Expression of invariant chain and pro-cathepsin L in Alzheimer's brain

Inflammatory and immune systems are involved in the pathogenesis of Alzheimer's disease (AD), but those systems in the human brain have not been well identified. Cathepsin L might play a predominant role in the degradation of the invariant chain (Ii), which plays a critical role in antigen presentation to block the antigen-binding site of the major histocompatibility complex class II. We examined the expression of Ii and pro-cathepsin L (pCPL) in AD and normal brains by using immunohistochemistry. Ii expresses only in resting or mildly activated microglia, whereas pCPL strongly expresses in fully activated microglia but not in resting or mildly activated microglia in AD. Normal brain tissues have rarely been stained for Ii or pCPL. These results suggest that the activation of microglia leads to expression of a complex of Ii and human leukocyte antigen class II at first, and that further activation, which is followed by cluster formation and enlargement of microglia frequently seen in the AD brain, might cause pCPL expression to degrade Ii. Our study confirmed that microglia plays a central role in the immune system of the brain, and that an activation of microglia is involved in the pathogenesis of AD.

Effect of non-weight-bearing body fat on bone mineral density before and after menopause

OBJECTIVE

To investigate the difference in the effect of non-weight-bearing body fat mass on bone mineral density between premenopausal and postmenopausal women.

METHODS

We studied 252 regularly menstruating premenopausal women and 213 postmenopausal women with right side dominance. Age, years since menopause (in postmenopausal women), height, weight, and body mass index were recorded. Bone mineral density of non-weight-bearing sites (ie, arms), weight-bearing sites (ie, lumbar spine including L2-4 and legs), and body fat mass were measured by whole-body scanning with dual-energy x-ray absorptiometry. Body fat mass was also measured by dual energy x-ray absorptiometry.

RESULTS

Body fat mass did not differ between groups. In postmenopausal women, body fat mass correlated positively with bone mineral density of the left leg (r =. 41, P <.001), right leg (r =.36, P <.001), left arm (r =.31, P <. 001), and lumbar spine (r =.27, P <.001). The correlation between body fat mass and bone mineral density of the left arm remained significant after adjusting for age, years since menopause, and height. In premenopausal women, body fat mass correlated positively with bone mineral density of left leg (r =.37, P <.001) and right leg (r = 0.31, P <.001), but correlated weakly with bilateral arms (r < or =.19) and lumbar spine bone mineral density (r = 0.13, P <.05).

CONCLUSION

The effect of non-weight-bearing body fat on bone mineral density was greater in postmenopausal than premenopausal women.

Coronary flow velocity immediately after primary coronary stenting as a predictor of ventricular wall motion recovery in acute myocardial infarction

OBJECTIVES

The purpose of this study was to examine the relationship between the pattern of coronary blood flow velocity immediately after successful primary stenting and the recovery of left ventricular (LV) wall motion in patients with acute myocardial infarction (AMI).

BACKGROUND

It is difficult to predict the recovery of LV wall motion immediately after direct angioplasty in AMI. Recent reports indicate that dysfunctional coronary microcirculation is an important determinant of prognosis for AMI patients after successful reperfusion.

METHODS

We measured left anterior descending coronary flow velocity variables using a Doppler guide wire immediately after successful primary stenting in 31 patients with their first anterior AMI. The patients were divided into two groups: those with and those without early systolic reverse flow (ESRF). Changes in LV regional wall motion (RWM) and ejection fraction (EF) at admission and at discharge were compared between the two groups. Coronary flow velocity variables immediately after primary stenting were compared with changes in left ventriculographic indexes.

RESULTS

The change in RWM was significantly greater in the non-ESRF group than it was in the ESRF group (0.9 +/- 0.7 vs. -0.1 +/- 0.3 standard deviation/chord, respectively, p < 0.001). The change in EF was also significantly greater in the non-ESRF group than it was in the ESRF group (10 +/- 10 vs. 1 +/- 6%, respectively, p < 0.05). In the non-ESRF group (diastolic to systolic velocity ratio [DSVR] <3.0), the DSVR correlated positively with the change in RWM (r = 0.60, p < 0.005, n = 24) and the change in EF (r = 0.52, p < 0.01).

CONCLUSIONS

The coronary flow velocity pattern measured immediately after successful primary stenting is predictive of the recovery of regional and global LV function in patients with AMI.

Relationship between left atrial appendage function and plasma concentration of atrial natriuretic peptide

BACKGROUND

It has been reported that the most intensely granuled cardiocytes secreting atrial natriuretic peptide (ANP) are located in the atrial appendages.

AIMS

To evaluate the mechanisms of ANP release in congestive heart failure.

METHODS AND RESULTS

The relationship between ANP and left atrial appendage (LAA) function was evaluated in 36 patients who underwent both transoesophageal echocardiography and cardiac catheterization. ANP level correlated positively with mean pulmonary capillary wedge pressure (mPCWP; r=0.75, P<0.0001), whereas it showed no significant correlation with the mean right atrial pressure. mPCWP correlated positively with the maximal LAA area (LAAa; r=0.79, P<0.0001) and negatively with the LAA ejection fraction during atrial contraction (LAA-EF; r=-0.61, P<0.0001) and peak late diastolic LAA emptying flow velocity (LAAF; r=-0.69, P<0.0001). ANP level correlated negatively with the LAA-EF (r=-0.56, P<0.001) and with LAAF (r=-0.61, P<0.0001). ANP level correlated more closely with the LAAa (r=0.79, P<0.0001) than with maximal LA volume (r=0.34, P<0.05). Multiple stepwise regression analysis selected LAAa as the only factor independently related to the plasma concentration of ANP (ANP=-22.4+28.6 LAAa, r=0.79, P<0.0001).

CONCLUSIONS

We conclude that the factor most predictive for ANP in patients with left-sided cardiac dysfunction is distension of the LAA wall rather than elevation in the LA pressure or distension of the body of LA. This is consistent with the known distribution of ANP-secreting cardiocytes.

