296 EFFECT OF GnRH AND ESTRADIOL BENZOATE INJECTION ON SUPEROVULATORY RESPONSE IN EARLY POSTPARTUM SUCKLING JAPANESE BLACK COWS

The objective of this study was to investigate the effect of GnRH and EB injection on the SOV response in early postpartum suckling Japanese Black cows. Forty-eight cows were included in this study. All cows received a controlled internal-drug-releasing device containing 1.9 g progesterone (CIDR; Easi-Breed; InterAg, Hamilton, New Zealand) at 40 days postpartum, and were subsequently superstimulated with a total dose of 20 armour units FSH (Antrin 40; Kawasaki-Mitaka, Kanagawa, Japan) twice daily, with gradually decreasing doses from day 45 till day 47. CIDR was withdrawn with 0.75 mg of cloprostenol (Estrumate; Nagase Medicals, Itami, Japan) injection at day 47. After FSH treatment, the cows were assigned to 3 groups: (1) 100 μg GnRH (Conceral; Nagase Medicals) injection at day 49 (GnRH, n = 19), (2) 2 mg EB (Kawasaki-Mitaka) injection at day 48 (EB, n = 15), and (3) control (n = 14). AI was carried out twice based on the estrous behavior of the cows, which was examined several times daily. Embryos were nonsurgically collected 7 to 8 days after estrus. The ovaries were examined by ultrasonography, and the number of CL and unovulated follicles (UF) were counted. After uterine flushing, the cows were re-employed for reproductive purposes. The intervals to first estrus after flushing and days open were examined. Blood samples were collected temporally, and concentrations of progesterone (P4) and estradiol (E2) were measured. The ovaries were examined by ultrasonography and the number of CL, small follicles (<5 mm in diameter), medium follicles (between 5 and 10 mm in diameter), and large follicles (>10 mm in diameter) were counted temporally. Data were analyzed by GLM and Dunnett’s T3 test. There were no significant differences between both treatment groups and the control group in the number of CL (15.2 ± 6.8, 18.9 ± 9.4, and 14.9 ± 8.9 in the GnRH, EB, and control groups, respectively; mean ± SD), UF (5.3 ± 3.2, 4.7 ± 3.2, and 7.2 ± 9.5, respectively), recovered ova or embryos (11.4 ± 8.1, 11.1 ± 8.9, and 11.1 ± 9.1, respectively), transferable embryos (6.8 ± 5.3, 7.5 ± 7.6, 7.2 ± 6.7, respectively), and freezable embryos (6.3 ± 5.6, 6.6 ± 7.9, and 5.7 ± 6.1, respectively). Furthermore, there were no significant differences in the intervals to first estrus after flushing and days open (12.7 ± 13.6 and 90.0 ± 23.1 in the GnRH, 8.6 ± 5.3 and 79.1 ± 20.1 in the EB, and 9.4 ± 6.0 and 88.5 ± 33.8 in the control groups, respectively). Changes in the P4 level were similar among the 3 groups. The E2 level of the EB group at 15 h after EB injection was significantly higher (P < 0.05) than that in the other groups (19.0 ± 15.7, 49.4 ± 22.8, and 8.0 ± 5.7 pg mL–1 in the GnRH, EB, and control groups, respectively). The number of small follicles in the control group (17.0 ± 12.2) was significantly greater (P < 0.05) than that in the GnRH group (7.4 ± 7.2) at the first AI. These results suggest that EB and GnRH injection after SOV treatment in early postpartum Japanese Black cows does not affect the SOV response or embryo quality.

Cloning and characterization of the antigenic membrane protein (Amp) gene and in situ detection of Amp from malformed flowers infected with Japanese hydrangea phyllody phytoplasma

A Japanese hydrangea phyllody (JHP) disease found throughout Japan causes economic damage to the horticultural industry. JHP phytoplasma-infected Japanese hydrangea plants show several disease symptoms involved in floral malformations, such as virescence, phyllody and proliferation. Here, we cloned and characterized the antigenic membrane protein (Amp) gene homolog from the JHP phytoplasma (JHP-amp), expressed the JHP-Amp protein in Escherichia coli cells, and then obtained an antibody against JHP-Amp. The antibody against JHP-Amp had no cross-reactions with the antibody against the Amp protein from a closely related onion yellows phytoplasma. This serologic specificity is probably due to the high diversity of the hydrophilic domains in the Amp proteins. The in situ detection of the JHP-Amp protein revealed that the JHP phytoplasma was localized to the phloem tissues in the malformed flower. This study shows that the JHP-Amp protein is indeed a membrane protein, which is expressed at detectable level in the JHP phytoplasma-infected hydrangea.

Biochip array-based analysis of plasma cytokines in HIV patients with immunological and virological discordance

Assessment of cytokines in body fluids or cells provides important information in understanding the disease process and designing treatment strategies. Recent introduction of antibody-based protein arrays have provided investigators simultaneous and specific detection of multiple analytes in a single sample using minimum volumes. In this study, we used a biochip array system capable of measuring 12 cytokines and growth factors (IL-2, IL-4, IL-6, IL-8, IL-10, IL-1alpha, IL-1beta, IFN-gamma, TNF-alpha, monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF)) in HIV patients with immunological and virological discordance (discordant) to find out differences if any, in their plasma cytokine profiles when compared with concordant HIV-infected individuals. A sandwich chemiluminescent assay was performed with plasma specimens of 110 HIV patients (55 discordant, 55 concordant) and 22 normal healthy individuals followed by enzyme-linked immunosorbent assay (ELISA) to the confirm levels of cytokines and growth factors that showed significant differences in the two groups. The discordant HIV patients showed significantly higher levels of plasma VEGF (P = 0.001) and EGF (P = 0.034) levels when compared with concordant patients. Overall, the patients showed significantly higher levels of TNF-alpha, MCP-1 and VEGF when compared with the normal healthy controls (P < 0.05). ELISA for VEGF (P < 0.001) and EGF (P = 0.004) confirmed the comparison obtained with biochip array, between the discordant and concordant patients. The results of cytokine quantitation by biochip array and ELISA confirmed that this technology is not only comparable but also has a good potential in the future applications involving measurement of multiple cytokines with limiting specimens.

