip than in the other two groups. The relationship of vertebral slip to the shape of the transverse processes of L5 may be explained by differences in the bulk or physiological strength of the posterior bands of the iliolumbar ligament.

[An analysis of familial prostate cancer]

BACKGROUND

Clinical and pathological features of familial prostate cancer patients were examined.

METHODS

We compared 7 pairs (14 patients) of familial prostate cancer patients (Group F) with those of 1741 prostate cancer patients diagnosed in around Gunma Prefecture between 1987 and 1993 (Group G). Relative survival rates were compared because the average age was different in two groups.

RESULTS

In Group F and Group G, age at diagnosis ranged from 54 to 86 and 47 to 97 years old, and the averages were 68.1 +/- 8.5 (S.D.) and 74.2 +/- 8.3, respectively. The average age tended to be younger in Group F. The ratio of early stage cancer tended to be higher and that of poorly differentiated cancer tended to be lower in Group F. The 3- and 5-year relative survival rate was 82.4% and 57.6% in Group F, and 84.3% and 73.9% in Group G, respectively. The 5-year survival rate tended to be lower in Group F, but almost no difference was observed between two groups on the whole. In Group F, of 6 patients whose causes of death were clear, 4 (66.7%) died of prostate cancer, while in Group G, of 398 patients whose causes of death were elaar, 224 (56.3%) died of prostate cancer. Family history of other cancer sites was positive in 3 of 6 families in Group F.

CONCLUSIONS

Familial prostate cancer patients tended to be young, in early stage and low ratio of poorly differentiated cancer.

Histological and immunohistochemical changes after transurethral balloon laser hyperthermia in the canine prostate

Transurethral balloon laser hyperthermia (TUBAL-H) for the prostate was performed in a canine model. Eleven normal and hyperplastic prostates were heated at between 40 to 45 degrees C for 30 min. Compared to the pretreatment weight, the prostatic weight significantly increased immediately after treatment and significantly decreased at 4 weeks later, but was not significantly different after 8 weeks. Histologically, shedding of epithelial cells was observed immediately after treatment, although, coagulonecrotic tissue was not seen. After 8 weeks, atrophic changes of epithelial cells were observed at the inner portion of the prostate. By immunohistochemical analysis, epithelial cells expressing apoptosis related antigen (Ley) were observed at the inner portion of the prostate from immediately after treatment until 4 weeks later. The atrophic epithelia and the expression of apoptosis in the prostate gland were pathological changes induced by TUBAL-H. From the present data, it is suggested that TUBAL-H combined with radiation or administration of anti-cancer drugs may be effective for prostate cancer.

Phosphotyrosyl protein phosphatase-like activity of a clonal osteoblastic cell line (MC3T3-E1 cell)

The homogenate of MC3T3-E1 cells hydrolysed phosphotyrosine, but not phosphoserine or phosphothreonine at acidic pH. It dephosphorylated lysozyme and Raytide (a gastrin analogue peptide) phosphorylated by tyrosine kinase, but showed little activity toward histones phosphorylated by cyclic AMP-dependent protein kinase. Dephosphorylation of phosphorylated lysozyme and Raytide were inhibited by zinc and vanadate, but were insensitive to okadaic acid. These data suggest that the osteoblastic cell line MC3T3-E1 has a phosphotyrosyl protein phosphatase-like activity that may participate in cellular regulation involving protein tyrosine phosphorylation.

[Renal cell carcinoma and acquired cystic disease of the kidneys in patients on long-term hemodialysis]

Since the first report in 1977 by Dunnill et al., a substantial number of articles have been written concerning the complications of acquired cystic disease of the kidneys (ACDK) and renal cell carcinoma developing in the native kidneys of patients undergoing long-term hemodialysis. The incidence has been reported to be 35% to 95% of ACDK in patients undergoing long-term hemodialysis. In addition, renal cell carcinoma has been described in 4% to 7% of the ACDK. The etiology of ACDK and renal cell carcinoma in the native kidneys of patients undergoing long-term hemodialysis remains unresolved. Because ACDK and renal cell carcinoma are usually asymptomatic, several reports described the use of imaging studies in the native kidneys of patients undergoing long-term hemodialysis and suggest a variety of management schemes to screen or monitor the status of the native kidneys. Ultrasonography is the most common screening study, but CT scan is more sensitive. Both studies are necessary to diagnose ACDK and renal cell carcinoma in the native kidneys of patients. We review our 10 cases and the Japanese literature with particular attention to the diagnosis and treatment of patients with ACDK and renal cell carcinoma. Our findings were similar to those reported by others. Patients receiving dialysis treatment for more than three years should have a baseline radiologic examination of the kidneys so that subsequent problems can be more easily identified and evaluated. The best surgical treatment for patients with ACDK and renal cell carcinoma is simple nephrectomy by flank incision in order to prevent surgical side effects, for example postoperative bleeding.

