Expression of multidrug resistance gene product (P-glycoprotein) in transitional cell carcinomas of the upper urinary tract

We assessed the expression of P-glycoprotein, the product of the multidrug resistance gene, in 107 specimens from patients with transitional cell carcinoma of the upper urinary tract, using an immunohistochemical method with a polyclonal antibody. P-glycoprotein was expressed in 28 of 107 (26%) specimens. While P-glycoprotein expression was not related to the grade or stage of these tumors, the incidence of P-glycoprotein in specimens with tumors which coexisted in renal pelvic and ureter is significantly higher than those with either renal pelvic or ureter tumor alone. In the patients with advanced upper urinary tract tumor who had adjuvant chemotherapy including at least one P-glycoprotein-transported drug (mdr regimen), overall survival of patients with P-glycoprotein-positive tumor was significantly shorter than that of patients with negative tumor. This pilot study demonstrates that P-glycoprotein can be expressed in one fourth of transitional cell carcinomas of the upper urinary tract and that P-glycoprotein expression serves as a prognostic indicator in patients with these tumors who are treated with mdr regimens.

Effects of glyceryl trinitrate on blood pressure and arterial compliance

Glyceryl trinitrate (GTN) mainly reduces systolic blood pressure (SBP) rather than diastolic blood pressure (DBP) in acute conditions. To examine the efficacy of GTN as an antihypertensive agent in patients with isolated systolic hypertension (ISH), the authors examined the effects of GTN on BP and arterial compliance (AC) in patients who underwent cardiac catheterization. Seventy patients (with old myocardial infarction, 36; angina pectoris, 25; chest pain syndrome, 9) who underwent cardiac catheterization because of chest pain were included in this study. They were aged between thirty-seven and seventy-four (mean sixty-one) years. According to the levels of BP at cardiac catheterization, the authors selected two subgroups: the normotensive group (NT group, n = 18) and the isolated systolic hypertensive group (ISH group, n = 20) from all subjects. The authors measured BP before and after (three minutes) sublingual administration of GTN (0.3 mg) at the cardiac catheterization. AC was assessed by means of diastolic pressure decay. The change of BP was estimated by the differences between values before and at three minutes after GTN. After administration of GTN, SBP was decreased significantly from 157 +/- 25 to 142 +/- 23 mmHg (P < 0.01), while DBP did not change (83 +/- 13 vs 84 +/- 15 mmHg). The change in SBP was positively correlated with the pretreatment SBP and negatively correlated with AC (r = 0.51, P < 0.001; r = 0.39, P < 0.001, respectively). AC was significantly lower in the ISH group than in the NT group (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

[Antigen-induced dynamic alterations of endothelin receptors--guinea pig lung tissues]

Endothelins (ETs) are a family of peptides with potent constrictive activity in vascular and treacheal smooth muscle. The lung tissues are abundant in these peptides and their receptors; the peptides are produced by endothelial cells and airway epithelial cells, while its receptor is mainly located on smooth muscle. Therefore, it has been proposed that endothelins act in a paracrine fashion on nearby smooth muscle, thus regulating its tone. However, little is known about its physiological and pathological roles in pulmonary functions. We hypothesized that ET plays an important role in bronchoconstriction elicited by antigen challenge. In order to test this hypothesis, we investigated tracheal contractile activities and ET-receptors by employing an animal model in guinea pigs. Here, we report that guinea pigs who were sensitized followed by multiple challenges with the antigens had alterations of ET receptor(s) with respect to number and affinity.

Localization of Cu/Zn and Mn superoxide dismutase in various thyroid disorders

The intracellular localization of Cu/Zn- and Mn-superoxide dismutase (SOD), which catalyze the dismutation of superoxide radicals (O2-) to O2 and H2O2, was studied in the thyroid tissue of various thyroid disorders by an immunohistochemical technique. The concentrations of both SODs in those tissues were measured also by a sandwich enzyme immunoassay technique. Copper/zinc-SOD in thyroid tissues were identified by immunocytochemical staining in most cases of papillary carcinoma and in some cases of other thyroid disorders. In normal follicular cells this enzyme is localized in the perinuclear cytoplasm, whereas in thyroid tumor or hyperplastic follicular cells it exists homogeneously in cytoplasm. Manganese-SOD stained strongly in papillary carcinoma and papillary-growing cells in the thyroid tissue of adenoma and Graves' disease. The concentrations of Cu/Zn-and Mn-SOD in thyroid tumor tissues and hyperplastic follicular disorders were significantly higher than those in normal thyroid tissue when they were compared as a function of protein or deoxyribonucleic acid contents. The ratio of Mn-SOD to Cu/Zn-SOD was significantly higher only in papillary carcinoma, except for other thyroid disorders as compared with that in the normal thyroid. In conclusion, SOD seems to be related to cell proliferation and differentiation in the thyroid follicular cell because Cu/Zn-SOD changes its localization in tumor and hyperplastic follicular cells and because the Mn-SOD concentration is increased in papillary carcinoma or papillary-growing cells.