Fine needle aspiration cytology of high grade T-cell lymphomas in human T-lymphotropic virus type 1 carriers

We studied the fine needle aspiration (FNA) cytology of high grade peripheral T-cell lymphomas from eight human T-lymphotropic virus-1 (HTLV-1) positive patients. FNA smears from seven lymphomas showed a distinctive cytologic pattern with a dominance of rounded cells with irregular nuclei and a moderately basophilic cytoplasm. Irregular cells with a pale abundant cytoplasm were present in varying amounts. Some smears contained a few giant cells with cerebriform nuclei. In addition, plasma cells and eosinophils were found. Epithelioid cells were an inconstant finding. On histology these seven lymphomas were assigned to the pleomorphic medium-large cell subtype and all but one were of T-helper phenotype with rearrangements of the T-cell receptor. FNA smears from a lymph node in a patient with a previous histological diagnosis of lymphomatoid papulosis of the gingiva showed a monotonous pattern of large immunoblastic cells with some binucleated variants consistent with a diagnosis of high grade immunoblastic lymphoma, which was confirmed histologically. Our results show that peripheral T-cell lymphomas from HTLV-1 positive patients have cytological patterns which are distinctive enough to allow a conclusive diagnosis of high grade T-cell lymphoma. However, we do not think that the cytology of HTLV-1 positive lymphomas can be differentiated from that of virus-unrelated high grade T-cell lymphomas.

Should all patients with duodenal adenocarcinoma be considered for aggressive surgical resection?

BACKGROUND

Long-term survival for duodenal adenocarcinoma is inconsistent in the literature, and the biology of duodenal adenocarcinoma is poorly understood.

METHODS

One institution's experience with duodenal adenocarcinoma from 1984 to 2005 is reviewed. Clinicopathologic data were analyzed, and overall survival was estimated using Kaplan-Meier curves with log-rank test.

RESULTS

Of the 52 patients, 35 (67%) underwent potentially curative surgery; 31 survived the postoperative period and were included in the analysis. Of these, the median survival was 34 months (range 6 to 186 months) compared with 13 months (range 1 to 24 months) for those not undergoing curative surgery (P < or = .001). Clinicopathologic factors favoring long-term survival were tumor size >3.5 cm (P < or = .001) and T-stage < or =4 (P = .014).

CONCLUSIONS

Clinicopathologic factors important to survival in duodenal cancer are T4 tumor status and tumor size. Interestingly, larger tumors were less likely to be invasive, and patients with these tumors had improved survival. The biology of this cancer is poorly understood; therefore, aggressive resection for all duodenal adenocarcinomas is recommended for all patients medically fit to undergo resection.

A high incidence of late-onset neutropenia following rituximab-containing chemotherapy as a primary treatment of CD20-positive B-cell lymphoma: a single-institution study

BACKGROUND

Late-onset neutropenia (LON) has been reported following rituximab-containing chemotherapy. Its incidence and risk factors, however, have not been extensively studied.

PATIENTS AND METHODS

We retrospectively reviewed the medical records of 107 patients treated with rituximab-containing chemotherapy as a primary treatment of CD20-positive B-cell lymphomas and identified cases with LON as defined by the neutrophil count of <or=1.0 x 10(9)/l without an apparent cause after the recovery of neutrophil count following completion of the intended chemotherapy.

RESULTS

With a median follow-up of 411 days, 23 patients developed LON out of the 107 at a median of 106 days after the last chemotherapy. Cumulative incidence of LON among the total patients was 24.9%. The median neutrophil count nadir was 0.61 x 10(9)/l. The LON episodes were generally self-limited, and filgrastim was administered in one patient. Including this patient, there were no serious infectious episodes in the cases with LON. In multivariate analysis, intensive chemotherapy regimens including high-dose therapy followed by autologous hematopoietic stem cell transplantation (ASCT) and high-dose methotrexate-containing regimens without ASCT were a risk factor for LON.

CONCLUSION

This study suggests that LON is a frequent complication of rituximab-containing intensive chemotherapy.

274 LOCALIZATION OF MACROPHAGE COLONY STIMULATING FACTOR (M-CSF) GENE IN THE ENDOMETRIUM OF JAPANESE BLACK COW

Macrophage colony stimulating factor (M-CSF), a member of the group of hemopoietic cytokines, plays an important role in placental physiology of humans and mice. The objective of this study was to investigate the localization of M-CSF gene in bovine endometrial tissues during pregnancy using in situ hybridization (ISH). Twelve Japanese Black cows aged between 1.4 and 14.5 years, with normal estrous cycles, were used in this study. They were observed daily for estrous behavior, and the day of estrus was considered as Day 0. Cows were artificially inseminated, and pregnancy was confirmed by presence of conceptus and/or corpus luteum using ultrasonography. They were euthanized and their uteri were collected on Days 20 to 21 (n = 2), 36 to 42 (n = 3), 59 to 64 (n = 3), 127 to 137 (n = 2), and 225 to 226 (n = 2) of pregnancy. Pregnancy was confirmed finally by the presence of a conceptus in the uterus, and the uterus was isolated by dissection, avoiding damage of the uterine artery. The uterus was perfused with 4% paraformaldehyde (PFA) solution using catheters inserted into the uterine artery, and placental tissues were isolated by dissection. Each tissue was cut into small pieces (5 mm thick) and fixed in 4% PFA solution. After being fixed in 4% PFA solution for 20 to 24 h, tissue pieces were embedded in paraffin using routine procedures. Several tissue pieces were collected from each individual cow. Sections (6 mm thick) were cut and placed on MAS-coated glass slides (Matsunami Glass, Kishiwada, Japan). The sections were dried in an oven for 3 days at 40�C. Antisense and sense biotin-labeled oligonucleotide probes for bovine M-CSF were designed from the sequence information (GenBank accession number D87917). Sense probe was used as the negative control. ISH was carried out using the GenPoint System (DakoCytomation, Glostrup, Denmark) according to the manufacturer&apos;s instructions. The sections were observed under an Eclipse 800 microscope (Nikon, Tokyo, Japan), and the positive signal for M-CSF gene was detected. Density analysis was performed by using Scion Image (Scion Corporation, Frederick, MD, USA). Data were analyzed by one-way ANOVA and Tukey-Kramer&apos;s HSD, using 0.05 as a significant level. The M-CSF gene was expressed in the stromal and luminal epithelial cells of endometrium, stromal cells of the fetal cotyledonary villus and caruncular crypt, and mono- and multi-nuclear epithelium cells of the fetal cotyledonary villus and caruncular crypt. Intensities of M-CSF gene-positive signals in all positive cells at Days 225 to 226 of pregnancy were stronger than those at other periods (P &lt; 0.05). These results suggest that M-CSF is produced in several cell types in the endometrium and placental tissues and may play important roles in bovine pregnancy.