Relationship between body fat distribution and bone mineral density in premenopausal Japanese women

OBJECTIVE

To investigate the relationship between body fat distribution and bone mineral density (BMD).

METHODS

Subjects were 282 premenopausal women (mean age +/- standard deviation [SD], 38.8 +/- 8.5 years; range, 20-51 years) with regular menstrual cycles. Baseline characteristics included age, age at menarche, height, weight, body mass index ([BMI], weight/height(2)), and parity. Anthropometric characteristics including the ratio of trunk fat mass to leg fat mass (trunk-leg fat ratio), percentage of body fat, and total body lean mass were measured by whole-body scanning with dual-energy x-ray absorptiometry. Lumbar spine BMD (L2-4) was also measured by dual-energy x-ray absorptiometry. Correlations of BMD to baseline and anthropometric characteristics were investigated using univariate and multivariate analysis.

RESULTS

Although height, trunk-leg fat ratio, and total body lean mass were positively correlated with lumbar spine BMD (r =.18, P <.01; r =.17, P <.01; and r =.25, P <.001; respectively), age at menarche was inversely correlated with BMD (r = -.19, P <.01). On multivariable analysis, trunk-leg fat ratio, height, age at menarche, and total body lean mass were still independently correlated with lumbar spine BMD (P <. 05). However, total fat mass was not correlated with BMD.

CONCLUSION

Upper body fat distribution rather than overall adiposity is associated with lumbar spine BMD in premenopausal women. Humoral factors associated with body fat mass appear to influence lumbar spine BMD.

Interaction of three pradimicin derivatives with divalent cations in aqueous solution

This study focused on further analysis of the aggregation behavior of pradimicin derivatives and their interaction with cations in aqueous solution. BMY was compared with two other pradimicin antibiotics (T2 and FB) with the same aglycone moiety but consisting of different substitute groups. The surface tension measurement showed a clear critical micelle concentration at 1-2 mM of the BMY aqueous solution. The role of Zn2+ in replacing the Ca2+ was examined using 1H nuclear magnetic resonance (NMR) method. From changes in the NMR spectrum and precipitability, it was concluded that zinc ion has lower affinity and higher precipitating ability to BMY than the divalent cations of alkaline earth metal. The aggregation behavior of T2 and FB in aqueous solution was also studied using NMR method. The results suggest that the supramolecular behavior of T2 is similar to BMY whether or not Ca2+ ions are present in solution and that there are two binding sites for calcium ions in a T2 molecule. Unlike BMY and T2, the NMR spectrum of FB does not show distinct change upon Ca2+ addition. The interaction of pradimicin antibiotics with divalent metal ions was thought to be related to ionic electronegativity and to the amphoteric property of the antibiotics.

The effects of physical exercise on body fat distribution and bone mineral density in postmenopausal women

OBJECTIVE

The present cross-sectional study investigated the effects of physical exercise on body fat distribution and bone mineral density (BMD).

METHODS

Subjects were 57 postmenopausal women (mean age, 60.5+/-6.4 years) who had exercised regularly for at least 2 years. Controls were 130 age-matched sedentary women. Age, years since menopause (YSM), height, weight, and body mass index (BMI, wt./ht.(2)) were recorded. Total fat mass, percentage of body fat, trunk fat mass, leg fat mass, the ratio of trunk fat mass to leg fat mass (trunk-leg fat ratio), total body lean mass, percentage of body lean, and lumbar spine BMD (L2-L4) were measured by dual-energy X-ray absorptiometry.

RESULTS

Baseline characteristics and leg fat mass did not differ between the two groups. Total fat mass, percentage of body fat, trunk fat mass, and trunk-leg fat ratio were lower (P<0.05, P<0.01, P<0.01 and P<0.001, respectively), while total body lean mass, percentage of body lean mass, and lumbar spine BMD were higher in exercising women (P<0.05, P<0.05 and P<0.01, respectively). Performing physical exercise was inversely correlated with trunk-leg fat ratio (standardized regression coefficient=-0.178, P<0.01), but positively correlated with BMD (0. 203, P<0.01) irrespective of age, height, YSM, and total fat mass.

CONCLUSION

Physical exercise has beneficial effects on body fat distribution and BMD in postmenopausal women. Reduction of upper body fat distribution with physical exercise may be more attributable to the decrease in trunk fat mass.

New Cdc25B tyrosine phosphatase inhibitors, nocardiones A and B, produced by Nocardia sp. TP-A0248: taxonomy, fermentation, isolation, structural elucidation and biological properties

Strain TP-A0248 which produces two new Cdc25B tyrosine phosphatase inhibitors and also possessing antifungal activity, designated nocardiones A (1) and B (2), was considered to belong to the genus Nocardia on the basis of literature comparison of chemotaxonomic properties. The nocardiones were isolated by solvent extraction of fermentation broth of Nocardia sp. TP-A0248 and purified by the conventional column chromatography. Spectroscopic studies led to determination that 1 and 2 belong to a class compound of naphtho[1,2-b]furan-4,5-diones. Compound 1 inhibited the activity of Cdc25B, PTP1B and FAP-1 protein tyrosine phosphatases at a concentration of 10 microM. It also showed moderate in vitro antifungal and cytotoxic activity.

Is autonomic dysfunction a necessary condition for chronic peptic ulcer formation?

BACKGROUND

The relationship between 1/f fluctuation of the heart rate variability and Helicobacter pylori infection was evaluated, in order to clarify whether autonomic nervous dysfunction is a necessary condition for chronic peptic ulcer formation.

METHODS

The subjects were 11 patients with recurrent chronic peptic ulcer and 20 age-matched normal subjects. Holter ECGs were recorded over 24 h, and the 1/f(-x) fluctuation of the heart rate was computed. The 1/f(-x) fluctuation of the heart rate is a novel index of autonomic function that has been shown to reflect a patient's pleasant mood. For 1/f(-x) fluctuation, the slope of the regression line (-x) was determined and cosine fitting of the absolute slope of the regression line over a 24-h period was performed.