Vertebral slip in lumbar spondylolysis and spondylolisthesis. Long-term follow-up of 22 adult patients

We studied the aetiology of vertebral slip in a long-term follow-up of 22 adult patients with isthmic spondylolysis or spondylolisthesis of L5. Of the 18 with spondylolysis without slip, 13 showed no slip after ten years, but five developed displacement of over 5%. All four patients with spondylolisthesis showed progression of the slip. We found that the vertical thickness of the transverse process of L5 was significantly greater (p < 0.01) in the 13 patients with no slip than in the other two groups. The relationship of vertebral slip to the shape of the transverse processes of L5 may be explained by differences in the bulk or physiological strength of the posterior bands of the iliolumbar ligament.

Calpain: novel family members, activation, and physiologic function

The current status of calpain research is summarized on the basis of the most recent results. The main points are as follows. (i) Calpain constitutes a large family. (ii) Ca2+ ions cause the dissociation of calpain into subunits and the resulting free 80 kDa subunit is the active form of the enzyme. This dissociation corresponds to the activation of calpain. (iii) Some powerful clues have been obtained that will be helpful for analyzing the physiological function.

Activation induces dephosphorylation of cofilin and its translocation to plasma membranes in neutrophil-like differentiated HL-60 cells

We suggested that a cytosolic 21-kDa phosphoprotein played an important role in opsonized zymosan-trigered activation of superoxide-generating enzyme in neutrophil-like HL-60 cells through dephosphorylation (Suzuki, K., Yamaguchi, T., Oshizawa, T., Yamamoto, Y., Nishimaki-Mogami, T., Hayakawa, T., and Takahashi, A (1995) Biochim. Biophys. Acta 1266, 261-267). In the present study, we characterized the phosphoprotein and studied changes in it localization upon activation of phagocytes. The 21-kDa phosphoprotein was rapidly dephosphorylated upon activation not only wit opsonized zymosan but also with formyl-Met-Leu-Phe and arachidonic acid. The peptide fragments derived from the 21-kDa phosphoprotein were found to have the same amino acid sequences as those of cofilin, an actin-binding protein. The phosphoprotein reacted exclusively with anti-cofilin antibody on two dimensional immunoblots. Accordingly, together with its apparent molecular weight, isoelectric point, and detection of phosphoserine as a phosphoamino acid, we concluded that the 21-kDa phosphoprotein was a phosphorylated form of cofilin. The amount of cofilin in membranous fractions was increased upon activation. Furthermore, confocal laser scanning microscopy showed that cofilin existed diffusely in the cytosol and nuclear region of the resting cells, while in the activated cells, it was accumulated at the plasma membrane area, forming ruffles or endocytic vesicles on which O2.- should be produced. These results suggested that in resting cells cofilin exists as a soluble phosphoprotein in the cytosol and nuclei, while upon stimulation a large portion of cofilin is dephosphorylated and translocated to the plasma membrane regions.

Induction of endometrial adenocarcinomas by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine to aged Donryu rats showing spontaneously persistent estrus

Induction of endometrial adenocarcinomas by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) to aged rats was examined. Donryu rats showing spontaneously persistent estrus were given a single intra-uterine administration of ENNG (20 mg/kg) at 10 months (44 weeks) of age. At the termination of the experiment (week 34 after the ENNG-treatment), 22% and 13% incidences of endometrial adenocarcinomas were observed in the experimental and control groups, respectively, the difference being without significance. No variation was found in the endocrine environment between experimental and non carcinogen-treated control animals throughout the experimental period. These results show that ENNG-treatment alone is not sufficient in aged rats for high induction of endometrial carcinomas. Comparison of the data with those from our previous studies, in which ENNG was given at a young age (10 weeks of age), indicates that young rats may be more sensitive than their old counterparts.