Preservation of ovarian function by ovarian shielding when undergoing total body irradiation for hematopoietic stem cell transplantation: a report of two successful cases

The purpose of this study was to evaluate the possibility of preserving ovarian function by ovarian shielding to reduce the irradiation dose in total body irradiation (TBI). The subjects in the study were females aged less than 40 years, who were undergoing allogeneic hematopoietic stem cell transplantation using a TBI-based regimen and who desired to have children after transplantation. For ovarian shielding, abdominal computed tomography (CT) and skin marking were performed in both the supine and prone positions, prior to the TBI. A pair of columnar blocks was placed just above the patient's body. Thus far three patients have been treated. The serum estradiol level decreased to an undetectable level (<8.5 pg/ml) after transplantation and the follicle-stimulating hormone (FSH) level increased above 90 mIU/ml in all patients and they became amenorrheic. However, regular menstruation recovered in patients no. 1 and 2 about 800 and 370 days after transplantation, respectively, with a decrease in the serum FSH level. Menstruation did not recover in patient no. 3, and serum estradiol was transiently detected above 20 pg/ml. The preservation of ovarian function was made possible by ovarian shielding. However, a longer follow-up is needed to know if normal pregnancy and delivery can occur.

High-grade cytomegalovirus antigenemia after hematopoietic stem cell transplantation

Clinical impact of high-grade (HG) cytomegalovirus (CMV) antigenemia after hematopoietic stem cell transplantation has not been clarified. Therefore, in order to investigate the risk factors and outcome for HG-CMV antigenemia, we retrospectively analyzed the records of 154 Japanese adult patients who underwent allogeneic hematopoietic stem cell transplantation for the first time from 1995 to 2002 at the University of Tokyo Hospital. Among 107 patients who developed positive CMV antigenemia at any level, 74 received risk-adapted preemptive therapy with ganciclovir (GCV), and 17 of these developed HG-antigenemia defined as > or = 50 positive cells per two slides. The use of systemic corticosteroids at > or = 0.5 mg/kg/day at the initiation of GCV was identified as an independent significant risk factor for HG-antigenemia. Seven of the 17 HG-antigenemia patients developed CMV disease, with a cumulative incidence of 49.5%, which was significantly higher than that in the low-grade antigenemia patients (4%, P<0.001). However, overall survival was almost equivalent in the two groups. In conclusion, the development of HG-antigenemia appeared to depend on the profound immune suppression of the recipient. Although CMV disease frequently developed in HG-antigenemia patients, antiviral therapy could prevent a fatal outcome.

259 LOCALIZATION OF LEUKEMIA INHIBITORY FACTOR (LIF) GENE IN BOVINE PLACENTA

Leukemia inhibitory factor (LIF), a member of the group of hemopoietic cytokines, plays a primary role in the control of embryo development and implantation and in the growth of the placenta in humans and mice. The objective of this study was to investigate the localization of LIF gene in bovine placenta tissues during pregnancy using in situ hybridization (ISH). Eleven Japanese Black cows aged between 1.8 and 14.5 years, with normal estrous cycles, were used in this study. They were observed daily for estrous behavior, and the day of estrus was considered as Day 0. They were artificially inseminated, and their uteri were collected on Days 61 to 63 (n = 3), 127 to 142 (n = 4), and 225 to 232 (n = 4) of pregnancy. Pregnancy was confirmed by the presence of a conceptus in the uterus, and the uterus was isolated by dissection, avoiding damage of the uterine artery. The uterus was perfused with 4% paraformaldehyde (PFA) solution using catheters inserted into the uterine artery, and placental tissues were isolated by dissection. Each tissue was cut into small pieces (5 mm thick) and fixed in 4% PFA solution for 20-24 h, after which they were embedded in paraffin using routine procedures. Several tissue pieces were collected from each individual cow. Six micrometer-thick sections were cut and placed on MAS coated glass slides (Matsunami Glass, Kishiwada, Japan). The sections were dried in an oven for three days at 40�C. Anti-sense and sense biotin-labeled oligonucleotide probes for bovine LIF were designed from the sequence information (GenBank accession number D50337). The sense probe was used as the negative control. ISH was carried out using GenPoint System (DakoCytomation, Glostrup, Denmark) according to the manufacturer's instructions. The sections were observed under an Eclipse 800 microscope (Nikon, Tokyo, Japan) to detect the positive signal for LIF gene. Density analysis was performed with Scion Image (Scion Corporation, Frederick, MD, USA). Data were analyzed by one-way ANOVA and Tukey-Kramer's HSD, using 0.05 as a significant level. Leukemia inhibitory factor gene was expressed in stromal cells of the fetal cotyledonary villus and caruncular crypt and in mono- and multi-nuclear epithelium cells of the fetal cotyledonary villus and caruncular crypt. Intensities of LIF gene positive signals in all positive cells at Days 127 to 142 tended to be weak compared with those at other periods. Furthermore, intensities of LIF gene positive signals of multinuclear cells of the villus and crypt demonstrated a tendency to be strong compared with those of other cells. These results suggest that LIF is produced in several cell types in the placenta and may play important roles in pregnancy.

Cardiac complications after haploidentical HLA-mismatched hematopoietic stem cell transplantation using in vivo alemtuzumab

Alemtuzumab is a humanized monoclonal antibody directed against human CD52 with a strong lympholytic effect. We have performed unmanipulated hematopoietic stem cell transplantation (HSCT) from 2- or 3-locus-mismatched family donors in 14 patients using in vivo alemtuzumab. All achieved complete donor cell engraftment and grade III-IV acute graft-versus-host disease was observed in only one patient. However, eight of the 14 patients developed grade II-IV cardiac complications according to Bearman's criteria. Next, we retrospectively analyzed the records of 142 adult patients who underwent allogeneic HSCT from 1995 to 2004 to evaluate whether the use of alemtuzumab was an independent risk factor for cardiac complications. Among several factors that increased the incidence of grade II-IV cardiac complications with at least borderline significance, a multivariate analysis identified the cumulative dose of anthracyclines (P=0.0016) and the use of alemtuzumab (P=0.0001) as independent significant risk factors. All of the cardiac complications in the alemtuzumab group were successfully treated with diuretics and/or catecholamines. Patient selection and close monitoring of cardiac function may be important in HLA-mismatched HSCT using in vivo alemtuzumab.