RESULTS

For the normal group, the absolute slope of the regression line during daytime and night-time were 0.53 +/- 0.16 and 1.05 +/- 0.18, respectively. For the peptic ulcer group, the corresponding values during daytime and night-time were 0.94 +/- 0.15 and 1.84 +/- 0.18, respectively. The mean value of the cosine curve was 0.76 +/- 0.23 in the normal group and 1.12 +/- 0.25 in the peptic ulcer group. Thus, these values were significantly higher for the latter group than for the former group (P<0.05). No statistically significant difference in H. pylori infection between the two groups was observed.

CONCLUSIONS

Autonomic nervous dysfunction as well as H. pylori infection appears to be a necessary condition for chronic peptic ulcer formation.

Difference in the effect of adiposity on bone density between pre- and postmenopausal women

OBJECTIVES

Elevated bone mineral density (BMD) in obese women is partially attributable to the higher circulating estrogen levels derived from extraglandular aromatization in adipose tissue. However, it remains unclear whether there is an effect of overall adiposity on BMD in both pre- and postmenopausal women. The difference in the effect of overall adiposity on BMD between pre- and postmenopausal women was investigated.

MATERIALS AND METHODS

Subjects were 296 premenopausal women with regular menstruation and 233 postmenopausal women. Age, age at menarche, years since menopause (YSM, in postmenopausal women), weight, height, and body mass index were recorded. Total fat mass amount, lean mass amount, and percentage of body fat were measured by whole body scanning with dual-energy X-ray absorptiometry (DEXA). Lumbar spine BMD (L2-L4) was measured by DEXA. In each group, significant determinants of BMD were investigated using univariate and stepwise multiple regression analysis.

RESULTS

In postmenopausal women, YSM, lean mass amount, total fat mass amount, and height were significant determinants of BMD (R(2)=0.273, P<0.001). In premenopausal women, only two variables including lean mass amount and age at menarche were significant determinants of lumbar spine BMD (R(2)=0.110, P<0.001), but total fat mass amount and percentage of body fat were not significant determinants of BMD.

CONCLUSION

The effect of overall adiposity on BMD is more prominent in postmenopausal women than in premenopausal women.

Arisostatins A and B, new members of tetrocarcin class of antibiotics from Micromonospora sp. TP-A0316. I. Taxonomy, fermentation, isolation and biological properties

Arisostatins A and B, new members of tetrocarcin class of antibiotics were isolated from the culture broth of an actinomycete strain. The producing strain, TP-A0316, was identified as Micromonospora sp. Arisostatins were obtained from the culture fluid by solvent extraction and chromatographic purification. They showed antibiotic activity against Gram-positive bacteria and antitumor activity.

Patient with atrioventricular node reentrant tachycardia with eccentric retrograde left-sided activation: treatment with radiofrequency catheter ablation

We describe a patient with supraventricular tachycardia with triple atrioventricular (AV) node pathway physiology. A discontinuous curve was present in the antegrade AV nodal function curves. During right ventricular pacing, the earliest retrograde atrial activation was recorded at the left-sided coronary sinus electrode. The retrograde ventricular-atrial interval was long and had decremental conduction. We induced a slow-slow AV node reentrant tachycardia (AVNRT) with eccentric retrograde left-sided activation. After slow pathway ablation, dual AV nodal pathway physiology was present. AVNRT with eccentric retrograde left-sided activation is relatively rare, and our findings suggest that eccentric retrograde left-sided atrial inputs consist partially of a slow pathway and disappear with slow pathway ablation.

Arisostatins A and B, new members of tetrocarcin class of antibiotics from Micromonospora sp. TP-A0316. II. Structure determination

Structures of arisostatins A and B were determined by spectroscopic analyses. Arisostatins were found to be new analogs of tetrocarcin A and possess an iso-butanoyldigitoxose unit instead of the acetyldigitoxose one. NMR analyses of arisostatins and tetrocarcin A led to the revision of the anomeric configurations in the tetrasaccharide moiety of tetrocarcin A.

Detection of left ventricular regional relaxation abnormalities and asynchrony in patients with hypertrophic cardiomyopathy with the use of tissue Doppler imaging

BACKGROUND

It is well known that the distribution and magnitude of left ventricular (LV) hypertrophy are not uniform in patients with hypertrophic cardiomyopathy (HCM), which results in regional heterogeneity of LV early diastolic function. The advent of tissue Doppler imaging (TDI) has allowed the noninvasive evaluation of regional LV wall motion velocities. The aim of this study was to evaluate regional LV relaxation abnormalities and asynchrony noninvasively in patients with HCM by using pulsed and color-coded TDI.

METHODS AND RESULTS

We studied 20 patients with asymmetric septal hypertrophy (HCM group) and 18 age-matched normal patients (control group). The peak early diastolic motion velocity (Ew) and time from the aortic component of the second heart sound to the peak of the Ew (II(A)-Ew) were measured by pulsed TDI. The myocardial velocity gradient during early diastole (MVG-Ew) also was measured by color-coded TDI. Mean values for these parameters were determined on the basis of measurements made at 2 sites of the ventricular septum or posterior wall at the levels of chordae tendineae and papillary muscles. The mean Ew and mean MVG-Ew for the ventricular septum and posterior wall were significantly lower, and mean II(A)-Ew was significantly prolonged in the HCM group compared with the control group. This difference was most pronounced in the hypertrophied ventricular septum of the HCM group. The standard deviations of II(A)-Ew for the ventricular septum and posterior wall were significantly greater in the HCM group than in the control group. The time constant of LV pressure decay during isovolumic diastole (tau) correlated inversely with Ew and MVG-Ew and correlated directly with II(A)-Ew. Furthermore, tau correlated directly with the standard deviation of the II(A)-Ew.

CONCLUSIONS

LV early diastolic function in patients with HCM may be mediated by an augmentation of regional LV relaxation abnormalities and asynchrony.

