Colony stimulating factor-inducing activity of hesperidin

To evaluate immunomodulating activities of bioflavones, colony-stimulating factor (CSF)-inducing activity of two dihydroflavones, three flavones and three flavonols were tested. These samples were suspended in saline and injected intraperitoneally (i.p.) into mice at a dose of 1 mg 6 h before bleeding. All compounds carrying the glucosyl-rhamnose moiety showed potent activity. Among them, hesperidin exhibited the strongest activity. Serum CSF production in mice injected with 1 mg hesperidin reached a peak at 9 h later. The activity of hesperidin was dose-dependent at a range of 0.3 to 20 mg/mouse.

Successful treatment of tracheomalacia associated with esophageal atresia without a tracheoesophageal fistula by aortopexy: report of a case

Tracheomalacia (TM) is well known as a complication associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF); however, the occurrence of TM requiring surgical treatment in a patient having EA without a tracheoesophageal fistula has never been reported. We describe herein a rare case of TM associated with EA without TEF. Respiratory distress was caused by compression of the trachea by a severely dilated upper esophageal pouch with weakness of the tracheal wall. Aortopexy was performed, and an excellent postoperative result was achieved.

Evaluation of complex activities in daily living of elderly Japanese with visual impairment

This study was conducted to determine whether elderly subjects with visual impairment differ in the performance of complex activities in daily living from those without visual impairment. The study subjects were residents in two homes for the aged in Japan, and consisted of 37 elderly people with visual impairment, and 42 elderly people, serving as controls; ages ranged from 64 to 95 years. Complex activities of the subjects were ascertained by interview using a 46-item questionnaire. The visually impaired elderly had lower performance levels for telephone use (p = 0.007), shopping (p = 0.049), cleaning up one's room (p = 0.001), and utilization of medical facilities (p = 0.001) in instrumental ADL (IADL); for interest in TV or radio (p = 0.004) and religious faith (p = 0.042) in "enriching activities"; and for visiting behaviors (p < 0.05) in "social role". The performances of complex activities by the elderly with visual impairment were diminished in specific categories, but not overall, and this may be attributable to poor mobility and/or more passive attitudes in their daily activities.

Vascular backache and consideration of its pathomechanisms: report of two cases

We experienced two cases whose low back pain was improved after vascular reconstructive surgery for arteriosclerosis obliterans in the abdominal cavity. Based on these observations, we propose the term "vascular backache" and we discuss possible pathomechanisms underlying this condition. One patient had a stenotic lesion in the lower abdominal aorta and was operated transluminally; the other patient had a diffuse stenotic lesion from the abdominal aorta to the femoral arteries and had an axillofemoral bypass operation. After surgery, they experienced a reduction of backache along with an improvement of the vascular intermittent claudication. It is suggested that one factor leading to low back pain in some cases might be various degrees of ischemia of the extensor muscles in the lumbar spine.

Tranilast inhibits the proliferation of human coronary smooth muscle cell through the activation of p21waf1

Restenosis after percutaneous transluminal coronary angioplasty (PTCA) occurs due to vascular smooth muscle cell proliferation and migration. Recently, tranilast, an anti-allergic drug, has been used for the prevention of restenosis after PTCA. To determine the molecular mechanism involved, the effect of tranilast on the proliferation of human coronary smooth muscle cells (SMCs) was investigated. Tranilast arrested the proliferation of human coronary SMCs at the G0/G1 phase of the cell cycle. In association with this inhibitory effect, tranilast increased p21waf1 and p53 tumor suppressor factor, and decreased cyclin-dependent kinase 2 (CDK2) activity. These results suggest that tranilast inhibits the proliferation of human coronary SMCs during restenosis after PTCA via an induction of p21waf1 and p53. Tranilast may thus allow us to prevent restenosis after PTCA by interfering with this mechanism.

