Predictive value of Ki-67, p53 protein, and DNA content in the diagnosis of gastric carcinoma

BACKGROUND

The ability to make a precise preoperative diagnosis is a valuable and effective method in improving the prognosis of patients with gastric carcinoma. The authors examined retrospectively whether preoperative histopathologic analysis with p53 protein, Ki-67 labeling index, and DNA ploidy along with preoperative radiographic and endoscopic findings led to a precise preoperative diagnosis of patients with gastric carcinoma.

METHODS

Histopathologic analysis of p53 protein, Ki-67 labeling index, and DNA content was performed on formalin fixed, paraffin embedded tissue. Tissue sections from endoscopic and surgically resected specimens were stained immunohistochemically for p53 protein and Ki-67 labeling index, and the cell nuclear DNA content of the surgically resected primary lesion was measured using a microspectrophotometer. These analyses were performed on 16 patients with early gastric carcinoma (EGC) who were diagnosed with advanced gastric carcinoma (AGC) based on the preoperative imaging findings and on 15 patients with AGC who were diagnosed preoperatively with EGC.

RESULTS

Overexpression of p53 in the AGC group was significantly more frequent compared with that in the EGC group (P = 0.0386). With regard to the correlation between lymph node metastases and p53 overexpression, there was no apparent relation in either the AGC group (P = 0.648) or the EGC group (P = 0.726). The AGC group had significantly higher Ki-67 labeling indices compared with the EGC group (P = 0.0195). There was complete concordance between endoscopic and surgically resected specimens with regard to the p53 and Ki-67 labeling index findings. DNA ploidy in the primary tumor did not differ between the AGC and EGC groups. The survival rates for the EGC group were significantly superior to those for the AGC group (P = 0.0312).

CONCLUSIONS

The findings of the current study suggest that in routine clinical practice, the combination of preoperative imaging findings in addition to Ki-67 labeling indexes, and p53 protein analyses may be useful for the accurate diagnosis of EGC; however, DNA ploidy did not appear to reflect the growth potential of gastric carcinoma.

Predictive value of Ki-67, p53 protein, and DNA content in the diagnosis of gastric carcinoma

BACKGROUND

The ability to make a precise preoperative diagnosis is a valuable and effective method in improving the prognosis of patients with gastric carcinoma. The authors examined retrospectively whether preoperative histopathologic analysis with p53 protein, Ki-67 labeling index, and DNA ploidy along with preoperative radiographic and endoscopic findings led to a precise preoperative diagnosis of patients with gastric carcinoma.

METHODS

Histopathologic analysis of p53 protein, Ki-67 labeling index, and DNA content was performed on formalin fixed, paraffin embedded tissue. Tissue sections from endoscopic and surgically resected specimens were stained immunohistochemically for p53 protein and Ki-67 labeling index, and the cell nuclear DNA content of the surgically resected primary lesion was measured using a microspectrophotometer. These analyses were performed on 16 patients with early gastric carcinoma (EGC) who were diagnosed with advanced gastric carcinoma (AGC) based on the preoperative imaging findings and on 15 patients with AGC who were diagnosed preoperatively with EGC.

RESULTS

Overexpression of p53 in the AGC group was significantly more frequent compared with that in the EGC group (P = 0.0386). With regard to the correlation between lymph node metastases and p53 overexpression, there was no apparent relation in either the AGC group (P = 0.648) or the EGC group (P = 0.726). The AGC group had significantly higher Ki-67 labeling indices compared with the EGC group (P = 0.0195). There was complete concordance between endoscopic and surgically resected specimens with regard to the p53 and Ki-67 labeling index findings. DNA ploidy in the primary tumor did not differ between the AGC and EGC groups. The survival rates for the EGC group were significantly superior to those for the AGC group (P = 0.0312).

CONCLUSIONS

The findings of the current study suggest that in routine clinical practice, the combination of preoperative imaging findings in addition to Ki-67 labeling indexes, and p53 protein analyses may be useful for the accurate diagnosis of EGC; however, DNA ploidy did not appear to reflect the growth potential of gastric carcinoma.

Predictive value of Ki-67, p53 protein, and DNA content in the diagnosis of gastric carcinoma

BACKGROUND

The ability to make a precise preoperative diagnosis is a valuable and effective method in improving the prognosis of patients with gastric carcinoma. The authors examined retrospectively whether preoperative histopathologic analysis with p53 protein, Ki-67 labeling index, and DNA ploidy along with preoperative radiographic and endoscopic findings led to a precise preoperative diagnosis of patients with gastric carcinoma.

METHODS

Histopathologic analysis of p53 protein, Ki-67 labeling index, and DNA content was performed on formalin fixed, paraffin embedded tissue. Tissue sections from endoscopic and surgically resected specimens were stained immunohistochemically for p53 protein and Ki-67 labeling index, and the cell nuclear DNA content of the surgically resected primary lesion was measured using a microspectrophotometer. These analyses were performed on 16 patients with early gastric carcinoma (EGC) who were diagnosed with advanced gastric carcinoma (AGC) based on the preoperative imaging findings and on 15 patients with AGC who were diagnosed preoperatively with EGC.

RESULTS

Overexpression of p53 in the AGC group was significantly more frequent compared with that in the EGC group (P = 0.0386). With regard to the correlation between lymph node metastases and p53 overexpression, there was no apparent relation in either the AGC group (P = 0.648) or the EGC group (P = 0.726). The AGC group had significantly higher Ki-67 labeling indices compared with the EGC group (P = 0.0195). There was complete concordance between endoscopic and surgically resected specimens with regard to the p53 and Ki-67 labeling index findings. DNA ploidy in the primary tumor did not differ between the AGC and EGC groups. The survival rates for the EGC group were significantly superior to those for the AGC group (P = 0.0312).

CONCLUSIONS

The findings of the current study suggest that in routine clinical practice, the combination of preoperative imaging findings in addition to Ki-67 labeling indexes, and p53 protein analyses may be useful for the accurate diagnosis of EGC; however, DNA ploidy did not appear to reflect the growth potential of gastric carcinoma.