Circulating adhesion molecules and severity of coronary atherosclerosis

BACKGROUND

Circulating leukocytes are recruited at atherosclerotic sites through a family of adhesion molecules. Circulating forms of adhesion molecules in peripheral blood can be quantified now.

OBJECTIVE

To evaluate the relationship between circulating adhesion molecules and severity of coronary atherosclerosis.

METHODS

Subjects included 81 patients undergoing diagnostic coronary angiography, 12 of whom had normal coronary arteries (control group). The remaining 69 patients with demonstrable coronary atherosclerosis were divided into two groups by use of Gensini scores, namely mild atherosclerosis (n = 36, Gensini score 1-20) and severe atherosclerosis (n = 33, Gensini score > 20). Serum levels of circulating intercellular adhesion molecule-1 (ICAM-1), vascular cellular adhesion molecule-1 (VCAM-1), and E-selectin of groups measured before angiography were compared.

RESULTS

Circulating levels of ICAM-1 in members of mild and severe atherosclerosis groups were significantly higher than those in members of the control group, whereas there was no significant difference among circulating levels of VCAM-1 in members of the three groups. Circulating levels of E-selectin in members of the mild atherosclerosis group were significantly higher than those in members of the severe atherosclerosis and control groups.

CONCLUSIONS

These findings suggest that E-selectin is related to the early stage, and ICAM-1 is related to the advanced stage, of coronary atherosclerosis. With progression of atherosclerosis, one-step adhesion by ICAM-1 could become more important than multistep adhesion involving E-selectin, ICAM-1, and VCAM-1. These molecules may serve as markers for severity of coronary atherosclerosis.

Subendocardial motion in hypertrophic cardiomyopathy: assessment from long- and short-axis views by pulsed tissue Doppler imaging

BACKGROUND

Tissue Doppler imaging (TDI) is a recently developed technique that allows the instantaneous measurement of intrinsic regional myocardial motion velocity. Pulsed TDI is capable of separately assessing left ventricular (LV) regional motion velocity caused by circumferential and longitudinal fiber contraction. This particular feature of function is still controversial in patients with hypertrophic cardiomyopathy (HC).

METHODS

To better characterize intrinsic circumferential and longitudinal LV systolic myocardial function in HC, we used pulsed TDI to measure short- and long-axis LV motion velocities, respectively. The subendocardial motion velocity patterns at the middle of the LV posterior wall (PW) and ventricular septum (IVS) in LV parasternal and apical long-axis views were recorded by pulsed TDI in 19 patients with nonobstructive HC and in 21 normal controls (NC).

RESULTS

Peak short- and long-axis systolic subendocardial velocities in both the LV PW and IVS were significantly smaller in the HC group than in the NC group, and the time to peak velocity was significantly delayed. Furthermore, peak PW systolic velocity was significantly greater along the long axis than along the short axis in the NC group (8.8 +/- 1.5 cm/s vs 8.2 +/- 1.4 cm/s, P <.05), whereas the opposite was observed in the HC group (6.1 +/- 1.2 cm/s vs 7.5 +/- 1.0 cm/s, P <.0001). No significant differences were found in either group between the long- and short-axis IVS velocities (HC: 5.9 +/- 1.4 cm/s vs 5.5 +/- 1.3 cm/s; NC: 7.8 +/- 1.3 cm/s vs 7.9 +/- 1.6 cm/s).

CONCLUSIONS

By using the capability of pulsed TDI for the evaluation of intrinsic myocardial velocity instantaneously in a specific region and direction, we found impairment of LV myocardial systolic function in patients with HC not only in the hypertrophied IVS but also in the nonhypertrophied LV PW. We also found a greater decrease in LV PW velocities along the long axis than the short axis, suggesting greater impairment of long-axis contraction in patients with HC. Because our HC patients did not appear to have excessive intracavitary pressure, these results suggest that the relatively normal-appearing PW is directly affected by the HC pathologic process.

Association of upper arm circumference at muscle flexion with lumbar spine bone mineral density

We investigated the association of upper arm circumference at muscle flexion with lumbar spine (L2-L4) bone mineral density (BMD) in 252 postmenopausal Japanese women (mean age, 62.0 +/- 7.6 years; range, 43-78 years) with right-side dominance. Age, age at menopause, years since menopause (YSM), weight, and height were recorded. Dominant upper arm circumference (cm) was measured at muscle flexion. Lumbar spine BMD was measured by dual-energy X-ray absorptiometry (DXA). Correlations between BMD and variables were determined using Pearson's correlation coefficient. Significant predictors of the lumbar spine BMD were determined using stepwise multiple regression analysis. Upper arm circumference, weight, and height were positively correlated with BMD (r = 0.397, 0.343, and 0.323, respectively), whereas YSM and age were inversely correlated with BMD (r = -0.415 and -0.392, respectively). On stepwise multiple regression analysis, YSM, upper arm circumference, and weight were significant predictors of BMD (R2 = 0.322, P < 0.0001). Predicted value of the lumbar spine BMD was calculated by the following formula: Predicted BMD = 0.249 - 0.0078 (YSM) + 0.016 (upper arm circumference) + 0.0046 (weight). Dominant upper arm circumference at muscle flexion in combination with YSM and weight is a useful predictor of lumbar spine BMD.

NMR, UV-vis and CD study on the interaction of pradimicin BMY-28864 with divalent cations of alkaline earth metal

In order to clarify the mechanism of the calcium-activated anti-fungal action of pradimicin derivatives, we investigated the compatibility of four divalent metal cations, Ca2+, Mg2+, Sr2+ and Ba2+, when combined with pradimicin BMY-28864 in an aqueous solution. The 1H NMR studies suggest that all the tested cations can induce a chemical exchange between two types of aggregation of BMY-28864 in an aqueous solution. The exchange rate, however, varies according to the cation species. In descending order they are: Ba2+ > Sr2+ > Ca2+ > Mg2+. The differences in the binding ability of BMY-28864 to the cations and the solubility of the chloride salts are explained by the electronegativity of these cations. The UV-Vis and CD spectra of these solutions show isosbestic points that correspond to an exchange process in the cations' binding to BMY-28864. The results provide experimental support for the hypothesis that there is a common mechanism underlying their cations interactions with the antibiotic. The CD study also provided evidence about the stoichiometric relation of the divalent metal ions to the antibiotic, 1:2, which was obtained by NMR analyses.