Impairment of thrombospondin-1 expression during epithelial wound healing in corneas of vitamin A-deficient mice

The purpose of this study is to investigate the expression of thrombospondin-1 (TSP-1), a multifunctional extracellular matrix protein, during re-epithelialization in wounded corneas of vitamin A-deficient mice. Epithelial defects were created in the corneas of normal and Vitamin A-deficient mice with a microgrinder. Wounded corneas were stained with fluorescein and photographed for evaluation of re-epithelialization. Histological examination and immunohistochemical analysis of TSP-1 expression were also performed on the specimens from wounded corneas. In vitamin A-deficient mice, re-epithelialization of the wounded corneal epithelium was significantly delayed compared with that in normal mice. TSP-1 was detectable neither in the unwounded corneal epithelium of normal mice nor in that of vitamin A-deficient mice. In normal mice, linear staining of TSP-1 was observed on the wounded corneal surface and stroma at 30 min and 8 h to 16 h, respectively, after abrasion, and this TSP-1 expression disappeared at 36 to 48 h, when re-epithelialization was completed. In contrast, no TSP-1 staining was observed in the wounded corneas of vitamin A-deficient mice, except for the endothelial cells, throughout the wound healing process. Histological examination revealed a progressive increase in polymorphonuclear neutrophil infiltration in the stroma of the corneas of vitamin A-deficient mice during the healing process. These findings suggest that vitamin A may modulate the expression of TSP-1 in the corneas to accelerate the re-epithelialization of wounded corneas.

125 CHANGES OF PLASMA MACROPHAGE COLONY-STIMULATING FACTOR LEVELS AND ITS GENE EXPRESSION IN PERIPHERAL WHITE BLOOD CELLS DURING PREGNANCY IN JAPANESE BLACK CATTLE

Macrophage colony-stimulating factor (M-CSF) is a hemopoietic cytokine that plays a primary role in placental physiology. Gene expression of M-CSF in bovine intercaruncular endometrium shows an upward trend in mid-pregnancy. The objective of this study was to determine the plasma M-CSF levels and the M-CSF gene expression levels in maternal peripheral white blood cells (PWBCs) during pregnancy using ELISA and quantitative RT-PCR. In Experiment 1, the plasma M-CSF levels in 112 Japanese Black heifers or cows were determined. Animals were divided into four groups according to pregnancy stage: first- (n = 29), second- (n = 33), third- (n = 26) trimester, and non-pregnant (n = 24). ELISA for bovine M-CSF established by Yoshihara et al. (2003 Vet. Immunol. Immunopathol. 95, 103–111) was used according to their instructions. The absorbance was measured at 405 nm in the Biomek Plate Reader (Beckman Coulter, Fullerton, CA, USA). In Experiment 2, the plasma M-CSF levels and M-CSF gene expression levels in PWBCs during pregnancy were determined. The plasma samples for ELISA were obtained from 8 heifers and 3 cows every 1 and/or 2 weeks. The PWBCs samples for quantitative RT-PCR were obtained from 4 heifers every 1 and/or 4 weeks. All quantitative RT-PCR protocols were carried out according to the previous report (Oshima et al. 2003 Theriogenology 60, 1217–1226). The quantitative PCR assay used an ABI Prism 7700 Sequence Detector (Applied Biosystems, Foster City, CA, USA). Signals were detected according to the manufacturer's instructions. The relative level of M-CSF expression was calculated on the basis of glyceraldehyde-phosphate-dehydrogenase (GAPDH) quantity (in the method of calculation, the relative level = M-CSF quantity/GAPDH quantity). Data were analyzed by Kruskal-Wallis test. In Experiment 1, the plasma M-CSF level in second-trimester cows was significantly higher than those in other stages (P < 0.05). In Experiment 2, the plasma M-CSF levels were significantly higher in gestational age from −4 to 1 weeks compared with the last stage of pregnancy (P < 0.05). The levels decreased until 6 weeks, appeared to temporarily increase, and were relatively constant until 35 weeks. Macrophage colony-stimulating factor genes were expressed in all samples examined; the levels were relatively constant in early pregnancy, and then were widely varied until parturition. These results suggest that plasma M-CSF levels may be related to the maternal condition of pregnancy and to a slight extent to M-CSF gene expression in PWBCs. This work was supported in part by a Grant-in-aid from the Recombinant Cytokine Project (RCP2002-2110), provided by the Ministry of Agriculture, Forestry, and Fisheries, Japan.

Treatment with buserelin, an agonist of gonadotropin-releasing hormone, suppresses ovarian hyperstimulation syndrome induced in rabbits

Human menopausal gonadotropin (hMG, 75 IU/body/day) and a gonadotropin-releasing hormone (GnRH) agonist buserelin (1, 10, 100 microg/kg/day) were simultaneously administered to female rabbits by the subcutaneous route for 7 days, and the effects on organ weights, plasma hormones and weight of ascitic fluid were examined. Treatment with hMG increased the ovarian weight, plasma estradiol and weight of ascites, thus indicating that ovarian hyperstimulation syndrome had been induced. Simultaneous treatment with buserelin decreased the changes induced by hMG. GnRH agonists can thus be surmised to reduce the severity of ovarian hyperstimulation syndrome in the rabbit. However, caution is needed when extrapolating the results of this rabbit model to humans.