Precise assessment of myocardial damage associated with secondary cardiomyopathies by use of Gd-DTPA-enhanced magnetic resonance imaging

To evaluate the myocardial damage in patients with secondary cardiomyopathies, the authors examined gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) in 5 patients (2 with cardiac amyloidosis, 2 with acute myocarditis, 1 with cardiac thyrotoxicosis). MR images were performed at 1.5-T by using a spin echo pulse sequence before and after intravenous administration of Gd-DTPA (0.2 mmol/kg). All patients revealed distinct high-intensity areas on postcontrast images. Moreover, MRI with Gd-DTPA could determine the severity and precise regions of myocardial damage associated with secondary cardiomyopathies. It is suggested that gated cardiac MRI with Gd-DTPA enhancement is useful for detecting the myocardial damage in secondary cardiomyopathies.

A patient with cardiac amyloidosis presenting a rapid increase in technetium-99m-hydroxymethylene diphosphonate accumulation

We assessed the changes in cardiac condition in a patient with cardiac amyloidosis, by means of dual nuclei single photon emission computed tomographic (SPECT) images with technetium-99m-hydroxymethylene diphosphonate (99mTc-HMDP) and thallium-201 (201Tl). Dual SPECT showed a marked increase in myocardial 99mTc-HMDP accumulation along with deterioration of symptoms and signs, while 201Tl scintigraphy remained almost unchanged.

Atrial natriuretic peptide and left atrial systolic function in normal subjects

The purpose of this study is to elucidate factors determining the release of atrial natriuretic peptide (ANP) in normal volunteers at rest. Ten normal volunteers were included in this study. Ages ranged between twenty-seven and thirty-three years (mean twenty-seven). The authors measured plasma levels of ANP, and four cardiac chamber volumes, and their functions by cine magnetic resonance imaging using the rephased gradient-echo method. Plasma levels of ANP in 10 normal subjects were 15.0-37.1 pg/mL (mean 23.6 pg/mL). No significant relationship was seen between ANP level and heart rate or blood pressure. The level of ANP was positively correlated with left atrial (LA) emptying fraction and negatively correlated with LA minimal volume (r = 0.85, P < 0.01; r = 0.64, P < 0.05, respectively). No significant relationship was observed between plasma ANP level and left ventricular, right ventricular, or right atrial parameters. These results suggest that LA systolic function is one of the major determinants for ANP release in normal subjects at rest.

IC101, extracellular matrix antagonist produced by Streptomyces sp. MJ202-72F3. Production, isolation, structure determination and biological activity

In our search for inhibitors of cell adhesion to components of extracellular matrix (ECM), fibronectin, laminin and collagen type IV, we succeeded in finding a novel cyclic hexadepsipeptide antibiotic, named IC101, which was isolated from cultured mycelium of Streptomyces albulus MJ202-72F3. It was purified by centrifugal partition chromatography, preparative reverse phase HPLC and Sephadex LH-20 and was obtained as a white powder. IC101 strongly inhibited cell adhesion to ECM components, suppressed immune responses in vitro and in vivo, and exhibited antimicrobial activity on Gram-positive bacteria.

Acetylcholine-induced myocardial ischemia without epicardial coronary artery spasm: a possible vasospasm of small coronary arteries--a case report

Small-vessel vasospasm has been speculated upon as a possible cause of chest pain in patients with normal-appearing coronary angiograms. In this report, a patient who experienced typical chest pain during acetylcholine testing, which caused ST segment elevation without epicardial coronary spasm, is presented. This finding suggests that small-vessel vasospasm may be involved in the induction of myocardial ischemia in patients with normal epicardial coronary arteries.

Production of nerve growth factor by cultured vascular smooth muscle cells from spontaneously hypertensive and Wistar-Kyoto rats

OBJECTIVE

Nerve growth factor (NGF) is a neurotrophic protein which acts on peripheral sympathetic nerves. Elevated NGF in vascular tissues of young spontaneously hypertensive rats (SHR) has been reported. The aim of the present study was to compare the amount of NGF secreted from cultured vascular smooth muscle cells (VSMC) and mesenteric artery and thoracic aorta segments from SHR and Wistar-Kyoto (WKY) rats.