Congenital balloon digits in two neonates caused by constriction rings

Balloon digits were found in two neonates with congenital constriction ring syndrome. The affected digits were the right long finger and right great toe. They were surgically treated at the age of 10 and 9 days, respectively. Morphologic improvement was dramatic after surgery. In cases with extensive enlargement, severe cyanosis, redness, and no subsidence of edema within several days after birth, early operative treatment may be necessary to maintain digit viability and prevent autoamputation due to circulatory embarrassment. It can also be helpful to prevent fibrosis of the subcutaneous tissue. Pathologic examination revealed marked proliferation of fibrous tissue and lymphatic vessels.

Neuron-specific expression of reporter gene in transgenic mice carrying the 5'-upstream region of mouse P/Q-type Ca2+ channel alpha 1A subunit gene fused to E. coli lacZ reporter gene

To dissect the molecular mechanisms underlying the neuron-specific expression of the P/Q type calcium channel alpha 1A subunit gene, transgenic mice carrying a 0.5-kb, 1.5-kb, 3.0-kb or 6.3-kb 5'-upstream region of the gene fused to Escherichia coli lacZ reporter gene were produced. In transgenic mice carrying the 1.5-kb, 3.0-kb or 6.3-kb 5'-upstream region, the reporter gene was exclusively expressed in the nervous system, although those with the 0.5-kb 5'-upstream region failed to show reporter expression. Histological examinations showed that the three 5'-upstream regions induced distinct expression patterns of the reporter gene in the CNS and adrenal medulla. The 1.5-kb 5'-upstream region drove reporter gene expression in the olfactory bulb, dorsal cortex and hippocampus, while the regulatory element for the expression in the amygdaloid nucleus, septum, habenula medial nucleus, choroid plexus, substantia nigra, inferior colliculus, pontine nucleus and cerebellum was located in the 5'-upstream sequence between 1.5 kb and 6.3 kb. In the cerebellum, the expression of the reporter gene was induced by the 3.0-kb region in granule cells, whereas it was induced by the 6.3-kb region in Purkinje cells. The expression of the reporter gene in chromaffin cells in the adrenal medulla was induced only by the 6.3-kb 5'-upstream region. These results suggest that the expression of the mouse P/Q-type Ca2+ channel alpha 1A subunit gene is regulated in a complex fashion by both positive and negative cis-regulatory elements.

Influence of aging on systolic left ventricular wall motion velocities along the long and short axes in clinically normal patients determined by pulsed tissue doppler imaging

Our objective was to evaluate the influence of aging on left ventricular (LV) regional systolic function along the long and short axes in clinically normal patients. We recorded LV wall motion velocity patterns at the mid-wall portion of the middle of the LV posterior wall in the parasternal long-axis view (short-axis direction) and at the endocardial portion of the middle of the LV posterior wall in the apical long-axis view (long-axis direction) with pulsed tissue Doppler imaging in 80 normal patients (age range 15 to 78 years). In all patients the LV pressure curve and its first derivative (dP/dt) were recorded. The systolic wave of the LV posterior wall motion velocity pattern exhibited 2 peaks, the first (Sw(1)) and second (Sw(2)) systolic waves. No significant changes were seen with aging in the percent LV fractional shortening determined by M-mode echocardiography, LV ejection fraction determined by left ventriculography, the peak Sw(1) and Sw(2) along the short axis, the peak Sw(2) along the long axis, and the peak dP/dt. The peak Sw(1) along the long axis correlated inversely with age (P <.0001) but did not correlate significantly with the peak dP/dt. These results suggest that shortening of the longitudinal fibers in early systole is impaired with increased age in healthy individuals. This impairment results in insufficient spherical change in the LV cavity, although global LV pump function and myocardial contractility are maintained.

Evaluation of left ventricular contraction abnormalities in patients with dilated cardiomyopathy with the use of pulsed tissue Doppler imaging

The left ventricular (LV) systolic wave, as recorded by pulsed tissue Doppler imaging, usually consists of 2 components (Sw(1) and Sw(2)). However, the clinical significance of these waves has not been studied in patients with dilated cardiomyopathy (DCM) and sinus rhythm. We studied 25 patients with DCM (DCM group) and 22 age-matched normal subjects (control group). The LV posterior wall motion velocities along the short and long axes were recorded by pulsed tissue Doppler imaging, and the peak velocities of the Sw(1) and Sw(2) and the times from the electrocardiographic Q wave to the peak Sw(1) and Sw(2) (Q-Sw(1) and Q-Sw(2), respectively) were determined. In all patients cardiac catheterization was performed immediately after the noninvasive examination, and the LV end-diastolic pressure and peak dP/dt were determined. The LV end-diastolic pressure and peak dP/dt were significantly greater and lower, respectively, in the DCM group. The peak Sw(1) along the long axis was significantly greater than Sw(1) and Sw(2) along the short axis and Sw(2) along the long axis in the control group. The peak Sw(1) and Sw(2) along the long and short axes were all significantly lower in the DCM group than in the control group. The Q-Sw(1) along the long axis was significantly shorter than that along the short axis, whereas no significant difference was seen in the Q-Sw(2) in either axis in any patient. The Q-Sw(1) and Q-Sw(2) along both axes were significantly longer in the DCM group than in the control group. All systolic pulsed tissue Doppler imaging variables, particularly the peak Sw(1) along the long axis, correlated well with the peak dP/dt in all patients. LV contractility along both the short and long axes is commonly impaired in patients with DCM. In particular, peak Sw(1) along the long axis is a useful parameter for evaluating LV myocardial contractility during isovolumic contraction.