Effective control of Epstein-Barr virus-related hemophagocytic lymphohistiocytosis with immunochemotherapy. Histiocyte Society

The familial form of hemophagocytic lymphohistiocytosis (HLH) is a lethal disorder. Although the prognosis for Epstein-Barr virus-associated HLH (EBV-HLH) remains uncertain, numerous reports indicate that it can also be fatal in a substantial proportion of cases. We therefore assessed the potential of immunochemotherapy with a core combination of steroids and etoposide to control EBV-HLH in 17 infants and children who met stringent diagnostic criteria for this reactive disorder of the mononuclear phagocyte system. Treatment of life-threatening emergencies was left to the discretion of participating investigators and typically included either intravenous Ig or cyclosporin A (CSA). Five patients (29%) entered complete remission during the induction phase (1 to 2 months), whereas 10 others (57%) required additional treatment to achieve this status. In 2 cases, immunochemotherapy was ineffective, prompting allogeneic bone marrow transplantation. Severe but reversible myelosuppression was a common finding; adverse late sequelae were limited to epileptic activity in one child and chronic EBV infection in 2 others. Fourteen of the 17 patients treated with immunochemotherapy have maintained their complete responses for 4+ to 39+ months (median, 15+ months), suggesting a low probability of disease recurrence. These results provide a new perspective on EBV-HLH, showing effective control (and perhaps cure) of the majority of EBV-HLH cases without bone marrow transplantation, using steroids and etoposide, with or without immunomodulatory agents.

Preventive effect of matrix metalloproteinase inhibitor, R-94138, in combination with mitomycin C or cisplatin on peritoneal dissemination of human gastric cancer cell line TMK-1 in nude mice

R-94138, a matrix metalloproteinase inhibitor, was examined for the ability to prevent peritoneal dissemination of a human gastric cancer xenograft, TMK-1. When the supernatant of a co-culture of TMK-1 cells and human normal fibroblast cells was subjected to gelatin zymography, it was clear that the protein expression of MMP-2 had been inhibited by R-94138. When TMK-1 was injected intraperitoneally (i.p.) into nude mice at 5 x 10(5) cells/body, the resulting peritoneal dissemination mimicked clinical carcinomatous peritonitis. When the maximum tolerated dose of mitomycin C (MMC) or cisplatin (DDP) was given 12 h after the tumor inoculation, peritoneal dissemination was completely inhibited, while the effect of R-94138 was limited when it was given i.p. at a dose of 20 mg/kg in a schedule of q.d. x 5 starting 12 h after tumor injection. MMC and DDP also suppressed peritoneal dissemination when they were administered 1 week after the tumor inoculation at a single dose of 2 and 3 mg/kg i.p., respectively. R-94138 inhibited peritoneal dissemination when it was administered i.p. at a dose of 30 mg/kg in a schedule of q.d. x 5 starting from 1 week after tumor injection. The combination of MMC and R-94138 increased the preventive effect on peritoneal dissemination. R-94138 seems to be a promising candidate to prevent peritoneal dissemination of gastric cancer.

Oxidative stress causes enhanced endothelial cell injury in human heme oxygenase-1 deficiency

The first known human case of heme oxygenase-1 (HO-1) deficiency is presented in this report. The patient is a six-year-old boy with severe growth retardation. He has been suffering from persistent hemolytic anemia characterized by marked erythrocyte fragmentation and intravascular hemolysis, with paradoxical increase of serum haptoglobin and low bilirubin. An abnormal coagulation/fibrinolysis system, associated with elevated thrombomodulin and von Willebrand factor, indicated the presence of severe, persistent endothelial damage. Electron microscopy of renal glomeruli revealed detachment of endothelium, with subendothelial deposition of an unidentified material. Iron deposition was noted in renal and hepatic tissue. Immunohistochemistry of hepatic tissue and immunoblotting of a cadmium-stimulated Epstein-Barr virus-transformed lymphoblastoid cell line (LCL) revealed complete absence of HO-1 production. An LCL derived from the patient was extremely sensitive to hemin-induced cell injury. Sequence analysis of the patient's HO-1 gene revealed complete loss of exon-2 of the maternal allele and a two-nucleotide deletion within exon3 of the paternal allele. Growth retardation, anemia, iron deposition, and vulnerability to stressful injury are all characteristics observed in recently described HO-1 targeted mice. This study presents not only the first human case of HO-1 deficiency but may also provide clues to the key roles played by this important enzyme in vivo.

Photosensitive drug eruption induced by flutamide

We describe a 68-year-old man who showed a photosensitive drug eruption induced by flutamide. The minimal erythema dose with ultraviolet A light was reduced to 2 J/cm2 under administration of flutamide, which recovered to over 16 J/cm2 after cessation of the medication, without changing the reactivity to ultraviolet B. The absorption spectrum of flutamide was not altered after ultraviolet A irradiation, suggesting that flutamide is photostable with regard to ultraviolet A. In addition, bovine serum albumin was not covalently photocoupled with flutamide under ultraviolet A. Thus, flutamide seems to have low potency to act as a photohapten, and it is likely that a non-photohaptenic mechanism operates in this photosensitivity or its active metabolite may work as a photosensitizer.

Distribution and expression of mRNAs for the proto-oncogenes c-fos and c-jun in bone cells in vivo

In this study we assessed the expression and localization of the proto-oncogenes c-fos and c-jun in normal bone so as to gain more insight into the role of these proto-oncogenes in bone tissue. Femurs of 4-week-old rats were examined by non-radioactive in situ hybridization. cDNA probes for c-fos- and c-jun-labeled digoxygenin were produced by Polymerase Chain Reaction (PCR). C-fos and c-jun exhibited similar distribution in growth plate and bone tissue. Expression of c-fos and c-jun mRNAs in growth plate was observed in the proliferative zone and partly in the upper layer of the hypertrophic zone. In spongy bone, high expression of c-fos and c-jun mRNAs was observed in the osteoblast cytoplasm. However, there was little expression in bone lining cells. In the bony trabeculae, slight expression of c-fos and c-jun was observed in the premature osteocytes situated close to the bone surface, but no expression was detected in osteocytes that possessed relatively large lacunae in the center of the trabeculae. C-fos and c-jun were also slightly expressed in osteoclasts. These data strongly suggest that c-fos and c-jun are involved in regulating chondrocyte proliferation as immediate early genes, and may also be involved in the gene expression of bone matrix proteins as transcription factor (AP-1) in vivo. In addition, the fact that strong expression was observed in osteoblasts but hardly any expression at all in bone lining cells seems to suggest that these genes are also involved in osteoblast activation.