Characterization of the binding of factor Xa to fibrinogen/fibrin derivatives and localization of the factor Xa binding site on fibrinogen

The binding of human factor Xa to fibrinogen and its derivatives was characterized. Factor Xa bound to immobilized fibrin with a concentration at half-maximal binding (C50) of 100 nM. The 4-carboxyglutamic acid (Gla) domain of factor Xa is important in factor Xa binding to fibrin monomer, based on the following observations; the binding requires Ca2+; Gla-domain-lacking factor Xa could not bind to fibrin; factor Xa binding was significantly reduced by prior treatment of factor Xa with factor IX/factor-X-binding protein from the venom of Trimeresurus flavoviridis which specifically binds to the Gla domain of human factors IX and X. Factor Xa also bound to fibrinogen, fibrinogen degradation products (FDP)-D and FDP-E, with a similar affinity (C50 = 75-131 nM). In a solution-phase equilibrated binding assay, approximately 0.76 mol factor Xa bound to 1 mol fibrinogen with a dissociation constant of 180 nM. The binding of 125I-labeled factor Xa to the fibrin monomer was inhibited markedly by unlabeled factor Xa, but only slightly by thrombin, suggesting that the binding site of factor Xa on fibrin monomer differs from that of thrombin. We localized the binding site of factor Xa on fibrinogen: factor Xa bound strongly to the A alpha chain, but weakly to the B beta and gamma chains of fibrinogen. The A alpha chain was then digested with lysyl endopeptidase and separated by reverse-phase HPLC. Among resulting peptides, factor Xa bound specifically to a peptide corresponding to residues Asp82-Lys123 of the A alpha chain. This factor-Xa-binding site is located in the boundary between the central E domain and the terminal D domain of fibrinogen and is apparently distinct from the reported thrombin-binding site.

Molecular characterization of cDNA encoding a novel protein related to transcriptional enhancer factor-1 from neural precursor cells

We identified a novel cDNA related to that of transcriptional enhancer factor-1 (TEF-1) during the course of isolation and characterization of cDNAs, whose mRNAs are preferentially expressed in the mouse neural precursor cells. The putative polypeptide, termed embryonic TEA domain-containing factor (ETF), deduced from the nucleotide sequence contains 445 amino acids and shares 66% amino acid identity with mouse and human TEF-1 proteins. The primary structure of the TEA domain, a probable DNA-binding domain, and the specific DNA binding activity to the GT-IIC motif of ETF are indistinguishable from those of the known vertebrate TEF-1 proteins. However, the expression of the ETF gene is strictly regulated in developing embryos and is limited to certain tissues, such as the hindbrain of a 10-day-old mouse embryo, in contrast to the ubiquitous expression pattern of the TEF-1 gene. These results suggest that ETF is a novel mammalian member of the TEA domain-containing transcription factor family and may be involved in the gene regulation of the neural development. We have discussed the possible existence of multiple subtypes of the mammalian TEF-1 family proteins, which may play different roles in cellular and development gene regulation.

Male reproductive toxicity study of nitrazepam in rats

The main focus of this study is the optimal administration period concerning toxic effects on male fertility in rats. To assess functional and morphological changes induced in the testis by nitrazepam, male rats were administered the drug at doses of 0, 20, 40 or 80 mg/kg during pre-mating periods of 2, 4 or 9 weeks and then the 2 weeks of mating. At the end of the administration period the animals were sacrificed and sperm number, motility, abnormalities and histopathological changes in the testis were examined. Decreases in testis weight, epididymis weight, number of sperm in the testis and sperm motility were observed in the 40 and 80 mg/kg sections of the 2, 4 and 9 week pre-mating treated groups. Mating with untreated females revealed no adverse effects on copulation rate in any group; however, a remarkable decrease in pregnancy rate was noted in the 80 mg/kg section of the 2, 4 and 9 week treated groups. On histological examination, various degrees of localized necrosis in the seminiferous epithelium and Leydig cell hyperplasia were observed in the testis. No clear changes were observed in the 20 mg/kg section of the 2 week pre-mating administration group, but at the 4 week time point, necrosis of spermatogenic cells began to appear. The primary morphological event was evident in spermatocytes with necrosis of the cytoplasm observed from 4 weeks after administration of nitrazepam, although sperm motility and sperm head counts were unaffected. From these findings, examination of sperm characteristics and histopathological changes in the testis are important parameters for evaluation of drugs inducing testicular damage. We conclude that a 4 week administration period is sufficient to detect effects of nitrazepam on male fertility.