METHODS

VSMC prepared by the enzyme digestion method from the thoracic aortic media of 14-week-old SHR and age-matched WKY rats were subcultured in Dulbecco's modified Eagle's medium containing 10% fetal calf serum. Segments of mesenteric artery and thoracic aorta from 4-week-old SHR and age-matched WKY rats were similarly cultured. The NGF content in conditioned medium was measured using an enzyme immunoassay. The protein content of VSMC was measured by the Lowry method.

RESULTS

Total NGF content in the cell culture medium was increased during an exponential growth phase and then gradually decreased during a quiescent phase in both rat strains. There were no significant differences in the levels of NGF secreted from mesenteric artery and thoracic aorta segments between the SHR and WKY rats. The differences in cellular protein content between SHR and WKY rats were very small.

CONCLUSIONS

In contrast to the reports of increased NGF in SHR tissues, our data demonstrate that NGF secretion was lower in VSMC from SHR, and was equivalent in mesenteric artery and thoracic aorta segments from SHR and WKY rats. We have no clear explanation for these observations, but the present results indicate that upregulation of NGF in SHR tissues is not responsible for a simple enhancement of NGF synthesis in VSMC, and suggest a breakdown of the regulatory mechanism or mechanisms of NGF gene expression in SHR tissues.

Adjuvant chemotherapy for patients with soft tissue sarcoma

Forty patients with soft tissue sarcoma (Enneking's stage I and II) were treated in our department between 1965 and 1992. We administered VACA regimen (composed of vincristine, actinomycin-D, cyclophosphamide, and doxorubicin) to 14 of 40 patients. Among 40 patients, the 5-year survival rate was 56% in 14 patients with chemotherapy and 39% in 26 without chemotherapy (p < 0.02). In 32 patients of Stage II, the 5-year survival rate was 40% in 11 patients with chemotherapy and 31% without chemotherapy (p < 0.05). The improvement of the survival rate was due to delay in the development of lung metastases (chemotherapy group: 21.2 months after first visit, non-chemotherapy group: 9.4 months) and prolongation of the survival period after metastases (chemotherapy group: 26 months, non-chemotherapy group: 7.4 months).

Cardioplegic effect of University of Wisconsin solution on hypothermic ischemia of rat myocardium assessed by mitochondrial oxidative phosphorylation

The effectiveness of the University of Wisconsin solution and the Collins' M solution for preservation of rat hearts was compared by examining histologic appearance, tissue water content, and mitochondrial respiratory functions after prolonged hypothermic storage and subsequent heterotopic transplantation. Survival of transplanted hearts after 5 days of reperfusion was markedly lowered by storage in Collins' M solution for 15 hours. Hearts stored in University of Wisconsin solution for 10 hours showed no increase in myocardial necrosis after 5 days of reperfusion, whereas hearts stored in University of Wisconsin solution for 15 hours and Collins' M solution for 10 and 15 hours showed a significant increase in tissue necrosis. University of Wisconsin solution reduced tissue swelling during hypothermic storage, whereas Collins' M solution did not cause such reduction. The yield of mitochondrial protein after reperfusion was significantly decreased by storage in either solution, especially after 15 hours in Collins' M solution. Mitochondrial oxidative phosphorylation was significantly inhibited by storage, especially by storage in Collins' M solution and subsequent reperfusion. These results indicate that myocardial injury, after prolonged ischemia and reperfusion, results in a decrease in functionally and structurally intact mitochondria that is dependent on preservation conditions. University of Wisconsin solution protects isolated hearts against ischemia and reperfusion injury possibly by preventing cellular and mitochondrial deterioration.

Neoadjuvant chemotherapy using a platinum, vincristine and peplomycin (CVP) combination in patients with carcinoma of the uterine cervix

Neoadjuvant chemotherapy consisting of a cis-platinum, vincristine and peplomycin (CVP) combination has been used to treat patients with carcinoma of the uterine cervix at our departments since 1983. Twenty-one patients are reviewed in this study. A high response rate (71.4%) was obtained with 19.0% complete and 52.4% partial responses prior to radical therapy. Survival times and the progression free interval for stage I and III disease treated with CVP show improvement compared to patients not treated with CVP. No life-threatening toxicity related to chemotherapy was noted. This combination chemotherapy used in neoadjuvant setting warrants further study.