Apoptosis in adenoma and early adenocarcinoma of the colon

Twenty-six specimens of tubular adenoma and 7 specimens of adenocarcinoma in adenoma of the colon were examined to evaluate apoptosis between adenoma and early adenocarcinoma. Cell proliferation and cell death seemed to be balanced in adenoma with mild and moderate atypia, but unbalanced in adenoma with severe atypia and cancer. Apoptosis was considered to be suppressed at cancer in some cases. However, a number of apoptosis increased at cancer in other cases. Necrosis was seen only in cancer areas. The ratio of cells simultaneously stained by anti-Ki-67 antibody (MIB-1) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-nick end labeling (TUNEL) tended to be high from adenoma with moderate atypia to cancer, suggesting the unstableness of DNA. It is possible that cancer cells having highly unstable DNA easily underwent apoptosis as well as necrosis, accidentally. The p53 protein was positive only in cancer areas of three cases. One of these three showed decreased apoptosis in a cancer area, but the other two cases showed increased apoptosis. Furthermore, certain numbers of cancer cells were double-stained by p53 immunohistochemistry and TUNEL. These results suggest that the p53 protein may contribute to suppress apoptosis in the last stage of carcinogenesis of the colonic adenocarcinoma, but other factors including extrinsic stimulation may cause apoptosis despite the mutation of p53 protein.

Effects of food consistency on the modulatory mode of the digastric reflex during chewing in freely behaving rabbits

Effects of food consistency on the mode of the phase-linked modulation in the digastric reflex amplitude were examined in naturally chewing rabbits. Two test foods with different textures (bread as a soft food, pellet as a hard food) were used. The digastric reflex was elicited by electrical stimulation (10 train pulses at 2 kHz) of the inferior alveolar nerve. The amplitude of the digastric reflex measured was divided into three categories depending on the chewing phases in which the stimulus was delivered and each value was compared with the control response obtained when the animal was resting. The reflex was strongly inhibited in the jaw-opening phase and no difference was observed in the inhibitory effect between the foods. In the jaw-closing phase, larger digastric reflexes than those in the opening phase were elicited with both foods. This was the case in both the fast-closing and slow-closing phases. Reflex amplitude was significantly larger during chewing of the hard food than the soft food and, thereafter, inhibition of the reflex was observed only during chewing of the soft food in the closing phase. The results suggest the following: (1) food consistency may affect the central mechanism which regulates the digastric reflex and (2) the reflex may contribute to the regulation of masticatory force during chewing particularly hard food.

Application of a fine thread beam to the structure analysis of a hemihedrally twinned crystal of hydroxylamine oxidoreductase

Accurate diffraction intensity data have been collected from a twinned P6(3) crystal of the 24-haem protein hydroxylamine oxidoreductase, from a nitrifying chemoautotrophic bacterium Nitrosomonas europaea, using synchrotron radiation at station BL6A of the Photon Factory. Estimation of the twinning fraction and deconvoluted intensity data, including native and heavy-atom derivative data, gave an improved Patterson function. Four diffraction data sets were collected from one crystal and an estimation of the twinning fraction to confirm the phenomena was undertaken. The successfully detwinned data sets were utilized in the structure analysis of the present enzyme. The mechanism of twinned-crystal formation is also discussed.

Structure and function of 6,7-dicarboxyheme-substituted myoglobin

Myoglobin was reconstituted with 6,7-dicarboxy-1,2,3,4,5, 8-hexamethylheme, a compact synthetic heme with the shortest acid side chains, to pursue the structural and functional consequences after intensive disruption of the heme propionate-apoglobin linkages in the native protein. The electron-withdrawing carboxylate groups directly attached to the porphyrin ring lowered the oxygen affinity by 3-fold as compared with native myoglobin. Autoxidation of the oxy derivative to the ferric protein proceeded with 1.6 x 10(-)2 min-1 at pH 7.0 and 30 degrees C. The crystallographic structure of the cyanomet myoglobin with 1.9 A resolution shows that the heme adopts a unique orientation in the protein pocket to extend the two carboxylates toward solvent sphere. The native globin fold is conserved, and the conformations of globin side chains are almost intact except for those located nearby the heme 6,7-carboxylates. The 7-carboxylate only weakly interacts with Ser92 and His97 through two mediating water molecules. The 6-carboxylate, on the other hand, forms a novel salt bridge with Arg45 owing to conformational flexibility of the guanidinium side chain. The proton NMR shows that the small heme does not fluctuate about the iron-histidine bond even at 55 degreesC, suggesting that the salt bridge between Arg45 and heme 6-carboxylate is of critical importance to recognize and fix the heme in myoglobin.

[Laparoscopic surgery for early gastric cancer--its advantages and pitfalls]

We have successfully established two different laparoscopic procedures for early gastric cancer since March 1992, which are laparoscopic wedge resection of the stomach using a lesion-lifting method and laparoscopic intragastric mucosal resection. The indication is as follows; (A) mucosal cancer, (B) < 25 mm, if the lesion is elevated type, (C) < 15 mm and Ul (-), if the lesion is depressive type. The advantages of these methods are; 1) minimally invasiveness, 2) sufficient surgical margin, 3) feasibility of detailed histology, 4) feasivility of perigastric lymph node dissection. In contrast, there are several problems to be solved, which are; 1) preoperative diagnostic accuracy of the depth of cancer invasion, 2) possibility of reoperation because of sm invasion or lymphatic or venous invasion in final histology, 3) possibility of postoperative stenosis after laparoscopic intragastric mucosal resection for the lesion near the cardia, 4) incidence of metachronous multiple gastric cancer. In conclusion, if the indication is properly selected, these laparoscopic procedures are curative and minimally invasive treatment for early gastric cancer.