Autoantibodies to calpastatin (an endogenous inhibitor for calcium-dependent neutral protease, calpain) in systemic rheumatic diseases

We identified an autoantibody that reacts with calpastatin [an inhibitor protein of the calcium-dependent neutral protease calpain (EC 3.4.22.17)]. In early immunoblot studies, sera from patients with rheumatoid arthritis (RA) recognized unidentified 60-, 45-, and 75-kDa proteins in HeLa cell extracts. To identify these autoantigens, we used patient sera to clone cDNAs from a lambda gt11 expression library. We isolated clones of four genes that expressed fusion proteins recognized by RA sera. The 1.2-kb cDNA insert (termed RA-6) appeared to encode a polypeptide corresponding to the 60-kDa antigen from HeLa cells, since antibodies bound to the RA-6 fusion protein also reacted with a 60-kDa HeLa protein. The deduced amino acid sequence of the RA-6 cDNA was completely identical with the C-terminal 178 amino acids of human calpastatin except for one amino acid substitution. Patient sera that reacted with the RA-6 also bound pig muscle calpastatin, and a monoclonal antibody to human calpastatin recognized the RA-6 fusion protein, confirming the identity of RA-6 with calpastatin. Moreover, the purified RA-6 fusion protein inhibited the proteolytic activity of calpain, and IgG from a serum containing anti-calpastatin antibodies blocked the calpastatin activity of the RA-6 fusion protein. Immunoblots of the RA-6 product detected autoantibodies to calpastatin in 57% of RA patients; this incidence was significantly higher than that observed in other systemic rheumatic diseases, including systemic lupus erythematosus (27%), polymyositis/dermatomyositis (24%), systemic sclerosis (38%), and overlap syndrome (29%). Thus, anti-calpastatin antibodies are present most frequently in patients with RA and may participate in pathogenic mechanisms of rheumatic diseases.

Characterization of insulin-like growth factor-binding protein 5-degrading proteases produced throughout murine osteoblast differentiation

Insulin-like growth factor (IGF)-binding protein-5 (IGFBP-5) is uniquely regulated throughout MC3T3-E1 osteoblast differentiation: IGFBP-5 is first detectable in conditioned medium (CM) of replicating preosteoblasts (day 5); IGFBP-5 levels peak between culture days 8-12, then decline to almost undetectable levels in mature osteoblast cultures (> day 18) despite the persistence of IGFBP-5 messenger RNA. These observations suggest that IGFBP-5 concentrations may be regulated by posttranslational mechanisms. To determine whether proteolysis contributes to the disappearance of IGFBP-5 in CM of mature osteoblasts, serial samples of MC3T3-E1 cell CM obtained during a 30-day culture period were analyzed for IGFBP-5-degrading protease activity. Using [125I]recombinant human IGFBP-5 substrate zymography, we demonstrated that proteases with M(r) of 52-72 and 97 kilodaltons (kDa) were present in CM, and protease activity increased in concentration as cultures matured. The 52- to 72-kDa proteases were cation dependent and were inhibited by tissue inhibitor of metalloproteinase 1, a specific inhibitor of matrix metalloproteinases (MMPs), identifying them as MMPs. Furthermore, antisera to human MMP-1 and -2 immunoprecipitated IGFBP-5-degrading proteases with M(r) of 52 and 69/72 kDa, respectively, suggesting that homologous murine MMPs degrade IGFBP-5. Finally, MC3T3-E1 cell CM contained immunoreactive MMP-1 and -2, and MMP-2, in particular, increased significantly throughout differentiation. In contrast, the 97-kDa protease was neither inhibited by tissue inhibitor of metalloproteinase 1 nor immunoprecipitated by antisera to MMPs, suggesting that the 97-kDa protease is not a MMP. Together, these data suggest that MMPs along with an unidentified 97-kDa protease degrade IGFBP-5 in MC3T3-E1 cell cultures. Because truncated forms of IGFBP-5 have been shown to enhance the action of IGF in bone cells, IGFBP-5 proteases may be instrumental in IGF-mediated bone morphogenesis.