Coronary flow velocity immediately after reperfusion reflects myocardial microcirculation in canine models of acute myocardial infarction

Recent reports indicate that the coronary microcirculation is sometimes injured, despite successful reperfusion in acute myocardial infarction (AMI). However, it is difficult to evaluate the coronary microcirculation immediately after reperfusion by using only angiography. The purpose of this study was to examine the relationship between the pattern of coronary blood flow velocity and myocardial microcirculatory injury immediately after reperfusion in AMI. The authors recorded the left circumflex coronary flow velocity by using the Doppler guide wire method 10 minutes after reperfusion in a canine model of AMI. In addition, myocardial contrast echocardiography was performed with the injection of contrast medium into the left circumflex coronary artery before clamping of the coronary artery and 15 minutes after release of the clamp. From these images, the ratio of the normalized gray-level postreperfusion to preclamping in the contrast-enhanced area was determined. It was compared with coronary flow velocity variables. In the 10 dogs with a diastolic-to-systolic velocity ratio (DSVR) < 4.0, this velocity ratio 10 minutes after reperfusion correlated positively (r = 0.75, p < 0.01) with the normalized gray-level ratio. However, the remaining three dogs with a DSVR > or = 4.0 markedly deviated from this pattern. Coronary flow velocities in the three dogs were characterized by a greater decrease in systolic flow velocity and occurrence of early systolic retrograde flow. Myocardial contrast echocardiographic images in these three dogs demonstrated a lower normalized gray-level ratio. In conclusion, the coronary flow velocity pattern immediately after reperfusion may reflect myocardial microcirculatory injury.

NMR study of pradimicin derivative BMY-28864 and its interaction with calcium ions in D2O

The dynamic structure of the antifungal antibiotic pradimicin BMY-28864 in D2O and its interaction with calcium ions were analyzed using one- and two-dimensional 1H nuclear magnetic resonance (NMR). Spectra indicate extensive self-association of molecules in the solution. Two-component spectra were observed simultaneously in a very dilute solution, suggesting equilibrium of two aggregative states. The addition of CaCl2 caused a number of changes in NMR spectra. Therefore we concluded that pradimicin BMY-28864 could form a complex with the Ca2+ ion, causing a movement of the equilibrium. The position of the bound calcium ion is determined indirectly by observing how the NMR shift affects protons that are close to the binding site. The stoichiometry of Ca2+ ion to the Pradimicin molecule for the Ca(2+)-saturated complex is verified to be 1:2. Signal broadening and changes in chemical shift in the 1H NMR spectroscopy of BMY-28864 are assumed to be related to changes in the molecular aggregate conformation.

Evaluation of the hemodynamic relationship between the left atrium and left ventricle during atrial systole by pulsed tissue Doppler imaging in patients with left heart failure

The objective of the present study was to evaluate the hemodynamic relationship between the left atrium (LA) and left ventricle (LV) during atrial systole in the presence of an elevated left ventricular end-diastolic pressure (LVEDP) and LV failure using pulsed tissue Doppler imaging (TDI). Fifty-three patients with LV systolic dysfunction and no regional LV asynergy were divided into 3 groups: relaxation failure group (RF, n=20) with a ratio of peak early diastolic to atrial systolic velocity of the transmitral flow (E/A) < or = 1; pseudonormalization group (PN, n=19) with 1 <E/A<2; and restrictive group (RS, n=14) with E/A> or =2. In addition, 20 normal patients (E/A > or = 1) were studied as a control group. The transmitral and pulmonary venous flow velocities were recorded by transesophageal pulsed Doppler echocardiography. The wall motion velocity patterns were recorded at the middle portion of the LV posterior wall (LVPW) and at the mitral annulus (MA) of the LVPW site in the apical LV long-axis view by transthoracic pulsed TDI. The LVEDP was significantly greater in the PN and RS groups than in the RF and control groups. The moan pulmonary capillary wedge pressure was greatest in the RS group. The percent fractional change of the LA area during atrial systole determined by 2-dimensional echocardiography was significantly lower in the RS group than in the PN group. The peak atrial systolic pulmonary venous flow velocity was significantly greater in the PN group than in the RS group. The peak atrial systolic motion velocity (Aw) at the LVPW was significantly lower in the PN and RS groups than in the RF and control groups. The Aw at the MA was significantly lower in the RS group than in the other groups. There was no significant difference in Aw between the LVPW and MA in the RS group, whereas Aw at the MA was significantly greater than that at the LVPW in the PN group. In conclusion, the measurements of Aw at the LVPW and MA can be used to noninvasively evaluate the hemodynamic relationship between the LA and LV during atrial systole in patients with LV failure.

The contribution of menopause to changes in body-fat distribution

OBJECTIVE

To investigate whether menopause contributes to changes in body-fat distribution, irrespective of aging or obesity.

METHODS

The subjects were 545 premenopausal (aged 16-55 years; mean +/- standard deviation, 37.7 +/- 9.1 years) and 219 postmenopausal (aged 45-65 years, 58.0 +/- 5.0 years) women. Baseline characteristics included age, body mass index (BMI), and menopausal status (premenopause or postmenopause). The ratio of trunk fat to leg fat (trunk-leg ratio) was estimated by dual-energy X-ray absorptiometry. The trunk-leg ratio and baseline characteristics were compared between the 2 groups. In all subjects (n = 764), possible correlations between the trunk-leg ratio and the baseline characteristics were determined using univariate and multivariate analysis. In postmenopausal women, the relationship of the trunk-leg ratio to YSM or age after adjusting for BMI was investigated.

RESULTS

The trunk-leg ratio and BMI were significantly higher in postmenopausal women than in premenopausal women. In all subjects, age and BMI were positively correlated with the trunk-leg ratio (r = 0.445 and 0.587, respectively, p < 0.0001). Menopause was also positively correlated with the trunk-leg ratio on univariate regression analysis (standardized regression coefficient = 0.369, p < 0.0001). On multiple regression analysis, age, BMI, and menopause were independently correlated with the trunk-leg ratio (p < 0.05). In postmenopausal women, age and YSM were positively correlated with the trunk-leg ratio, independent of the BMI (p < 0.01).