Involvement of a chloroplast homologue of the signal recognition particle receptor protein, FtsY, in protein targeting to thylakoids

We isolated an Arabidopsis thaliana cDNA whose translated product shows sequence similarity to the FtsY, a bacterial homologue of SRP receptor protein. The Arabidopsis FtsY homologue contains a typical chloroplast transit peptide. The in vitro-synthesized 37 kDa FtsY homologue was imported into chloroplasts, and the processed 32 kDa polypeptide bound peripherally on the outer surface of thylakoids. Antibodies raised against the FtsY homologue also reacted with a thylakoid-bound 32 kDa protein. The antibodies inhibited the cpSRP-dependent insertion of the light-harvesting chlorophyll alb-binding protein into thylakoid membranes suggesting that the chloroplast FtsY homologue is involved in the cpSRP-dependent protein targeting to the thylakoid membranes.

Suppression of lipopolysaccharide-induced tumor necrosis factor-release and liver injury in mice by naringin

Suppressive effects of naringin on lipopolysaccharide-induced tumor necrosis factor (TNF) release followed by liver injury were investigated. Intraperitoneal (i.p.) treatment with naringin prior to an intravenous (i.v.) challenge of lipopolysaccharide significantly reduced serum TNF levels in a dose-dependent manner and was the most effective when administered 60 min prior to lipopolysaccharide challenge. Treatment with naringin 3 h prior to lipopolysaccharide challenge resulted in complete protection from lipopolysaccharide lethality in D-galactosamine-sensitized mice. Histological estimation revealed that massive cell infiltration followed by severe injury developed in the livers of lipopolysaccharide-treated and D-galactosamine-treated mice unless they had been pretreated with naringin. Appearance of apoptotic cells was also found to decrease by treatment with naringin. Increases in serum levels of aspartate aminotransferase, alanine aminotransferase and creatine kinase, responsible for lipopolysaccharide-induced liver injury, blocked by naringin administration and the levels were nearly to the normal level. These results indicate that action of naringin is mediated through suppression of lipopolysaccharide-induced TNF production.

Protective effects of the TNF-ceramide pathway against glutamate neurotoxicity on cultured mesencephalic neurons

Pretreatments with TNF-alpha and lower concentrations of C2-ceramide protected cultured mesencephalic neurons from excitotoxicity in a dose-dependent manner. These protective effects are reduced by cotreatment with N,N-dimethylsphingosine (DMS), an inhibitor of sphingosine kinase. Since the pretreatment with sphingosine-1-phosphate (SPP) showed a neuroprotective effect, our data suggest that protective effects of TNF and C2-ceramide could be attributable to their further metabolism to SPP.

Altered expression levels of G protein subclass mRNAs in various seizure stages of the kindling model

The expressions of mRNAs encoding G protein alpha subunits were analyzed in the cerebral cortex of amygdaloid kindled rats. A remarkable increase in Gsalpha mRNA were observed on the bilateral cerebral cortex at 24 h after the last generalized seizure and persisted 3 weeks on the unstimulated side. Gi2alpha mRNA level was also increased on the stimulated side at 24 h and persisted 3 weeks. These result suggest that dysfunction of Gs and Gi2 might relate to the basic mechanisms of seizure generation and the maintenance of epileptogenesis.

Does psychological stress improve physical performance?

The purpose of this study is to determine whether psychological stress enhances physical performance and how personality traits affect it. The annual physical test was chosen as the psychological stressor. Ninety three students ran 50 meters as part of the test and one week after that as a control. The pulse rate and time were measured and pulse rate was used as an indicator of psychological stress. All students took the anxiety-trait scale test of the State-Trait Anxiety Inventory. The pulse rate was higher and the time record was better in the annual physical test compared with that of control. When we categorized the subjects by the anxiety-trait scale test, only the high anxiety-trait students could run faster when faced with higher stress. In conclusion, psychological stress can enhance the physical performance of certain students. It is possible that psychological stress and personality traits interact and both of them affect physical performance.