[Two case reports of retroperitoneal leiomyosarcoma]

Two cases of retroperitoneal leiomyosarcoma are presented. The first case was in a 67-year-old female, whose chief complaint of right upper abdominal mass and dull pain. The tumor, 13 x 12 x 8 cm in size, developing in the retroperitoneum was removed with the right kidney and vena cava. The pathological diagnosis was reported as leiomyosarcoma. The second case was in a 62-year-old male, whose complaint was left abdominal swelling, also with general fatigue. A large tumor mass, invading over all of the left flank organs, was palpable by physical examinations, from which the mass was far beyond surgical approach. Needle biopsy revealed the pathological finding of leiomyosarcoma. One month later, the patient died of cachexia. Review of the literatures for the retroperitoneal leiomyosarcoma, revealed only a few cases; 1.7%, of all leiomyosarcoma to date.

Search for naturally occurring substances to prevent the complications of diabetes. II. Inhibitory effect of coumarin and flavonoid derivatives on bovine lens aldose reductase and rabbit platelet aggregation

An EtOAc extract of Artemisiae Capillari Spica inhibited both bovine lens aldose reductase (bovine-LAR) and rabbit platelet aggregation. Two simple coumarins, scoparone (1) and scopoletin (2), and three flavonoids, capillarisin (21), cirsimaritin (22) and rhamnocitrin (23), were isolated from this extract. Scoparone (1) and scopoletin (2) exhibit a potent inhibitory effect on rabbit platelet aggregation induced by four types of agent, ADP, PAF, sodium arachidonate and/or collagen. Capillarisin (21) exhibits a potent inhibitory effect on bovine-LAR. In addition, thirteen simple coumarins, five coumarin glycosides and two flavonoids were tested for their inhibitory effect against bovine-LAR and rabbit platelet aggregation.

Molecular characterization of a hamster oviduct-specific glycoprotein

There is growing evidence that the oviduct is not a passive conduit for gamete and embryo transport but serves a function for the gametes and/or embryos. The oviductal epithelium secretes one or more specific glycoproteins that associate with the egg after ovulation. Several published reports including our preliminary studies have suggested that the egg-associating glycoprotein(s) from the oviduct exists in several mammalian species including golden hamster. However, little or almost no biochemical characterization of the hamster oviduct-specific glycoprotein (HOGP) has been reported. To analyze the molecular structure of the HOGP in detail, we have attempted molecular cloning of cDNA corresponding to HOGP. A cDNA library constructed from the hamster oviduct in the phage vector lambda ZAPII was screened with digoxigenin-labeled, baboon oviduct-specific glycoprotein cDNA as the probe. A single positive clone was isolated, and the nucleotide sequence of the isolated cDNA was determined. Rapid amplification of cDNA end was carried out to obtain a proximal 5' cDNA end of the clone. The cDNA clone consisted of 2387 bp, and the coding region contained 2013 bp translating to 671 amino acids. The amino acid sequence deduced from the cDNA sequence confirmed the chemically determined NH2-terminal sequence of a HOGP and suggested that the derived amino acid sequence contained a signal peptide region (21 amino acids) and 650 amino acids (70,890 daltons) of the mature form of the HOGP region. The amino acid sequence of HOGP appeared to have eight potential N-glycosylation sites. Northern blot analysis revealed that a single message of approximately 2.5 kb was present in oviductal RNA but not in the RNA of several other hamster tissues. The HOGP showed high amino acid sequence homology with baboon, bovine, and human oviduct-specific glycoprotein. These results demonstrate that an oviduct-specific glycoprotein homologue gene exists in various mammalian species including rodent.

Ultrastructural changes in the lung in Niemann-Pick type C mouse

The biochemical and morphological aspects of BALB/c mice with many features of the Niemann-Pick disease type C in man (NP-C mouse) have been studied extensively. However, the pulmonary pathology has not been studied extensively and we describe here some unique ultrastructural features of the lung in the NP-C mouse. Ultrastructurally, macrophages in younger mice contained osmiophilic dense granules and annulolamellar structures, but larger multilamellar concentric structures increased in the macrophages of older mice. In contrast, endothelial cells and type I pneumocytes showed membrane-bound bodies with dense granules and vesicular or vesiculogranular structures as well as amorphous materials. Type II pneumocytes were unremarkable throughout. Our study suggests that endothelial cells and type I pneumocytes are the major site of metabolic derangement resulting in pronounced morphological changes with granular and round membranous structures in the lungs of NP-C mouse. Alveolar macrophages with multilamellar concentric structures may be a result of disturbed disposal of surfactant material from type II pneumocytes rather than that from storage material of type I pneumocyte.