247GENE EXPRESSION OF MAMMALIAN RELATIVE OF DNAJ IN BOVINE ENDOMETRIUM DURING EARLY PREGNANCY

The mammalian relative of DNAJ (MRJ), a member of the molecular chaperones that are known as heat shock proteins, plays an important role in the process of murine chorioallantoic fusion. The objective of this study was to determine the expression pattern of MRJ in the bovine endometrium during early and mid-pregnancy using quantitative RT-PCR. Twenty-eight Japanese Black cows, aged between 1.2 and 15.2 years, with normal estrous cycles, were used in this study. Twenty-one cows were used for study of the level of MRJ during pregnancy. They were artificially inseminated, and their endometrial tissues were collected on Days 16 to 21 (n=7), 30 to 36 (n=6), 48 to 49 (n=4) and 74 to 140 (n=4) of pregnancy. Seven cows were used as controls for the study of cyclic level of MRJ, and their endometrial tissues were collected on Days 13 to 14 (n=4) and 17 to 20 (n=3) of the estrous cycle. The caruncles and the intercaruncles were isolated from the endometrial tissues. All tissues were frozen immediately using liquid nitrogen. Total RNA from these samples was extracted from the tissue using Trizol (Invitrogen Corp., Carlsbad, CA, USA). The first strand of cDNA was synthesized from the total RNA by oligo (dT)12–18 and SuperScript™ II RNase H- Reverse Transcriptase (Invitrogen Corp.) according to the manufacturer’s instructions. Primers and the TaqMan probe for MRJ and glyceraldehyde-phosphate-dehydrogenase (GAPDH) were designed using the primer design software Primer Express™ (Applied Biosystems, Foster City, CA, USA). Bovine GAPDH was used as an internal standard. All PCR reactions were performed using a TaqMan™ PCR Reagent Kit and a MicroAmp Optical 96-Well Reaction Plate and Cap (Applied Biosystems). The assay used an ABI Prism 7700 Sequence Detector (Applied Biosystems). Signals were detected according to the manufacturer’s instructions. The relative level of MRJ expression was calculated on the basis of GAPDH quantity (the method of calculation: relative level=MRJ quantity/GAPDH quantity). Data were analyzed by one-way ANOVA, and means were conpared by Tukey-Kramer’s HSD test. Mammalian relative of DNAJ genes were expressed in all samples examined;; the levels in intercaruncle tended to be greater than those in caruncle. Although MRJ expression level at Days 16 to 21 of pregnancy was greater than at other days during pregnancy, there were no significant differences between the levels at Days 16 to 21 of pregnancy and those of the estrous cycle. These results suggest that MRJ is produced in the endometrium and may play a role in early and mid-pregnancy and the estrous cycle.

Frizzled 4 gene (FZD4) mutations in patients with familial exudative vitreoretinopathy with variable expressivity

AIMS

To search for mutations in the frizzled 4 (FZD4) gene in patients with familial exudative vitreoretinopathy (FEVR) and to delineate the defective gene associated clinical features.

METHODS

Direct sequencing following polymerase chain reaction of exons of FZD4 was performed for 24 probands with FEVR (18 familial and six sporadic), and some of their families. Clinical symptoms among individuals with mutations were assessed.

RESULTS

Four novel mutations were identified in four patients with familial and one with sporadic FEVR. Three of these mutations were missense (M105V, R417Q, and G488D) and one was a nonsense change (W319X). M105V, R417Q, and G488D co-segregated with the disease. None of these sequence changes was found among 300 chromosomes from 150 healthy volunteers. The severity of vitreoretinopathy in the individuals involved in this study varied, but no patient with mutations in FZD4 exhibited rhegmatogenous retinal detachment although this pathology is thought to be the most common type of retinal detachment in FEVR.

CONCLUSION

FZD4 gene mutations were found in some cases of autosomal dominant and sporadic FEVR. FZD4 mutations were responsible for FEVR with variable clinical manifestations.

Atypical late-onset dementia characterized by limbic degeneration with coiled bodies and argyrophilic threads

This report concerns an autopsy case of late-onset dementia with atypical neuropathological features. The patient was a Japanese man who was 83 years old at the age of death. At 73 years, he developed behavioral disorders, including emotional changes, and dementia. He died at the age of 83. A neuropathological study revealed largely confined involvement of the limbic regions, characterized by degeneration consisting of neuronal loss with a spongy state and gliosis. Massive tau-positive oligodendroglial coiled bodies and argyrophilic threads were also observed mainly in these regions. Although the clinicopathological findings of the present case showed some similarities to those of a unique subtype of frontotemporal dementia, including mesolimbocortical dementia, argyrophilic grain disease, corticobasal degeneration and dementia with tangles, there seems to be no suitable category of neurodegenerative disease into which our case can be classified. Further study is needed to determine whether the present case could be classified as an atypical case of these diseases or represents a new entity.

Quantitation of bovine macrophage colony-stimulating factor in bovine serum by ELISA

We established an enzyme-linked immunosorbent assay (ELISA) system for the quantitation of bovine macrophage colony-stimulating factor (M-CSF) and used it to measure the serum M-CSF levels in bovine fetuses and calves. The average serum M-CSF level was 2.7+/-1.5 ng/ml in 39 calves under 100 days old, and 1.8+/-0.8 ng/ml in 15 cattle between 101 and 418 days old. Fetal sera samples (n = 6) prepared from cattle between 150 and 280 days of gestational age had a higher average level of M-CSF (8.8+/-1.4 ng/ml). Alteration in serum M-CSF levels in each individual calf was also measured. The serum levels of M-CSF in calves at 0-1 day after birth ranged from 0.52 to 7.3 ng/ml. During the period 113-125 days after birth, serum levels were around 1.4+/-0.39 ng/ml. Although serum M-CSF levels generally decreased as the age of calves advanced, differences among individuals, especially among newborn calves, were observed.

Gene expression of leukemia inhibitory factor (LIF) and macrophage colony stimulating factor (M-CSF) in bovine endometrium during early pregnancy

Leukemia inhibitory factor (LIF) and macrophage colony stimulating factor (M-CSF), members of the group of hemopoietic cytokines, play a primary role in the control of embryo development and implantation and in the growth of the placenta in humans and mice. Gene expressions of LIF and M-CSF were investigated using quantitative RT-PCR in bovine endometrial tissues during early and mid-pregnancy (Days 16-17, 20-21, 30-36, 48-49 and 74-140) and during the estrous cycle (Days 13-14). Leukemia inhibitory factor and M-CSF genes were expressed in all samples examined. Significant differences were found between the gene expression patterns of LIF and M-CSF. Leukemia inhibitory factor expression level at Days 48-49 was the highest in caruncular endometrium, however, the large variability negated any significant differences. Leukemia inhibitory factor expression levels in intercaruncular endometrium at Days 48-49 and 74-140 of pregnancy were greater than at Days 13-14 of the estrous cycle and at other days of pregnancy. No significant change was recognized in M-CSF expression levels in caruncular endometrium. Macrophage colony stimulating factor expression level in intercaruncular endometrium at Days 74-140 was greater than those of the other samples. These results suggest that LIF and M-CSF are produced in the endometrium and may play different roles in early and mid-pregnancy.