Matrix metalloproteinase gene expression in chronic gastric ulcer: a potential role of eosinophils in perforation

Gene expression of matrix degrading enzymes was investigated in surgical specimens of perforated gastric ulcers. In these ulcers, the inflammatory cells infiltrating into the granulation tissue were granulocytes, particularly eosinophils. The extracellular matrix of the stomach wall consists mainly of collagen types I and III, which are selectively degraded by matrix metalloproteinase-1 (MMP-1). MMP-1 mRNA was detected in the cytoplasm of infiltrating cells, suggesting that eosinophils play an important role in ulcer recurrence and in perforation of the stomach wall. The degree of eosinophil infiltration into an ulcer base may be a useful marker for the risk of perforation. Patients showing this marker may benefit from a prophylactic therapy for preventing severe complications. The control of MMP gene expression represents a potential strategy for the treatment of recurrent gastric ulcer.

Assessment of intravascular ultrasound-bearing balloon catheter-guided percutaneous transluminal coronary angioplasty and stenting

To investigate the usefulness of an intravascular ultrasound (IVUS)-bearing balloon catheter, we analyzed results in 17 patients with 19 lesions who underwent percutaneous transluminal coronary angioplasty (PTCA) with IVUS-bearing balloon catheters (group A) and 25 patients with 28 lesions who underwent PTCA without IVUS (group B). The patients had angina pectoris with or without old myocardial infarction. The success rate (less than 50% residual stenosis on coronary angiography) in group A was 17/17 patients (100%) and 19/19 lesions (100%), and that in group B was 21/25 patients (84%) and 24/28 lesions (86%) (NS). The percent stenosis, by coronary angiography, in groups A and B was 71.3% and 76.8% before PTCA (NS) and 4.8% and 22.3% in groups A and B after PTCA (P = 0.005). Complication rates in the two groups were not significantly different, but non-Q myocardial infarction was observed in one patient with a type C lesion (according to the American Heart Association/American College of Cardiology [AHA/ACC] classification) in group A. Postdilation of Wiktor stents was determined by IVUS in four patients. These results suggest that the IVUS-bearing balloon catheter is useful to achieve larger lumen size for optimal PTCA.

The role of stromal cells in the expression of interstitial collagenase (matrix metalloproteinase-1) in the invasion of gastric cancer

BACKGROUND AND OBJECTIVES

In one of the steps of tumor invasion and metastasis, tumor cells must invade surrounding tissues and degrade the components of the basement membranes. Interstitial collagenase (matrix metalloproteinase-1: MMP-1) has been also investigated in relation to cancer invasion and metastasis.

METHODS

We investigated the formation and mechanism of MMP-1 expression using gastric cancer cell lines and gastric fibroblasts derived from normal gastric mucosa by ELISA and immunohistochemistry.

RESULTS

Production of MMP-1 protein in gastric fibroblasts was stimulated significantly by adding the conditioned medium of MKN-74. Localization of MMP-1 protein in the xenografted gastric cancer cell lines was heterogeneous according to different cell lines.

CONCLUSIONS

These results suggested that the production of MMP-1 protein in tumor invasion was regulated by interaction between stromal cells, particularly fibroblasts, and tumor cells.

[High fever during the treatment of acute promyelocytic leukemia with all-trans retinoic acid]

A 56-year-old woman was admitted for evaluation of petechiae and acute promyelocytic leukemia was diagnosed. Administration of all-trans retinoic acid (ATRA) at 60 mg per day was begun. On the same day, high fever was recognized. There was no evidence of infection nor other organ dysfunction. Administration of steroid caused a resolution of the fever. The same phenomenon was observed three times subsequently. High fever was the adverse reaction in this patient during the treatment of ATRA, and steroid was dramatically effective.

[Jejunal pouch interposition after total gastrectomy]

The results and procedures of interposed jejunal pouch after total gastrectomy for gastric cancer are reported. Basic requirements of reconstruction after total gastrectomy are 1) formation of a food reservoir, 2) maintenance of duodenal continuity, 3) avoidance of reflux esophagitis, 4) gradual emptying of reservoir into the small intestine. Since 1950's, several procedures of gastric substitutes have been reported. But they were not widely performed. Because scientific evaluation of the value of gastric substitutes was difficult and the operative procedures were time consuming and complicated. With an increasing ratio of early gastric cancer in 1990's, the importance of post-operative QOL, such as food intake and body weight maintenance, in patients after total gastrectomy has been recognized. Our procedure is a double lumen jejunal pouch distal to a interposed jejunum. The length of interposed jejunum is 20 cm and that of pouch is 10 cm. Using surgical staplers, this procedure is safe and simple. Jejunal pouch interposition leads to a satisfactory symptomatic and nutritional result in gastrectomized patients.

Cervical spinal cord infarction after surgery for a pineal region choriocarcinoma in the sitting position: case report

OBJECTIVE AND IMPORTANCE

Spinal cord injury is one of several devastating complications after operation in the sitting position. Young patients exhibiting extraordinary growth spurts demonstrate a higher risk for this complication.

CLINICAL PRESENTATION

We describe a 7-year-old male patient with a pineal region choriocarcinoma in whom a cervical spinal cord infarction (C5-T1) developed as an acute complication after operation in the sitting position. Preoperatively, high serum levels of human chorionic gonadotropin (5867.7 mIU/ml) and somatomedin-C (704 ng/ml) and an extreme growth velocity in height (16 cm/yr) were noted.

CONCLUSION

It is assumed that, in addition to head flexion, the abnormal skeletal growth spurt resulting from an excessive secretion of human chorionic gonadotropin from a tumor was a possible predisposing factor for this complication. To prevent this complication, surgeons need to pay great attention to head positioning, especially in a young patient experiencing an active growth spurt.