Dephostatin, a novel protein tyrosine phosphatase inhibitor produced by Streptomyces. I. Taxonomy, isolation, and characterization

A novel inhibitor of protein tyrosine phosphatase, dephostatin, was isolated from the culture broth of a strain of Streptomyces. The active principle was extracted from the broth filtrate with ethyl acetate and purified by silica gel chromatography and by HPLC. Dephostatin inhibited protein tyrosine phosphatase prepared from a human neoplastic T-cell line with an IC50 at 7.7 microM. The inhibitory pattern of dephostatin was competitive against the substrate. Dephostatin inhibited the growth of Jurkat cells.

[Effect of Na-L-glutamate on mitochondrial function of ATP synthesis after prolonged preservation in rat heart]

We studied the effect of Na-L-glutamate (Glu) on mitochondrial functions of ATP synthesis after prolonged hypothermic preservation of rat hearts. We divided isolated rat hearts into the following three groups: group A, hearts without immersion as control; group B, hearts immersed in Euro-Collins solution (E-C) without Glu for 24 h at 4 degrees C; group C, hearts immersed in E-C with 10mM Glu for 24 h at 4 degrees C. Number of each group used was 6. Mitochondrial functions of ATP production were determined by measuring respiratory control index (RCI). P/O ratio and state III respiration rate. The ability of ATP production (oxidative phosphorylation rate, OPR) was calculated. RCI and P/O ratio of groups B and C were significantly lower than those of group A. RCI and P/O ratio of group C were significantly higher than that of group B. S3 rates of groups B and C were significantly lower than those of group A. S4 rate of group B was significantly higher than those of groups A and C. OPRs of groups B and C were significantly lower than that of group A. OPR of group C was significantly higher than that of group B. We concluded that Na-L-glutamate effectively protected mitochondrial functions to synthesize ATP during prolonged hypothermic preservation.

Hepatitis in an adult with rubella

Rubella was accompanied by hepatic dysfunction in a 28-year-old male. Serum aminotransferase levels were moderately elevated and LDH markedly increased, especially LDH isoenzyme 5, whereas total bilirubin and ALP remained almost normal. GOT, GPT and LDH levels were completely normalized by the 21st hospital day. Paired antibody titers of viruses which may cause hepatitis, other than rubella, were of no significance. Laparoscopy showed enlarged, red liver. Histologic and electron microscopic findings of the liver were consistent with acute hepatitis. Hepatic damage with rubella is rare, and it is possible that the hepatic dysfunction seen in adult rubella may be mediated by an immunopathologic mechanism.

Delaminomycins, novel extracellular matrix receptor antagonist. IV. Structure-activity relationships of delaminomycins and derivatives

Delaminomycins A, B, C and their derivatives were prepared and investigated biological activities of them. Among these compounds, spiro compounds (A2, B2 and C2) showed stronger inhibitory activity than natural products (A1, B1 and C1) on B16 melanoma cells adhesion assay and Con A-induced proliferation of murine splenic lymphocytes assay. In MLCR and antimicrobial assay, however, A1, B1 and C1 showed more potent inhibitory activity than spiro compounds (A2, B2 and C2). On the other hand, as to C-5' substituents of pyrrolidine ring, the order of inhibitory activity was R = OH > R = OCH3 > R = H on Con A-induced proliferation of murine splenic lymphocytes assay. In MLCR and antimicrobial assay, however, the order of inhibitory activities were R = H > R = OCH3 > R = OH. Inhibitory activities of A4 which was lacked pyrrolidine ring were reduced on B16 melanoma cells adhesion assay and on cytotoxicity against tumor cells in vitro in comparison with those of A1.

Ewing's sarcoma: evaluation of chemotherapy in 17 cases

Seventeen patients with Ewing's sarcoma were divided into 3 groups according to treatment. Ten patients were treated with complete chemotherapy; 9 with VACA protocol, composed of vincristine, actinomycin-D, cyclophosphamide and doxorubicin, and the remaining 1 with T-11 protocol. Four were given incomplete VACA protocol, and another 3 received no chemotherapy. Clinical results were evaluated in the three treatment subgroups described above. All patients without systematic chemotherapy died from lung metastasis within 1 year of the initial treatment. Three of 4 patients who were given incomplete chemotherapy died after a mean survival period of 17.7 months, and one developed cancerous pleuritis after 38 months. In the group receiving complete systematic chemotherapy, 5 of 10 patients are alive, and 2 have been disease-free for more than 3 years. Distant metastasis is likely when viable cells persist at the site of the primary tumor, even if the tumor size has been considerably reduced by preoperative chemotherapy. Therefore, immediate initiation of intensive chemotherapy and maintenance for the full course of therapy can improve the prognosis of Ewing's sarcoma.