Anti-metastatic and anti-angiogenic activities of a new matrix metalloproteinase inhibitor, TN-6b

We investigated the anti-metastatic and anti-angiogenic effects of TN-6b, a new broad-spectrum inhibitor of matrix metalloproteinases (MMPs), against Lewis lung carcinoma (LLC) and hepatic sinusoidal endothelial (HSE) cells. TN-6b potently inhibited the activities of MMP-2 and -9 secreted by LLC and HSE cells in a zymogram assay. TN-6b, at non-cytotoxic concentrations, caused a marked inhibition of invasion and migration of LLC, and tube-like formation of HSE cells. In contrast, TN-6d, an inactive enantiomer of TN-6b, did not inhibit the invasion and tube-like formation. Daily subcutaneous (s.c.) administration of TN-6b at doses of 30 and 60 mg/kg in mice resulted in a potent inhibition of tumour-induced angiogenesis of B16 melanomas and lymph node metastasis of LLC cells. In conclusion, TN-6b effectively inhibited lymph node metastasis of LLC cells through its anti-invasive and anti-angiogenic properties. These findings suggest that the MMP inhibition correlates well with its anti-angiogenic and anti-metastatic efficacy and TN-6b has the therapeutic potential to inhibit angiogenesis and metastasis in vivo and in vitro.

STAT and SMAD signaling in cancer

STAT and SMAD often exert opposite biological effects on diverse cellular functions. Recent studies have shown that STAT can interface with SMAD at molecular level and that some novel molecules, such as SOCS (also called CIS) and APRO6 (also called TOB), modulate this signaling. A cofactor p300/CBP might act as a bridging molecule to mediate the interface. Thus, STAT and SMAD signaling pathways may crosstalk each other with interweaved regulatory mechanisms. Interestingly, the importance of all the proteins' function has been shown by the increasing evidence of their involvement in cancer. These recent progresses have been made in attributing novel exciting functions. Accordingly, we would like to review the latest advances of those pathways on a cross-section in cancer signaling.

Acute effects of ethanol on feeding behavior and leptin-induced STAT3 phosphorylation in rat hypothalamus

OBJECTIVE

Drinking ethanol stimulates the appetite, producing a positive energy balance. The mechanism by which ethanol regulates the appetite in the central nervous system, however, has not been fully understood. The aim of this study is to investigate the interaction of ethanol with the satiety effect of leptin, a hormone which suppresses the appetite in the hypothalamic region.

DESIGN

: Leptin (7.5 micro g) or the same dose of phosphate buffer saline (PBS) was administered into the third ventricle (i.c.v.), 30 min after an intraperitoneal injection (i.p.) of ethanol (0.5 g/kg body weight) or the same dose of PBS.

MATERIALS

Adult male Sprague-Dawley rats weighing 290-320 g were used.

MEASUREMENTS

Food intake was measured 2, 12 and 24 h after leptin i.c.v. infusion. The tyrosine phosphorylation of signal transducer and activator transcription factor 3 (STAT3) in the hypothalamus was analyzed by Western blotting.

RESULTS

The cumulative food intakes in the saline/leptin group (saline i.p.+leptin i.c.v.) were markedly reduced to about 45% of the saline/PBS group (saline i.p.+PBS i.c.v.) at 2, 12 and 24 h time points (P<0.05, 0.001, and 0.005, respectively). As compared with the saline/leptin group, those of the ethanol/leptin group (ethanol i.p.+leptin i.c.v.) were significantly increased to the level seen in the saline/PBS group at 12 and 24 h time points (P<0.05, and P<0.005 vs the saline/leptin group, respectively). Ethanol administration resulted in about a 50% reduction of the leptin-induced STAT3 tyrosine phosphorylation seen in the hypothalamic protein as compared to that of the saline/leptin group.

CONCLUSION

These findings suggest that ethanol-induced enhancement of the appetite may, in part, result from leptin resistance transiently caused by ethanol to attenuate the leptin signal transduction.

Analyses of serum lipoprotein(a) and the relation to phenotypes and genotypes of apolipoprotein(a) in type 2 diabetic patients with retinopathy

To elucidate the association of lipoprotein(a) (Lp(a)) with diabetic retinopathy (DR), we studied the serum Lp(a) concentrations (n = 412), apolipoprotein(a) (apo(a)) phenotypes expressed by the number of kringle 4 (K4) repeats (n = 150), apo(a) gene genotypes (n = 161) of type 2 diabetes with or without DR. The 5'-untranslated region of apo(a) gene was classified into seven haplotypes (A to G) and 18 genotypes by PCR-RFLP at three distinct sites. The serum Lp(a) concentrations were significantly higher in diabetic patients than in normal controls. Furthermore, the patients with DR, especially proliferative retinopathy showed higher serum Lp(a) concentrations than those without DR. Although a negative correlation was found between the serum Lp(a) concentrations and the number of K4 repeats in total diabetic patients, no difference was seen in the distribution of the number of K4 repeats between those with and without DR. In the same apo(a) phenotypes, the patients with DR had higher Lp(a) concentrations than those without DR. Among the genotypes, type CC showed significantly higher serum Lp(a) concentrations than the other genotypes. However, there was no difference in the ratios of the type CC between the patients with and without DR. In conclusion, other factors than phenotypes and genotypes in the 5'-untranslated region of apo(a) may be responsible for the elevation of serum Lp(a) in diabetic patients with retinopathy.

Peripheral pulmonary atelectasis and oxygentation impairment following coronary artery bypass grafting

BACKGROUND

Severe pulmonary oxygenation impairment occurred in some patients with pleurotomy during the harvest of the internal mammary artery graft followed by coronary artery bypass grafting (CABG). Peripheral pulmonary atelectasis in the postoperative chest X-ray was detected in these patients. We studied the efficacy of intraoperative positive end-expiratory airway pressure (PEEP) therapy for the prevention of postoperative pulmonary oxygenation impairment.