Analysis of the steroidogenic acute regulatory protein (StAR) gene in Japanese patients with congenital lipoid adrenal hyperplasia

Genomic DNA from 19 Japanese patients with congenital lipoid adrenal hyperplasia (lipoid CAH) representing 16 different families was examined to identify the genetic alterations of steroidogenic acute regulatory protein (StAR). Ten of 19 patients had a 46,XX karyotype and nine had a 46,XY karyotype. Six of the 46,XX patients have experienced spontaneous pubertal changes including breast development and irregular menstruation whereas none of the 46,XY subjects displayed pubertal changes. Eight different mutations were identified. Sixteen patients were either homozygotes or compound heterozygotes for the Q258X mutation. The seven other mutations identified were 189delG, 246insG, 564del13bp, 838delA, Q212X, A218V and M225T. The 189delG, 246insG, 546del13bp and Q212X mutants encode truncated proteins. COS-1 cells transfected with expression vectors encoding cDNAs for the mutant StAR proteins which affect the C-terminus, 838delA, A218V and Q258X, exhibited no steroidogenesis enhancing activity. However, the M225T mutant retained some steroidogenic activity. The patient with the M225T mutation had late onset of this disorder and some capacity to secrete testosterone in response to hCG. These findings suggest: (i) that the Q258X mutation can be used as a genetic marker for the screening of Japanese for lipoid CAH, (ii) that the C-terminus of StAR plays an important role in the protein's activity and (iii) that there are differences in the extent of functional impairment of the testis and ovaries in lipoid CAH.

The 2.8 A structure of hydroxylamine oxidoreductase from a nitrifying chemoautotrophic bacterium, Nitrosomonas europaea

The 2.8 A crystal structure of hydroxylamine oxidoreductase of a nitrifying chemoautotrophic bacterium, Nitrosomonas europaea, is described. Twenty-four haems lie in the centre bottom of the trimeric molecule, localized in four clusters within each monomer. The haem clusters within the trimer are aligned to form a ring that has inlet and outlet sites. The inlet is occupied by a novel haem, P460, and there are two possible outlet sites per monomer formed by paired haems lying within a cavity or cleft on the protein surface. The structure suggests pathways by which electron transfer may occur through the precisely arranged haems and provides a framework for the interpretation of previous and future biochemical and genetic observations.

Para-chloroamphetamine (PCA)-induced ejaculation in aged rats, semen analysis and artificial insemination

The present study was undertaken to determine sperm motility and counts in semen yielded by para-chloroamphetamine (PCA)-induced ejaculation of aged rats which had lost their reproductive ability, and to attempt artificial insemination with suspensions of spermatozoa obtained in this way. The semen yielded by PCA-induced ejaculation from aged (75-week-old) rats had average sperm counts of 0.82 +/- 0.69 x 10(7), which were much lower than the average counts (9.42 +/- 1.65 x 10(7)) for semen spontaneously ejaculated by young adult rats (14 weeks old). However, 77.5% of the spermatozoa contained in the PCA-induced semen were rated as showing the most active movement. Spermatozoa collected in this way were injected into the upper parts of both uterine horns or into both ovarian bursae. Both methods made the females pregnant, but the results were better after injection into the ovarian bursae. The offspring born to these females showed no abnormalities.

Synthesis and bronchodilatory activity of four new derivatives of deoxyvasicine

As part of a continuing effort aimed at the development of efficacious antihistaminic and bronchodilator agents for the treatment of asthma and related respiratory diseases, a series of novel trisubstituted deoxyvasicine derivatives was designed and synthesized. Bronchodilatory activity of pure samples of ligands 17a-d, and DL-8-chlorovasicine hydrochloride is investigated and compared with isoprenaline and aminophylline. These studies confirm the activity of ligands 17a-d and the potentiating effect of 17c on aminophylline.

Morphological analysis of pancreatic endocrine cells in newborn animals delivered by experimental diabetic rats

Rats with mildly impaired glucose tolerance (MIGT) were prepared by the administration of streptozotocin and subsequent islet-isotransplantation. Of pups born to these rats, 65% exhibited macrosomia that weighed over 6.8 g (average weight of control pups was 5.96 g). The morphological changes in the endocrine pancreas in pups born of MIGT and normal control rats were studied using immunohistochemical methods and quantitative morphological analysis. In macrosomic pups, the percentages of pancreatic tissue devoted to islet areas and B cell areas were significantly higher than in control pups. The percentage of pancreas devoted to A cell areas was also higher in macrosomic than normal pups, while the ratio of A/B cell areas was in normal range. In non-macrosomic pups born to MIGT rats, the percentages of pancreas devoted to islet tissues, B cell, and A cell areas were each lower than these in macrosomic pups. Moreover, increase in the proportions of islet and B cell areas in the pancreatic tissue in pups born of MIGT mothers was linearly correlated with increase in birthright. There were no significant differences in D cell area as a proportion of pancreas among macrosomic, non-macrosomic and control pups. These findings suggest that insulin secreted from B cells play important roles in the control of fetal growth.

The relationship between serum levels of interleukin-6 and thyroid hormone during the follow-up study in children with nonthyroidal illness: marked inverse correlation in Kawasaki and infectious disease

Our previous study demonstrated that the serum IL-6 correlated inversely with serum T3 and the T3/T4 ratio in children with acute respiratory infection during the acute phase of illness. To investigate whether serum IL-6 inversely correlates with serum thyroid hormone during not only the active stage of the disease but also in the follow-up period in nonthyroidal illness, we measured serum levels of IL-6, T3 and T4 in 31 children from the acute to the convalescent phase. They were divided into 3 groups; 7 patients with Kawasaki disease, 16 patients with infectious disease and 8 patients with non-inflammatory disease. In the follow-up of patients with Kawasaki disease, a marked inverse relationship was observed between serum IL-6 and T3 (r = -0.844, P < 0.001) or the T3/T4 ratio (r = -0.863, P < 0.001). Serum T4 showed a weak but significant negative correlation with serum IL-6 (r = -0.474, P = 0.035) only in this situation. There was also a significant negative correlation between serum IL-6 and T3 (r = -0.582, P < 0.001) or the T3/T4 ratio (r = -0.660, P < 0.001) during the follow-up of children with infectious disease. In the follow-up study of patients with non-inflammatory disease, however, no significant relationships were observed between serum thyroid hormones and IL-6. IL-6 may be one important factor involved in the decrease in the serum T3 level and the T3/T4 ratio in patients with nonthyroidal illness particularly characterized by strong inflammation and activation of the immune system as observed in Kawasaki and infectious disease.