CONCLUSIONS

Menopause contributes to a change in body-fat distribution, irrespective of aging or obesity.

The interaction of cellular fibronectin with collagen during fibroblast-mediated contraction of collagen gels

In the first instance highly hydrated collagen gels contract to dense and compact gels when populated by fibroblasts. We previously reported the involvement of fibronectin (FN) in an early process of the collagen gel contraction, utilizing a specific monoclonal antibody dubbed A3A5 (MoAb-A3A5) that inhibits the gel contraction. This study was performed to further characterize the role of the epitope for MoAb-A3A5 in the interaction between fibroblasts and collagen fibrils. Although both cellular FN (cFN) and plasma FN (pFN) were reactive with MoAb-A3A5, the FN that actually participates in a process of the gel contraction was shown to be cFN. The gel contraction was significantly accelerated when fibroblasts were pretreated with excess amounts of cFN and was significantly inhibited when the collagen molecules were pretreated with excess cFN. Such effects of the pretreatments were not observed for pFN. The involvement of cFN, but not pFN, in the interaction of fibroblasts with collagen fibrils was additionally shown by the similar inhibitory action of cFN, but not pFN, on the spreading and elongation of fibroblasts on collagen fibrils. The epitope for MoAb-A3A5 was strongly suggested to be a new functional domain responsible for the interactions between fibroblasts and native collagen molecules. This was not the case for those with denatured one, because fibroblasts on collagen fibrils were not stainable with MoAb-A3A5, whereas the interactions on gelatin were stainable. The lack of the reactivity of fibroblasts on collagen fibrils toward MoAb-A3A5 was not a result of the absence of FN on the cell membrane, but seemed to be a steric hindrance to the access of the antibody.

Serum androgen levels and muscle mass in women with polycystic ovary syndrome

OBJECTIVE

To relate serum androgen levels and muscle size in women with polycystic ovary syndrome (PCOS).

METHODS

Forty-eight women with PCOS were studied. Baseline characteristics included age, height, weight, and hirsutism. Total-body lean mass was measured by wholebody scanning with dual-energy x-ray absorptiometry, and the lean mass index (total-body lean mass/height2, kg/m2) was calculated. Trunk-leg fat mass ratio (trunk-leg fat ratio) was assessed by dual-energy x-ray absorptiometry. Serum testosterone, dehydroepiandrosterone sulfate, and androstenedione levels were measured by radioimmunoassay. Subjects were arbitrarily divided into two groups according to lean mass index (lean mass index at least 14 kg/m2, n = 24; or less than 14 kg/m2, n = 24). Baseline characteristics and serum androgen levels were compared between the groups. In all subjects, lean mass index was correlated with age, height, trunk-leg fat ratio, and serum androgen levels.

RESULTS

Although trunk-leg fat ratio, serum testosterone and androstenedione levels, and the prevalence of hirsutism were significantly higher in women with a lean mass index at least 14 kg/m2, age and height did not differ significantly between the groups. Trunk-leg fat ratio and serum testosterone and androstenedione levels correlated significantly with lean mass index (r = .68, .75, and .54, respectively). Hirsutism also correlated with lean mass index (standardized regression coefficient = .49; P<.05).

CONCLUSION

Muscle size in women with PCOS correlated positively with serum androgen levels and upper body-fat distribution, independent of height.

Effect of aging on diastolic left ventricular myocardial velocities measured by pulsed tissue Doppler imaging in healthy subjects

We evaluated the effect of aging on diastolic left ventricular (LV) wall motion velocity in 80 healthy persons with the use of pulsed tissue Doppler imaging. The wall motion velocity patterns were recorded at the middle regions of the LV posterior wall and ventricular septum in the parasternal (along the short axis) and apical (along the long axis) LV long-axis views. In the posterior wall, the peak early diastolic wall motion velocities (Ews) along both axes correlated inversely with age (long axis: r = -0.61, P <. 0001; short axis: r = -0.55, P <.0001), and the peak atrial systolic wall motion velocities(Aws) along both axes correlated directly with age (long axis: r = 0.59, P <.0001; short axis: r = 0.65, P <.0001). In the ventricular septum, the Ew along the long axis correlated inversely with age (r = -0.51, P <.0001), and the Aws along both axes correlated directly with age (long axis: r = 0.57, P <.0001; short axis: r = 0.53, P <.0001). The Ews along both axes at the posterior wall correlated directly with the peak early diastolic transmitral flow velocity. The Aws along both axes at the ventricular septum and posterior wall correlated directly with the peak atrial systolic transmitral flow velocity. The times from the second heart sound to the peak of the early diastolic waves of the ventricular septum and posterior wall along both axes significantly increased with age. The times from the aortic component of the second heart sound to the peak of the early diastolic motion velocities along both axes were significantly longer at the ventricular septum than at the posterior wall. Pulsed tissue Doppler imaging may be useful for evaluating the effect of aging on diastolic LV function in healthy persons.

Isolation and functional characterization of the 5'-upstream region of mouse P/Q-type Ca2+ channel alpha1A subunit gene

The omega-agatoxin-IVA-sensitive P/Q-type Ca2+ channel is predominantly expressed in the nervous system. To dissect the molecular mechanisms underlying the neuron-specific expression of the P/Q-type channel, we have isolated and characterized the 5'-upstream region of the mouse alpha1A subunit gene. A transcription start site appeared to exist at -269 bp upstream from the start codon as found by 5' RACE analysis. The proximal promoter of the alpha1A subunit gene lacks a typical TATA box, but contains several transcription factor binding sequences, including two Sp1 sites. When linked to a placental alkaline phosphatase (PLAP) reporter gene to examine the promoter activity, the 6.3-kb (-6,273 to +269) 5'-upstream region, but not a smaller 3.0-kb construct (-3, 021 to +269), was able to drive the reporter gene in neuron-like PC12 cells. In contrast, neither of these constructs enhanced the PLAP expression in fibroblast NIH3T3 cells. The sequence between 6.3 and 3.0 kb of the 5'-upstream region did not show promoter activity in either of the cell lines, but enhanced TK promoter activity in PC12 cells, though not in NIH3T3 cells. These results suggest that neuron-specific elements of the alpha1A subunit gene are likely to be located in the distal upstream regions (-6,273 to -3,021) of the 5'-upstream sequence.