METHODS

The pleural cavity was intraoperatively opened in 40 patients with solitary CABG procedure performed during 5 years since January 1992. These patients were divided into two groups. Intraoperative PEEP therapy, which is initiated just after pleurotomy, was not used in 32 patients before May, 1996 (control group) and used for recent 8 patients with pleurotomy (PEEP group). The mean age of patients was 60 years old in the control group and 68 in the PEEP group.

RESULTS

Respiratory insufficiency (A-aDO2 >400 mmHg and RI >1.5) was detected in 6 patients in the control group. Three out of these 6 patients required long-term mechanical respiratory support over a week. No respiratory insufficiency occurred in patients of the PEEP group. Values of PaO2, A-aDO2, respiratory index and shunt ratio were significantly worse in the control group than in the PEEP group.

CONCLUSIONS

In conclusion, PEEP therapy may prevent pulmonary atelectasis and oxygen impairment after CABG.

Surgical approach for repair of descending thoracic aortic aneurysms and postoperative respiratory function

Good exposure and the minimization of lung and thorax injuries are important objectives of surgery for descending thoracic aortic aneurysm (DTAA). In this study, three surgical approaches for DTAA were compared to assess postoperative respiratory function. The subjects were 21 patients with DTAA, three of whom had a thoracoabdominal aneurysm. The mean age was 61 years, and there were 12 men and 9 women. The causes of aneurysm were atherosclerosis in 16 patients, chronic dissection in 4, and traumatic pseudoaneurysm in 1. All the patients underwent femoro-femoral partial cardiopulmonary bypass. The DTAA was replaced with a prosthetic graft in 18 patients and repaired with a patch graft in 3. Three approaches were selected, namely, posterolateral thoracotomy (PL group, n = 12), median sternotomy combined with anterolateral thoracotomy (M group, n = 5), and spiral incision (S group, n = 4). There were no significant differences in operation time, cardiopulmonary bypass time, intraoperative blood loss volume, or water balance. The duration of respiratory support and intensive care unit stay were significantly (P < 0.05) longer in the M group than in the other two groups. The alveolararterial oxygen difference (AaDO2) and respiratory index (RI) levels immediately after surgery were also significantly (P < 0.05) higher in the M group than in the PL group. There were no significant differences in AaDO2 and RI levels 12 and 24h after surgery among the three groups. These results suggest that posterolateral thoracotomy is a desirable surgical approach for DTAA repair in view of the fact that it has the least effect on postoperative respiratory function.

Relationship between thrombolytic therapy and perfusion defect detected by Gd-DTPA-enhanced fast magnetic resonance imaging in acute myocardial infarction

To study whether thrombolytic therapy affects Gd-DTPA-enhanced pattern and whether its pattern indicates myocardial viability, Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed in 43 patients with reperfused acute myocardial infarction 14.8+/-5.0 days after onset with breathhold scanning on a 1.5-T whole body system. The hypoenhanced area at 90 sec after contrast injection was defined as a perfusion defect (PD). Patients were divided into PD(+) and PD(-) groups. The PD was detected in 77.8% of patients treated with direct percutaneous transluminal coronary angioplasty (PTCA) and in 28.6% of patients treated by thrombolytic therapy with or without PTCA in the thrombolysis in myocardial infarction grade 3 group (p < 0.05). The myocardial wall was divided into seven segments based on the American Heart Association committee report. Wall motion of each segment was classified by one of six patterns (wall motion score [WMS]: dyskinesis, -1; akinesis, 0; severe hypokinesis, 1; hypokinesis, 2; slight hypokinesis, 3; normal, 4). By echocardiography, the average WMS and ejection fraction were similar between the PD(+) group and the PD(-) group on admission. Those parameters were significantly worse in the PD(+) group than in PD(-) group 1 month after onset. The change in WMS was significantly lower in the PD(+) group than in the PD(-) group. The number of patients and segments with more than two grades of improvement of WMS in the PD(+) group was significantly lower than that in the PD(-) group. Angiographically, left ventricular ejection fraction and WMS of the PD(+) group were significantly lower than those of the PD(-) group 3 months later. PDs were detected significantly less frequently in patients treated with thrombolytic therapy, suggesting that microvascular embolization related to formation of the no-reflow phenomenon.

The diagnostic value of kappa/lambda ratios determined by flow cytometric analysis of biopsy specimens in B-cell lymphoma

Flow cytometry (FC) is widely utilized in the diagnosis of lymphoma and the light chain ratio (LCR) is especially useful in the diagnosis of B-cell malignancy. In this study we analysed, retrospectively, the predictive value of the LCR in the diagnosis of B-cell lymphoma in 105 consecutive patients with persistent lymph node enlargement or extranodal masses who underwent biopsy. We used a receiver-operating characteristic curve to establish a LCR threshold value of 2.0. The specificity, sensitivity, positive and negative predictive values were 92.3%, 73.1%, 90% and 77%, respectively. We concluded that determination of LCR is a useful adjunct to pathological diagnosis.

Lung impairment following cardiac surgery in patients with pulmonary hypertension

BACKGROUND

Postoperative respiratory management following cardiac surgery is sometimes troublesome in patients with pulmonary hypertension. We retrospectively studied the relationship between the etiology of preoperative pulmonary hypertension and the postoperative decline of blood oxygenation capacity by focusing on the postoperative intravascular fluid volume.

METHODS

Sixteen adult patients with an atrial septal defect (preload group) and 17 patients with solitary mitral valve disease (afterload group) were studied. The mean age of the patients in the preload and afterload group was 51 and 52 years old, respectively.