Distribution and developmental changes in vasopressin V2 receptor mRNA in rat brain

The extrarenal presence of vasopressin V2 receptors (V2Rs) has been suggested but never been demonstrated. We investigated the distribution of V2R mRNA expression in the brain of newborn and adult rats using the reverse transcription-polymerase chain reaction (RT-PCR) and in situ hybridization (ISH). RT-PCR assay revealed V2R mRNA in the cerebellum of both newborn and adult rats, and in the cerebrum of newborn but not adult rats. Further examination of the newborn rat brain by ISH showed dense localization of that V2R mRNA in the choroid plexus, and the neurons of the hippocampus and granular layer of the cerebellum. Epithelial cells and vascular endothelial cells were strongly stained in the choroid plexus. Moreover, expression of V2R mRNA in the hippocampus of the newborn rat decreased with age and could not be detected in rats more than 2 weeks old, while in the cerebellum V2R mRNA expression was stable and did not change with development. The results of our study have demonstrated the presence and distribution of V2R in the brain for the first time, and also show that expression of V2R mRNA in the hippocampus changes dynamically during the process of development. V2R may play an important role in the development of the central nervous system.

Crystallization and preliminary X-ray analysis of cytochrome c-554 from Nitrosomonas europaea

Cytochrome c-554 from Nitrosomonas europaea was crystallized by the batch method utilizing ammonium sulfate as the precipitant. The crystals belong to the space group, P21, with unit cell dimensions of a = 64.8 A, b = 44.7 A, c = 78.7 A, and beta = 99.0 degrees. The crystals diffracted X-rays beyond 2.5 A resolution.

Effects of tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 on type I iodothyronine 5'-deiodination in rat thyroid cell line, FRTL-5

Using a functioning rat thyroid cell line (FRTL-5), we studied the effects of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) on thyroidal type I iodothyronine 5'-deiodination (I-5'-deiodination) and on the expression of I-5'-deiodinase (I-5'-D) mRNA. After 24 h incubation in medium containing 0.5 microM rT3 with a tracer amount of [125I]rT3, radioactivity of released 125I- was counted. Deiodination in live FRTL-5 cells was enhanced about three times from the basal level by the addition of TSH and was inhibited markedly by propylthiouracil and dose dependently by T4. These results suggest the suitability of this model for investigating I-5'-deiodination in live thyroid tissue. Basal and TSH-induced I-5'-deiodination were significantly inhibited by 100 ng/liter of IL-1 beta and IL-6, and the inhibitory effect of TNF-alpha was seen over 1 microgram/liter. I-5'-deiodination was restored by removal of the cytokines. TSH-induced cAMP production and (Bu)2cAMP-induced I-5'-deiodination were also inhibited by the cytokines. Catalase, dexamethasone, and indomethacin did not abolish the inhibitory effects of the cytokines. Reverse transcriptase-polymerase chain reaction (RT-PCR) revealed a marked suppression of I-5'-D mRNA expression by IL-1 beta and IL-6. We conclude that these cytokines inhibit the thyroidal type I I-5'-deiodination in the order of potency IL-1 beta > IL-6 >> TNF-alpha, probably by decreasing the I-5'-D mRNA level.(ABSTRACT TRUNCATED AT 250 WORDS)

The relationship between serum levels of interleukin-6 and thyroid hormone in children with acute respiratory infection

To determine whether monocyte-derived humoral factors such as tumor necrosis factor-alpha (TNF alpha), interleukin-1 beta (IL-1 beta), and IL-6 modulate serum thyroid hormone levels in infectious disorders, we measured serum levels of these monocyte-derived products, T3, T4, and C-reactive protein (CRP) in 59 out-patients with acute respiratory infection, aged 5 months to 15 yr (mean +/- SD, 5.7 +/- 4.2 yr). To minimize individual variation in their clinical and nutritional conditions, we selected out-patients with fever lasting for at least 3 days who had no severe disturbance of food intake. Serum T3 concentrations tended to be low in these subjects; 3 (5.1%) had levels below 1.2 nmol/L, L, and 13 (22.0%) had levels below 1.5 nmol/L. Serum T3 levels in 22 patients with elevated IL-6 (> 15 pg/mL) were significantly lower than those in 19 patients with normal IL-6 (< or = 5 pg/mL; T3, 1.7 +/- 0.4 vs. 2.2 +/- 0.6 nmol/L; P < 0.05). The serum IL-6 concentration was correlated inversely with the serum T3 level (r = -0.324; P = 0.012) as well as the T3/T4 ratio (r = -0.279; P = 0.032). Furthermore, a significant negative correlation was observed between CRP (induced mainly by IL-6) and T3 (r = -0.408; P = 0.001) or the T3/T4 ratio (r = 0.302; P = 0.020). On the other hand, TNF alpha was measurable in only 9 of 59 patients, and there was no correlation between TNF alpha and levels of thyroid hormone, CRP, or IL-6. Serum IL-1 beta was weakly detected in only 1 patient. On follow-up study of 10 of these patients, the serum T3 and T3/T4 ratio increased significantly with a reciprocal decrease in IL-6 and CRP during convalescence. No remarkable change in the serum T4 level was observed in our study. Our data suggest that the euthyroid sick syndrome is relatively common in children with acute respiratory infection, and IL-6 appears to mediate this syndrome in infectious disorders.

Relationship between the number of fetuses and the blood constituents of beagles in late pregnancy

The relationship between the number of fetuses and the blood constituents in late pregnant beagles was examined. The red blood cell count, hemoglobin concentration and hematocrit values in late pregnancy were found to be negatively correlated to the number of fetuses.

Inhibitory effects of emedastine difumarate on histamine release

The inhibitory effects of emedastine difumarate on histamine release were studied in rat peritoneal mast cells. Emedastine significantly inhibited substance P (SP)-induced histamine release at concentrations above 10(-9) M in the presence of extracellular Ca2+ and at concentrations above 10(-11) M in its absence. At concentrations of 10(-8) M or higher, emedastine significantly inhibited SP-induced Ca2+ release from intracellular Ca stores and SP-induced 45Ca uptake into mast cells. Emedastine also inhibited passive peritoneal anaphylaxis in rats and guinea pigs. We conclude that the clinical antiallergic effects of emedastine involve the inhibition of histamine release and that this inhibition is mediated by the inhibition of Ca2+ release from intracellular Ca stores and the inhibition of Ca2+ influx into mast cells.