Interaction stabilizing tertiary structure of bacteriorhodopsin studied by denaturation experiments

The structural stability of bacteriorhodopsin was studied by denaturation experiments, using aliphatic alcohol as denaturants. The disappearance of a positive peak at 285 nm of the circular dichroism spectra, the change in the intrinsic fluorescence decay time, and the decrease of the regeneration activity bacteriorhodopsin indicated the denaturation of the tertiary structure of this protein at a methanol concentration of about 3 M. The circular dichroism band at 222 nm was unchanged by the denaturation. It was concluded that the alcohol-denatured state in water was similar to the molten globule state of soluble proteins, in which only the tertiary structure was destroyed. Solvent substitution from water to hexane did not cause denaturation of bacteriorhodopsin. However, further addition of alcohol destroyed the secondary as well as the tertiary structures. Comparing the alcohol effects of bacteriorhodopsin in water to that in hexane, the dominant interactions for the structure formation of this protein could be revealed: the hydrophobic interaction that arose from the structure of water is essential for the stability of membrane spanning helices, while the interaction which binds the helices is polar in nature.

Lower number and thinner myelin of large myelinated fibers in human cervical compression radiculopathy

The authors conducted a morphometric investigation of the histopathological alterations in myelinated fibers (MFs) of the nerve roots of C-6, which showed macroscopic indentation, presumably due to cervical spondylotic radiculopathy. In six cadavers, designated as the radiculopathy group, in which the nerve roots of C-6 showed indentation due to compression on one side (indented side) and the remaining nerve roots (normal side) showed a normal appearance macroscopically, morphometric findings of the nerve roots and the MFs on both the indented and normal sides were evaluated and subjected to blind comparison. Seven cadavers with normal-appearing C-6 nerve roots served as controls. In the control group, there were no differences in the morphometric parameters: that is, total transverse fascicular area, total number of small and large MFs, and relationship between myelin thickness and the radius of the axon between the right and left sides in either the ventral or dorsal roots. There was no evidence found of axonal degeneration, ongoing demyelination, or loss of MFs in either the ventral or dorsal roots in the radiculopathy group on the indented side. However, there were significantly lower numbers of large MFs per root and significantly thinner myelin sheaths relative to axon size on the indented side compared with those on the normal side in both the ventral and dorsal roots. These findings are characteristic alterations of the MFs produced by chronic low-grade compression.

[Study on reverse transcriptase inhibiting antibody in plasma of HIV-1 seropositive subjects]

Reverse transcriptase (RT) inhibiting antibody in a series of plasma of HIV-1-seropositive subjects was quantitatively measured by poly A-linked colorimetric microtiter plate assay. The plasma were obtained from 6 asymptomatic carrier (AC)s and from 3 patients who progressed to AIDS. They had been followed 29-51 months. RT inhibiting antibody levels in the plasma were measured by inhibition assay against HTLV-IIIB RT activity. In five of the 6 AC cases, RT inhibiting antibodies in the serial plasma maintained high levels, and 50% inhibiting titers of the serial plasma did not decrease throughout the observation periods (45-51 months). HIV isolation from peripheral blood mononuclear cell (PBMC) of these 5 ACs did not succeed, and HIV p24 antigens were not detected in the plasma. In one AC case (046) RT inhibiting antibody levels gradually decreased after 48 months. In this case, HIV p24 antigen was not detected in the serial plasma throughout the observation period (48 months), but HIV was isolated from PBMC after 27 months. On the other hand, RT inhibiting antibody levels in the serial plasma of all 3 patients who progressed to AIDS gradually decreased in observation periods (29-35 months). HIV strains were isolated from these 3 cases. These results suggest that reduction of RT inhibiting antibody levels correlate well with the success of HIV isolation and with progression of clinical manifestation.

Efficacy of an ultrasonic surgical system for laparoscopic adrenalectomy

PURPOSE

We determine the value of an ultrasonic surgical system for laparoscopic adrenalectomy.

MATERIALS AND METHODS

We analyzed 16 patients who underwent laparoscopic adrenalectomy using the ultrasonic surgical system and compared the results with those of patients undergoing laparoscopic adrenalectomy without the system.

RESULTS

The system simplified exposure of the renal pedicles and inferior vena cava, and facilitated adrenal separation from the perinephric fat as well as dissection and identification of the adrenal vessels. Operating time was shorter and blood loss was also less with use of the ultrasonic surgical system.

CONCLUSIONS

The ultrasonic surgical system simplified laparoscopic adrenalectomy and made the operation much safer.