Aortic valvular disease and right coronary artery stenosis induced by mediastinal irradiation--report of a case

This report presents a case of aortic valvular dysfunction and right coronary artery disease following radiation therapy on the mediastinum. A 61-year-old woman had received mediastinal radiation for the treatment of right mammary cancer 20 years previously. She developed symptoms of congestive heart failure 6 months ago. The patient was found to have aortic valvular dysfunction and proximal stenosis of the right coronary artery. Surgical aortic valve replacement improved cardiac status, and vasodilator treatment reduced ischemia due to right coronary artery stenosis.

Delaminomycins, novel nonpeptide extracellular matrix receptor antagonist and a new class of potent immunomodulator. I. Taxonomy, fermentation, isolation and biological activity

In order to develop a new class of immunomodulator we have searched for a low molecular weight inhibitors of cell adhesion to components of extracellular matrix (ECM), fibronectin (FN), laminin (LM) and collagen type IV (CL), and succeeded to find a group of novel antibiotics, named delaminomycins. Delaminomycins were isolated from the mycelium and cultured broth of Streptomyces albulus MJ202-72F3. It was purified by use of centrifugal partition chromatography (CPC), preparative reverse phase HPLC and Sephadex LH-20 and was obtained as a white powder. Delaminomycins with inhibitory activity for cell adhesion to ECM components suppressed immune responses in vitro and in vivo and exhibited antimicrobial activity on Gram-positive bacteria.

Coronary artery ectasia--a case report and literature review

A case report of coronary artery ectasia is presented. A middle-aged man was admitted with sudden onset of respiratory arrest which is a rather rare occurrence. Relevant articles are reviewed, and discussion mainly concerns the etiologic and pathophysiologic point of view.

Morphological characteristics of hypertrophic cardiomyopathy estimated by left ventriculography

To determine the common morphological characteristics of hypertrophic cardiomyopathy (HCM) by ventriculography from a right anterior oblique projection, diaphragmatic and free wall configurations were analyzed in 15 patients with obstructive HCM (HOCM), 32 patients with nonobstructive HCM (HNCM) and 17 controls. There was a convexity extending into the left ventricle in the right anterior oblique projection due to hypertrophy of the interventricular septum (IVS) in all patients with HCM. The peak convexity, where septal thickness was maximal (M point), was closer to the base in HOCM than in HNCM. Due to this convexity, the left ventricle showed a catenoid-shaped distortion at the M point. The distortion was severer in HOCM than in HNCM. Left ventricular free wall (LVFW) thickness was measured at the base and near the apex. LVFW thickness in HOCM decreased toward the apex, similar to that in controls, but in 17 of 32 HNCM (53%) LVFW thickness increased toward the apex. Cardiac index and stroke index in HCM were significantly smaller than those in controls. There was a significant correlation between the position of the M point and stroke index in HCM. These results indicate that a common morphological characteristic of HCM on the diaphragmatic side is the existence of a convexity extending into the left ventricle, and that cardiac performance in HCM is greatly influenced by the nature of the convexity. Myocardial abnormality seems to exist primarily at the base of the IVS in HOCM, and primarily in the lower part of the IVS and LVFW in HNCM.

Effects of casein and soy protein on accumulation of cholesterol and dolichol in rat liver

A diet containing 15% (w/w) fat and 20% (w/w) of either casein (CAS) or soy protein (SOY) was fed to 4-week-old rats for a period of 18 months. The effects of these dietary proteins on the accumulation of cholesterol and dolichol in livers were studied. After 1 month, the amount of liver cholesterol was about 5 mg/g of liver. After an additional 5 months of feeding, there was a slight decrease in cholesterol per gram of liver (3.6 mg/g of liver in CAS-fed rats and 2.6 mg/g of liver in SOY-fed rats). However, after 18 months, there were a remarkable increase (7.5 mg/g of liver) in CAS-fed rats and only a slight increase in SOY-fed rats. The proportions of liver cholesterol ester in rats fed the CAS diet were 60-70% of the total cholesterol during the experimental period, but in the case of the SOY diet, only rats fed the diet for 1 month showed a high level, 70%, of cholesterol ester. The amounts of liver dolichol in rats fed the CAS and SOY diets after feeding for 18 months were 60 micrograms and 47 micrograms of liver, respectively. There was a 1.5-fold increase in both diets for a period of 18 months. The proportions of liver dolichyl fatty ester in rats fed the CAS diet were 35-40% of the total dolichol during the experimental period, but in the case of the SOY diet, only rats fed the diet for 1 month showed a high level, 36%, of dolichyl fatty ester. The proportions of dolichol ester in rats fed the SOY diet were 25-30% after 6 and 18 months of feeding. These observations indicated that the SOY diet depresses the accumulation of both liver dolichol and cholesterol.