Internalization of constitutive desmogleins with the subsequent induction of desmoglein 2 in pemphigus lesions

Acantholytic blisters in pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are caused by a dissociation of desmosomes mediated by autoantibodies against desmoglein (Dsg) 3 and Dsg 1, respectively. The blistering occurs at the suprabasilar level in PV and at the subcorneal level in PF, which corresponds to the distribution of target antigens in the epidermis: there is a more prominent expression of Dsg 1 in the upper layer, whereas Dsg 3 is more prominent in the lower layer. To elucidate the histogenesis of acantholysis, we studied the alterations of the desmosomal components and the expression pattern of Dsg isoforms in the lesional and perilesional epidermis of pemphigus patients. The results demonstrated an internalization of the desmosomes in the lower epidermis of PV, PF and pemphigus vegetans. A similar phenomenon was induced in monolayers of keratinocytes cultured with PV sera. However, little change was observed in E-cadherin expression until acantholysis became manifest. This internalization occurred prior to overt acantholysis, and was frequently associated with the induction of Dsg 2 expression in the basilar or lower layers of the epidermis. These findings indicate an alteration of Dsg isoform expression in subclinical pemphigus lesions, which might be related to the characteristic acantholytic patterns: the suprabasilar layer in PV and the upper epidermis in PF.

Gastric cancer with invasion limited to the muscularis propria

The clinicopathological features of 84 muscularis propria (mp) gastric cancers, defined as gastric cancer invading the muscularis propria of the stomach, were reviewed retrospectively, and compared with 267 early gastric cancers (m/sm cancer) and 333 gastric cancers invading beyond the subserosal layer (ss-si cancer). There were statistical differences in tumor size, histological growth pattern, cancer-stromal relationship, lymph node metastasis, lymphatic invasion, vascular permeation and operative procedure between mp gastric cancer and early gastric cancer or ss-si gastric cancer. The mp tumors were significantly larger than the early cancer tumors but significantly smaller than the ss-si tumors (P < 0.0001), and mp cancer had more frequent lymph node metastasis (50%) than did early gastric cancer (10%) but less frequent lymph node metastasis than did ss-si cancer (84%; P < 0.0001). Histologically, infiltrative and scirrhous types were more common in the mp cancer group than in the early cancer group. The frequency of vascular permeation in the mp cancer group was almost the same as that in the early cancer group. Univariate analysis revealed that the significant prognostic factors were nodal involvement (P = 0.0213) and lymphatic invasion (P = 0.0364). Multivariate analysis of the mp-invaded cancer cases, however, revealed that lymph node metastasis was not a significant prognostic factor, although it was more important than was lymphatic invasion. Multivariate analysis also revealed that the prognosis of our mp gastric cancer patients was affected most by vascular permeation, followed by tumor size.

Clinicopathologic prognostic features in patients with gastric cancer associated with esophageal or duodenal invasion

BACKGROUND

We evaluated the influence of several clinicopathologic variables on 5-year survival of patients with gastric cancer associated with esophageal or duodenal invasion, and determined the significance of resection line involvement.

PATIENTS AND METHODS

A review of the database for gastric adenocarcinoma at Sendai National Hospital between January 1985 and December 1995 identified 923 patients who underwent gastric cancer resection. Of these patients, 37 were reported to have tumour infiltration of the esophagus or duodenum on histological examination of the resected specimens. Univariate and multivariate analyses of patients with esophageal or duodenal invasion were performed to evaluate the prognostic significance of clinicopathologic features. Then the patients were divided into two groups based on the results of microscopic examination: a tumour wedge-positive group for resection margins of less than 5 mm in width and a tumour wedge-negative group for resection margins of more than 5 mm in width. There were 8 patients in the narrow (margin-positive) group and 29 patients in the wide margin (margin-negative) group, respectively.

RESULTS

Univariate analysis revealed that the significant prognostic factors were nodal involvement (p=0.0004) and gross type (p=0.0031). Multivariate analysis of the esophagus or duodenum-invaded cancer cases, however, revealed that only nodal involvement was a significant prognostic factor. There were statistical correlations between these groups (margin-positive and margin-negative groups) and the Borrmann type of tumour and tumour size. The survival rate was worse in patients with tumour line involvement.

CONCLUSIONS

Multivariate analysis revealed that the prognosis of patients with esophageal or duodenal invasion was affected only by nodal involvement independently. The risk of surgical margin involvement was high in cases of a large Borrmann type-4 tumour and infiltrative carcinoma.