Structural analysis of the myoglobin reconstituted with iron porphine

Sperm whale apomyoglobin was complexed with iron porphine to examine the influence of completely removed heme side chains on the entire molecular structure. Paramagnetic NMR peak from the proximal histidine of the deoxy protein ensured formation of the iron-histidine bond. Porphine pyrrole-proton NMR signals of the cyanmet and deoxy derivatives are unusually sharp single lines manifesting rapid heme rotation about the iron-histidine bond. X-ray crystallographic structure of the cyanmet derivative, determined with a final R factor of 0.21 for 11,808 independent reflections ranging from 7 to 1.8 A, was resolved at 1.8 A resolution. The result confirmed 1:1 coupling between apomyoglobin and iron porphine. The cyano ligand adopts a bent configuration with an Fe-C-N angle of 127 degrees and a Fe-CN distance of 1.89 A. The overall globin structure and side chain conformations are remarkably similar to those of native myoglobin despite intensive disruption of the original heme-globin interactions. The native apoprotein structure unexpectedly conserved even after iron porphine insertion demonstrates that the complex polypeptide fold of holomyoglobin is more inherent in the amino acid sequence than is generally believed.

An enzyme-linked immunosorbent assay for urinary albumin in patients with insulin-dependent diabetes mellitus

Microalbuminuria is considered to be an early indicator of diabetic nephropathy. In this report, we developed an enzyme-linked immunosorbent assay (ELISA) for the measurement of urinary albumin (UA) and examined UA in 38 patients with insulin-dependent diabetes mellitus (IDDM). The assay range of ELISA for albumin was 5-1,000 ng/ml, and the albumin levels determined by ELISA were well correlated with those by immunoagglutination methods. The UA values of daytime single-void specimens in control subjects, which correlated significantly with UA excretion rates (micrograms/minute) in 24-hour urine, were 10.9 +/- 8.2 micrograms/mg creatinine. In 38 IDDM patients, there were four cases with microalbuminuria and one case with overt nephropathy. Their disease duration was longer than 8 years, and the diabetic control was fair to poor. On SDS-PAGE analysis. the urinary protein of the cases with microalbuminuria consisted mainly of albumin, and in the case of nephropathy, an IgG band was also detected. The measurements of UA in single-void specimens by ELISA is a satisfactory approach to detect impending nephropathy in IDDM patients.

[Free fatty acid responses to growth hormone (GH)-releasing factor and the GH-GH receptor axis]

The functional assessment of GH receptor has been previously performed by GH-induced somatomedin (SM) generation test. There is a specific GH receptor on adipocytes, and GH induces lipolysis with an increment of plasma free fatty acid (FFA). In this report, we examined GH and FFA responses to GRF loading tests and GH-binding protein, which reflects the tissue GH-receptor concentration, in 30 short children, and we evaluated the lipolysis mediated by GH and GH-receptor axis. Following GRF administration, there was a definite increase in plasma FFA levels, which mainly consisted of palmitic acid and oleic acid on HPLC analysis. In the group of GH high responders, peak GH levels more than 30 ng/ml, the increments of FFA were apparently more than those in the GH low responders, peak GH levels less than 30 ng/ml. There was a significant correlation between the integrated GH secretion and the integrated FFA net-increments. In the GH low responders, the integrated FFA net-increments significantly correlated with their serum GH-binding protein activities. The net increments of FFA were also correlated with basal SM-C levels. In a case of GH-resistant dwarfism, in which GH-binding protein activity was markedly reduced, the patient's GH secretion to GRF as high as 51 ng/ml did not induce any increment of FFA levels. These results suggest that FFA responses to GRF loading depend on the integrated GH secretion and tissue GH-receptor content. FFA measurements in GRF test samples may be a simple and useful method for the functional assessment of GH and GH-receptor axis.

Relationship between inhibitor of extrathyroidal 5'-deiodinase activity and serum free fatty acid in children with nonthyroidal illness and acute ketosis

To clarify whether serum free fatty acid (FFA) is an inhibitor of extrathyroidal conversion (IEC) of thyroxine (T4) to thyronine (T3), we measured the concentration of FFA, IEC activity and thyroid hormones in normal subjects, acute ketotic children and children with low T3 syndrome due to nonthyroidal illness (NTI). Iodothyronine (I) 5'-deiodinase activity was assayed with reverse triiodothyronine (rT3) as substrate and liberated 125I-was measured. The IEC was determined by the inhibition of I 5'-deiodination by ether extract of sera or standard oleate solution. IEC values were represented as mM oleate. The serum concentration of FFA was 0.470 +/- 0.117 (SD) mM in 11 normal subjects, and it was significantly higher (1.242 +/- 0.248 mM; P < 0.01) in 10 acute ketotic children and in 7 samples from 6 NTI children (0.904 +/- 0.530 mM; P < 0.05). In contrast, there was no difference in IEC among three groups (normal subject, 0.451 +/- 0.069 mM; acute ketosis, 0.437 +/- 0.040 mM; NTI, 0.465 +/- 0.224 mM). No correlations were found between IEC activity and the serum FFA concentration or thyroid hormones in 28 samples from three groups. The sequential changes in serum thyroid hormones, FFA and IEC in 3 of 6 NTI children revealed no consistent relationship. Furthermore, one NTI child had significantly high IEC (> 1.000 mM) but its serum FFA (1.182 mM) was below the mean value for the acute ketotic group. These results indicate that 1) many NTI patients may bear no relation to IEC and 2) IEC may not be caused by serum FFA only but includes several factors.