RESULTS

Preoperative pulmonary-systemic pressure ratio and pulmonary artery resistance index were significantly higher in the preload group than in the afterload group. The respiratory index (RI) and the pulmonary shunt ratio (Qs/Qt) measured immediately after the operation was larger in the afterload group than in the preload group. Postoperative RI and Qs/Qt remained high until postoperative day 3 in both groups. In the preload group RI on postoperative day 1 had a reverse correlation with the central venous pressure (CVP). Meanwhile, the RI in the afterload group on postoperative day 1 was slightly larger in patients with a high CVP and pulmonary capillary wedged pressure. Similar relationships were seen in the relations between pulmonary capillary wedged pressure and RI in the afterload group. CONCLUSIONS In conclusion, a preoperative pulmonary vascular change and a postoperative precipitous decrease of pulmonary blood flow may have caused postoperative lung oxygenation impairment in the preload group. An extended period of extracorporeal circulation associated with cardiac arrest and postoperative volume overload may have caused lung impairment in the afterload group. In aspect of postoperative management, low CVP is beneficial to the patients in the afterload group, however, hypovolemia should be avoided in patients of the preload group.

Simple prognostic model for patients with multiple myeloma: a single-center study in Japan

The range of survival duration in myeloma patients is wide and several percent of patients live longer than 10 years. Therefore, a precise prediction of survival for the individual patient is required to decide treatment. We evaluated possible prognostic factors at diagnosis for 116 Japanese patients with multiple myeloma. Twelve parameters reported to affect survival were analyzed using a log rank test and stepwise Cox proportional hazards regression. Factors identified as adversely affecting survival were age over 60 years, male sex, blood hemoglobin less than 8.5 g/dl, platelets less than 100 x 10(9)/l, serum creatinine level more than 2.0 mg/dl, serum C-reactive protein (CRP) level more than 6.0 mg/l, and serum beta2-microglobulin level more than 6.0 mg/l. Among them, only high age and high serum CRP level were independently prognostic for poor survival. In conclusion, we have established a simple prognostic model for Japanese myeloma patients only, using factors that can be determined in routine examinations without the need of subjective information.

Growth of the pulmonary arteries after systemic-pulmonary shunt

Pulmonary artery growth after a systemic-pulmonary shunt was angiographically evaluated in 19 out of 35 patients. The mean age of the subjects at the time of the initial operation was 18+/-18 months including 12 patients under a year old. The preoperative diagnosis was tetralogy of Fallot (TOF) in 10 patients, TOF plus pulmonary atresia in five and transposition of great arteries in four. A Blalock-Taussig shunt (BTS) operation was performed in 16 patients (15 classical and 1 modified) and a central shunt was performed in three patients as an initial operation. The preoperative pulmonary artery index (PAI) was 129+/-42 in all patients and there were no significant differences between patients under or over a year old (139+/-42 vs. 115+/-49). Postoperative angiography was performed 32+/-13 months after the surgery. Room air arterial O2 pressure increased significantly from 29+/-5 mmHg to 42+/-5 mmHg just after an initial palliative shunt operation. PAI change in patients under a year old was 214+/-73%, which was higher than 145+/-27% in patients over a year old after a palliative shunt operation. On the ipsilateral side, PAI change was almost the same between patients under and over a year old. On the contralateral side, PAI change in patients under a year old was 216+/-68%, which was significantly higher than the 116+/-21% in patients over one year old. There was a significant negative correlation (r=-0.65, p<0.05) between PAI change and arterial O2 pressure as measured just after a palliative shunt operation. In conclusion, a palliative shunt operation prior to a year old is desirable in order to produce sufficient and bilateral pulmonary artery growth.

Detection of AP12-MALT1 chimaeric gene in extranodal and nodal marginal zone B-cell lymphoma by reverse transcription polymerase chain reaction (PCR) and genomic long and accurate PCR analyses

t(11;18)(q21;q21) has been recognized as a characteristic chromosomal translocation in mucosa-associated lymphoid tissue (MALT)-type lymphoma, and recent studies have demonstrated that this translocation results in the chimaeric transcript of API2 (apoptosis inhibitor 2)-MALT1 (mucosa-associated lymphoid tissue lymphoma translocation gene 1). In this study, we used reverse transcription polymerase chain reaction (RT-PCR) to analyse the incidence of this fusion product in a large series of MALT lymphoma, nodal marginal zone B-cell lymphoma (nMZBCL) and extranodal diffuse large B-cell lymphoma (DLBL) cases. RT-PCR analysis revealed that 17 of the 95 (17.9%) MALT lymphomas but none of the nine nMZBCLs or 16 DLBLs had API2-MALT1 fusion transcripts. The incidence of API2-MALT1 varied among MALT lymphomas arising from different sites and was highest for pulmonary MALT lymphomas (10 out of 16 cases, 62.5%). The presence of the API2-MALT1 fusion gene was also confirmed by long and accurate (LA)-PCR with genomic DNA, and the result correlated well with that obtained with the RT-PCR assay, thus demonstrating the usefulness of LA-PCR for the detection of the API2-MALT1 fusion gene.

Cytokine induction by LVAD in the canine kidney

BACKGROUND

The outcome of left ventricular assist device (LVAD) support is reported to be associated with proinflammatory cytokines. We investigated the effect of LVAD support on renal function and the resultant cytokine induction.

METHODS

A prospective experimental study was performed using 15 mongrel dogs weighing 14 to 36 kg. LVAD was introduced in nine dogs (LVAD group) and the remaining six dogs were managed without LVAD support (control group). All animals were observed for six hours after thoracotomy. Renal regional blood flow was measured, and albumin-creatinine ratio (ACR) and N-acetyl-beta-D-glucoseaminidase index (NAGI) were evaluated as parameters of glomerular and tubular function, respectively. Tumor necrosis factor alpha (TNF-alpha) concentrations in the blood and homogenate of renal tissues were measured and immunohistological examination of renal tissues was conducted by means of anti-nuclear factor kappa B (NF-kappa B), TNF-alpha and interleukin 1 beta (IL- 1 beta) antibodies.

RESULTS

In the LVAD group, the renal cortex-medullar blood flow ratio significantly (p<0.05) decreased, and ACR was significantly (p<0.05) higher than in the control group, indicating glomerular insufficiency. There were no significant differences in NAGI and TNF-alpha levels in the blood and renal tissues between the two groups. Immunohistological examination of renal tissues demonstrated an accumulation of NF-kappa B, TNF-alpha, and IL-1 beta in the LVAD group.

CONCLUSIONS

An LVAD alters renal regional blood flow and induces a small amount of cytokines. We speculate that if an LVAD is introduced during systemic inflammatory response syndrome, the LVAD will induce a second attack resulting in multiorgan failure. For successful LVAD support, the appropriate selection of time periods is essential.