The protective effect of good physical fitness when young on the risk of impaired glucose tolerance when old

BACKGROUND

The role of physical activity or fitness on preventing impaired glucose tolerance (IGT) has not been widely investigated. The present case-control study examined the relationship between the occurrence of IGT in men in their 50s and the level of their physical fitness while in their 30s.

METHODS

The subjects consisted of 38 male Japan Self-Defense Forces officials in their 50s who had IGT, as diagnosed by the 75-g oral glucose tolerance test, and 60 control individuals. Nine diabetics were included in the IGT cases. As an indicator of physical fitness between the ages of 30 and 39 years, we selected the best time recorded for each individual during that decade of life for the 1,500-m physical fitness test run. We calculated the odds ratio for IGT in relation to selected risk factors (including physical fitness), and a logistic regression analysis was used to adjust for possible confounding variables.

RESULTS

The odds ratio (95% confidence interval, P value) for IGT with physical fitness in their 30s was 0.25 (0.11-0.58, P < 0.05). With adjustment for a parental history of diabetes and body mass index in both their 30s and their 50s, the odds ratio was 0.31 (0.11-0.86, P < 0.05).

CONCLUSIONS

We concluded that the occurrence of IGT, including diabetes, in men in their 50s can be reduced by maintaining a high level of physical fitness while in their 30s.

Poorly differentiated, solid-type adenocarcinoma of the stomach

Data of 58 cases of poorly differentiated, solid-type adenocarcinoma of the stomach treated at our hospital between 1985 and 1995 were reviewed and compared to data of 146 cases of non-solid-type carcinoma in order to determine whether there are distinguishable clinicopathological features between these two types of carcinoma. Significant differences were observed with respect to tumor size, stage, macroscopic appearance, depth of invasion, histologic growth pattern, lymph node metastasis, microscopical lymphatic invasion and vascular permeation. Patients in the solid-type cancer group tended to have smaller tumors; the disease was in the early stage in 48% of the patients, and total gastrectomy was performed in only 20 of the 58 patients. Nodal involvement, lymphatic invasion and vascular permeation were also less common in patients with solid-type cancer. The overall survival rate of patients with solid-type carcinoma was higher than that of patients with non-solid-type carcinoma, though no significant differences were observed when corrected for stage. Our results suggest that poorly differentiated solid-type carcinoma of the stomach should be regarded as a distinct type of adenocarcinoma that has a good prognosis. The significant prognostic factors for this type of gastric cancer are lymphatic invasion and tumor location.

Does gastrojejunostomy for unresectable cancer of the gastric antrum offer satisfactory palliation?

BACKGROUND/AIMS

Gastrojejunostomy is the procedure of choice for patients with obstruction or stenosis of the gastric outlet or duodenum. However, the palliative benefits of this procedure in gastric cancer remain uncertain. Thus, the present study was performed to address this problem.

METHODOLOGY

In the present study, 52 patients who had undergone gastrojejunostomy for unresectable cancer of the gastric antrum at Kitasato University Hospital and Kitasato University East Hospital in Japan between 1972 and 1994 were examined.

RESULTS

The median survival time in these 52 patients was 5.0 months. The duration of palliation ranged from 0-13 months, with an average of 2.8 months. No significant difference between clinicopathologic factors and duration of palliation was found and location of tumor was the only independent prognostic factor (coefficient: 0.890; hazard ratio: 2.435).

CONCLUSIONS

Although gastrojejunostomy for unresectable cancer of the gastric antrum is the procedure most often chosen at laparotomy, the palliative benefits of gastrojejunostomy do not sufficiently compensate for the patients' limited post-operative survival and quality of life.

Strength distribution in the tibia

Stress fracture of a tibia is rarely associated with osteoarthros of the knee joint (gonarthrosis), whereas the present authors experienced a case of tibial stress fracture with high level lateral flail. To make an analysis with the statics of an elastic body, the shape of the tibia was read from a roentgenogram with a digitizer. The bend of a tibia was expressed with curvature (the reciprocal with curvature radius); fracture was expected to occur where the curvature was large. From the analysis, the fracture had occurred near one of the maximums of the curvature when the knee side was fixed and a force was applied to the ankle side --walking situation, e.g. The analysis also has indicated that the tibia would be very weak when the ankle side was fixed--skiing situation, e.g.