Effect of dilazep dihydrochloride against ischemia and reperfusion-induced disruption of blood-brain barrier in rats: a quantitative study

The effect of dilazep dihydrochloride (dilazep) against ischemia and reperfusion-induced disruption of blood-brain barrier (BBB) was quantitatively investigated in Slc:Wistar strain rats using Evans blue dye as a BBB destruction indicator. The forebrain of sham-operated animal had a small amount of the dye. A treatment of 3.5-h ischemia plus 2-h reflow extravasated the dye into the brain and markedly increased the dye content as compared with that of sham group (P less than 0.01 vs. sham group). Continuous infusion (i.v.) of dilazep during cerebral ischemia dose-dependently reduced the increase of the dye content, and a significant reduction was found at 3 mg/kg/h (P less than 0.05 vs. control group). Evans blue dye extravasation after ischemia was also greatly reduced in saline-perfused brains by the treatment with dilazep. Dilazep has been reported to inhibit edema formation in cerebral ischemia model of spontaneously hypertensive rats. These results suggest that dilazep prevents the ischemic damage of BBB, which may contribute to reduction of the brain edema.

[A case of dwarfism with severely reduced activity of growth hormone-binding protein]

We presented a 16-year-old boy with severe growth retardation and markedly decreased levels of growth hormone-binding protein (GHBP) in plasma, which was shown to correspond to the extracellular composition of hepatic GH receptor and suggested to reflect tissue concentration of the receptor. His height was 92.5 cm (-13.5 SD), the weight 9.6kg (-5.8 SD) and Tanner stage was I. His bone age was 3.5 years old at 16 years of age. Karyotype was 46,XY and thyroid function was normal. SM-C levels, determined by Nichols RIA using unextracted plasma, were within the low normal range, 0.67/0.68U/ml. In contrast, using a method of acid-ethanol extraction, IGF-I and IGF-II levels were definitely low, 29ng/ml (normal 88-240) and 165ng/ml (374-804) respectively. GH responses in various provocation tests, including insulin, arginine and GRF, were within normal. Basal GH levels were 20 +/- 12ng/ml and urinary GH excretion rates 217 +/- 85pg/mg. Cr, which were elevated compared to age-matched control. Molecular size of his circulating GH was similar to control subjects. The biological activities of GH, evaluated by radioreceptor assay and Nb2 cell bioassay, were proportional to the immunoactivities of GH. SM bioactivities, which were determined by the stimulatory effects on DNA synthesis of rabbit costal chondrocytes and human fibroblasts, were apparently reduced. Electrophoretic patterns of IGF-binding protein was similar to those of GH deficient cases. Daily administration of hGH (4U/day) for 5 days resulted in a poor response of SM-C production (before 0.68, after 0.77U/ml). GHBP activities were definitely low by gel-filtration, immunoprecipitation and charcoal methods, as seen in Laron dwarfism which is defined as a syndrome of congenital GH receptor defects. These results indicate that the tissue content of GH receptor in this case was quantitatively reduced and as a result, he showed a resistance to endogenous and exogenous GH. It remains to be elucidated whether the GH receptor defect in our case is derived from a genetic origin or an acquired condition.

Growth hormone (GH) profiles with successive provocation by GH-releasing hormone and arginine in children: a clinical appraisal

To establish a single and reliable test for evaluating growth hormone (GH) secretion, we examined successive GH provocation by two agents with different modes of action, GH releasing-hormone (GHRH) and arginine (Arg) in 60 children of short stature, 6 patients with pituitary dwarfism and 9 normal young adults. Their GH profiles were qualitatively classified into 4 types: 25 children and 7 adults responded to both stimuli with 2 GH peaks (48.7 +/- 4.3 [SEM] micrograms/L for GHRH and 32.2 +/- 2.6 micrograms/L for Arg in children; 25.8 +/- 7.6 micrograms/L and 30.1 +/- 9.2 micrograms/L respectively in adults) (type A). A single peak for GHRH (57.7 +/- 4.6 micrograms/L) without an Arg-induced peak was obtained in 29 younger children (type B), which is considered to be a GHRH-dominant pattern. Two of them were diagnosed as hypothalamic GHRH deficiency based on a low nocturnal plasma GH and good response to GH treatment. Six adolescents and 2 adults showed a blunted response to GHRH (9.0 +/- 1.1 micrograms/L) but a normal response to Arg (40.6 +/- 9.5 micrograms/L) (type C), which appears to be caused by somatostatin (SRIH) hypertonicity. None with pituitary dwarfism responded to both stimuli (4.5 +/- 1.3 and 2.3 +/- 0.5 micrograms/L). Thus, the GHRH-Arg test makes it possible to evaluate the counterbalance between GHRH and SRIH as well as to differentiate pituitary GH deficiency from hypothalamic GHRH dysfunction.

Mutual priming effects of GHRH and arginine on GH secretion: informative procedure for evaluating GH secretory dynamics

To establish a single and reliable test for evaluating GH secretion, we examined successive GH provocation by two agents with different modes of action: GHRH and arginine (Arg). In 4 normal subjects, a bolus injection of 50 micrograms of GHRH followed by 0.5 g/kg Arg infusion after 90 min evoked two GH peaks and the priming of the GHRH potentiated Arg-induced GH peak by 88% of that by Arg alone. In contrast, Arg pretreatment suppressed the GHRH-induced GH peak to a level of 15%. This inhibitory effect of Arg priming was not recovered by an increase in the GHRH dose (100 micrograms) or by prolongation of the GHRH injection period to 180 min. During Arg infusion, plasma somatostatin (SRIH) was significantly reduced and there was a linear correlation between Arg-induced GH peaks and basal TSH levels. This suggests that GH release by Arg is mediated by suppression of hypothalamic SRIH. One subject showed a blunted GH peak in response to GHRH but a normal peak in response to Arg repeatedly, suggesting an endogenous hypertonicity of SRIH. In 4 other normal subjects, the effect of endogenous GH fluctuation on the GHRH-Arg test was examined in the morning, afternoon and evening. The GH secretory profile was fairly consistent in individuals, but in 2 of them, GH response to GHRH was exaggerated in the evening and Arg-unresponsiveness ensued. This potentiation of GH release appears to be due to an increase in endogenous GHRH secretion or a decrease in SRIH tone. The GHRH-Arg test is therefore able to evaluate GH secretory dynamics through two major mechanisms, GHRH stimulation and SRIH inhibition in a single procedure, reducing the incidence of false negative GH response to Arg.