Acute effects of nucleus pulposus on blood flow and endoneurial fluid pressure in rat dorsal root ganglia

STUDY DESIGN

An experimental study to elucidate the initial factors in the pathogenesis of lumbar pain caused by disc herniation.

OBJECTIVE

To evaluate the effects of autologous nucleus pulposus on blood flow and endoneurial fluid pressure in dorsal root ganglia.

SUMMARY OF BACKGROUND DATA

Human sciatica is known to be associated with compression of lumbar nerve roots and dorsal root ganglia by herniated intervertebral discs. Recently, it has been shown that application of nucleus pulposus to nerve roots induces injury and pain-related behavior in experimental animals. In this study, the authors hypothesized that nucleus pulposus applied to a nerve root would cause increased intraneural edema and reduced blood flow in the corresponding dorsal root ganglia. Studies in peripheral nerves have shown that these initial pathophysiologic disturbances initiate complex events that exacerbate nerve injury and cause pain.

METHODS

A total of 29 adult female Sprague-Dawley rats weighing 200 to 250 g had their left L5 nerve roots and associated dorsal root ganglia exposed. Autologous nucleus pulposus was harvested from the tail and applied to the L5 nerve root just proximally to the dorsal root ganglia (nucleus pulposus group). For control, the same volume of muscle was harvested from the surgical area in the back and applied similarly to the neural tissue (control group). Blood flow was continuously monitored using a laser Doppler flow probe for 3 hours (n = 10) or 4 hours (n = 8) in animals with indwelling cannulas for measurement of systemic arterial pressure. Endoneurial fluid pressures were recorded with a servonull micropipette system using glass micropipettes with tip diameters of 4 microns. Endoneurial fluid pressure in the dorsal root ganglia was measured before and 3 hours after application of nucleus pulposus (n = 7) or muscle (n = 4). After measurement of blood flow and endoneurial fluid pressure, the nerve root and dorsal root ganglia were processed for histology and evaluated by light microscope.

RESULTS

Blood flow in the nucleus pulposus group was reduced by 10% to 20% from the initial value after 3 to 4 hours. This reduction was statistically significant compared with that of the control group (P < 0.01). Endoneurial fluid pressure was initially 2.6 +/- 1.2 cm H2O in the nucleus pulposus group, and 2.1 +/- 0.6 cm H2O in the control group. Three hours after application, endoneurial fluid pressure was 7.5 +/- 4.6 in the nucleus pulposus group (P > 0.05), and 2.0 +/- 0.8 in the control group (P > 0.05). Edema was the principal pathologic finding seen consistently in the nerve roots and in many of the associated dorsal root ganglia from animals treated with nucleus pulposus.

CONCLUSION

Application of nucleus pulposus to nerve root increased endoneurial fluid pressure and decreased blood flow in the dorsal root ganglia. This study's acute observations in the dorsal root ganglia may thus help to explain why disc herniations without compression of neural tissue are sometimes painful because similar pathologic findings are observed after only nucleus pulposus application to the nerve root. The authors further suggest that exposure of nerve roots to nucleus pulposus may establish a "compartment syndrome" in the dorsal root ganglia.

Effects of lidocaine on nucleus pulposus-induced nerve root injury. A neurophysiologic and histologic study of the pig cauda equina

STUDY DESIGN

Application of autologous nucleus pulposus on nerve roots and treatment with local application of lidocaine in the pig.

OBJECTIVES

Studies of the effects of lidocaine on nucleus pulposus-exposed nerve roots.

SUMMARY OF BACKGROUND DATA

Nerve root infiltration may improve radicular symptoms beyond the pharmacologic duration of local anesthetics, but the mechanisms for this effect are not known.

METHODS

Nucleus pulposus was harvested from a lumbar disc and placed onto the sacrococcygeal cauda equina in pigs. In Series 1, early lidocaine treatment of nucleus pulposus-induced nerve root injury, pigs received 2% lidocaine (n = 5) or saline (n = 5) before and after surgery. Nerve conduction velocity and histologic appearance were studied after 3 days. In Series 2, delayed lidocaine treatment of nucleus pulposus-induced nerve root injury, after 7 days 2% lidocaine was administered epidurally to nucleus pulposus-exposed (n = 4) and -nonexposed (n = 4) nerve roots. Nerve conduction velocity, muscle action potentials, and histologic appearance were assessed.

RESULTS

In Series 1, early treatment with lidocaine limited the reduction in nerve conduction velocity. The epidural inflammation was less in lidocaine treated animals. In Series 2, nerve conduction velocity was lower in nucleus pulposus-exposed animals than in nonexposed animals. The initial reduction of nerve conduction velocity and muscle action potential was similar between the groups, but the recovery of muscle action potential was slower and less complete in nucleus pulposus-exposed nerve roots. There was minimal histologic nerve injury in both series and in both protocols.

CONCLUSIONS

Early treatment with lidocaine may reduce nucleus pulposus-induced nerve root injury. Lidocaine induced a delayed recovery in nerve roots exposed to nucleus pulposus. Further studies are needed to clarify the therapeutic effects of nerve root infiltration and the pathophysiology of nucleus pulposus-induced nerve root injury.

[A survey of opioid use in preanesthetic medication]

A mailing survey was carried out to assess the current practice of sedative premedication in anesthesia. Questionnaires were sent by mail to 77 university hospitals. We especially evaluated use of opioids for premedication. Sixty-one percent (n = 47) of the hospitals answered these questionnaires and 31 percent (n = 15) of them were using opioids for the preanesthetic medication. Pethidine was used most frequently for premedication of all opioids, and morphine was often used for the premedication before cardiac surgery. All opioids were administrated intramusculary both in adults and children.

Detection rate of the cervical gland area during pregnancy by transvaginal sonography in the assessment of cervical maturation

OBJECTIVES

To detect the cervical gland area during normal pregnancy, and to determine its detection rate and relationship with cervical maturation.

DESIGN

This was a mixed longitudinal and cross-sectional sonographic study involving a total of 514 transvaginal scans performed for detection of cervical gland area and measurement of cervical length in 260 normal singleton pregnancies at 16-41 weeks of gestation. The conventional cervical maturation index was measured simultaneously by digital examination.

RESULTS

The detection rate of cervical gland area remained practically constant until the 31st week of pregnancy, but significantly decreased thereafter. Highly significant correlations were noted between the detection rate of cervical gland area and cervical length, cervical gland area and cervical maturation index, and cervical length and cervical maturation index.

CONCLUSIONS

This study showed for the first time that cervical gland area can be detected sonographically and that its absence might be a predictor of preterm labor.

Helicobacter pylori risk associated with sibship size and family history of gastric diseases in Japanese adults

Helicobacter pylori is thought to be a cause of gastric cancer. Risk factors of H. pylori positivity were investigated among 4,361 public service workers in Japan. Sera and information on family history and lifestyle were collected, and H. pylori antibody was measured using the sera. Sex- and age-adjusted odds ratios of factors expected to influence H. pylori seropositivity were calculated. The factors with a significant influence were included in a logistic regression model and the final model was obtained by backward elimination. Sibship size (4 and more vs. 1), smoking habit (current vs. never), and paternal and siblings' histories of gastric diseases showed significant relationships to H. pylori seropositivity, with odds ratios (95% confidence intervals) of 1.5 (1.0-2.1), 0.8 (0.7-0.9), 1.5 (1.3-1.8) and 1.7 (1.1-2.6) respectively. However, spouse's history was not related. In the final model, sibship size and paternal history remained as positive factors, and smoking as a negative one. Contradictory results on the relationship between H. pylori status and smoking among recent studies indicate the existence of hidden confounding factors. It is suggested that infection from family members in childhood considerably affects the H. pylori status of Japanese adults, whereas infection between adults is rare.