Effect of an acute increase in afterload on left ventricular regional wall motion velocity in healthy subjects

We recorded left ventricular (LV) wall motion velocities before and after angiotensin II infusion by pulsed tissue Doppler imaging in 20 healthy subjects, and evaluated the responses of systolic and diastolic LV function along the long and short axes during an acute increase in afterload. Angiotensin II was administered intravenously to obtain a 30% increase in mean blood pressure. After angiotensin II infusion, LV end-systolic dimension and end-systolic circumferential wall stress increased significantly, and the percentage of LV fractional shortening decreased significantly. Peak first systolic LV wall motion velocity (Sw1 ) along the long axis decreased markedly compared with that along the short axis, and peak second systolic LV wall motion velocity (Sw2 ) along the short axis decreased significantly compared with that along the long axis. Early diastolic LV wall motion velocities along both the long and short axes decreased significantly, whereas atrial systolic LV wall motion velocity did not change. In conclusion, an acute increase in afterload caused a significant decrease in longitudinal fiber shortening during the isovolumic contraction phase (Sw1 along the long axis), circumferential fiber shortening during the ejection phase (Sw2 along the short axis), and LV relaxation during early diastole (early diastolic LV wall motion velocities along both axes) in healthy subjects. Pulsed tissue Doppler imaging may be useful for detecting the effect of various loading conditions on LV wall motion velocities along the long and short axes.

Regional left ventricular myocardial contraction abnormalities and asynchrony in patients with hypertrophic cardiomyopathy evaluated by magnetic resonance spatial modulation of magnetization myocardial tagging

Global left ventricular (LV) pump function is generally preserved in patients with hypertrophic cardiomyopathy (HCM). However, it is unknown whether regional myocardial contractility is impaired, especially in nonhypertrophied regions. The purpose of this study was to evaluate regional LV myocardial contraction in patients with HCM using magnetic resonance (MR) spatial modulation of magnetization (SPAMM) myocardial tagging. The study group comprised 20 patients with asymmetric septal hypertrophy (HCM group) and 16 age-matched normal patients (control group), and data were collected using transthoracic M-mode and 2-dimensional echocardiography, and MR SPAMM myocardial tagging. The systolic strain ratio, maximum systolic strain velocity, and time from end-diastole to maximum systolic strain (deltaT) in the anterior, ventricular septal, inferior and lateral regions for 2 LV short-axis sections at the levels of the chordae tendineae and papillary muscles were measured at 50-ms intervals by MR myocardial tagging. The end-diastolic anterior and ventricular septal wall thicknesses and LV mass index were significantly different between the HCM and control groups. The systolic strain ratio for all 4 walls, particularly the anterior and ventricular septal regions, was significantly lower in the HCM group. In the HCM group, the maximum systolic strain velocity was significantly lower and deltaT was significantly shorter for all 4 walls, particularly the anterior and ventricular septal regions. The standard deviation for the deltaT, calculated from the deltaT for the 8 regions of the 2 LV short-axis sections, was significantly greater in the HCM group. In conclusion, regional LV myocardial contraction is impaired in both hypertrophied and nonhypertrophied regions, and systolic LV wall asynchrony occurs in patients with HCM.

Development of a self-cloning system for Actinomadura verrucosospora and identification of polyketide synthase genes essential for production of the angucyclic antibiotic pradimicin

A self-cloning system for Actinomadura verrucosospora, a producer of the angucyclic antibiotic pradimicin A (PRM A), has been developed. The system is based on reproducible and reliable protoplasting and regeneration conditions for A. verrucosospora and a novel plasmid vector that consists of a replicon from a newly found Actinomadura plasmid and a selectable marker cloned from the Actinomadura strain. The system has an efficiency of more than 10(5) CFU/microgram of DNA. Using this system, we have cloned and identified the polyketide synthase (PKS) genes essential for PRM A biosynthesis from A. verrucosospora. Nucleotide sequence analysis of the 3.5-kb SalI-SphI fragment showed that ketosynthase subunits (open reading frame 1 [ORF1] and ORF2) of the essential PKS genes have strong similarities (59 to 89%) to those for angucyclic antibiotic biosynthesis.

Involvement of Ca2+ ion and reactive oxygen species as a mediator in pradimicin-induced apoptosis

Pradimicin (PRM) induces apoptosis in mammalian cells which had been incubated with 1-deoxymannojirimycin (DMJ). Flow cytometric analysis revealed that PRM preferentially induced apoptosis to the cells of the G1 phase. Two possible mediators in this apoptotic cascade were identified. Exposure of DMJ-treated cells to PRM resulted in a rapid (approximately 5 seconds) and slow (approximately 30 minutes) elevation of the intracellular calcium level. Reactive oxygen species (ROS) were proved to be involved in this system by the fact that the apoptosis was completely inhibited by treating the cells with a ROS scavenger, N-acetylcysteine in prior to the PRM stimulation.

High-mannose type oligosaccharide-dependent apoptosis in U937 cells induced by pradimicin, a mannose-binding antibiotic

Cell surface oligosaccharides play a role in a variety of biological events such as cell adhesion and signal transduction. We have shown that BMY-28864, a semi-synthetic analog of pradimicin, induced apoptosis of U937 cells which had been incubated with 1-deoxymannojirimycin, an inhibitor of mannosidase I. BMY-28864 was not cytotoxic to the cells which had been cultivated with other glycosidase inhibitors such as castanospermine and swainsonine. We thus propose that BMY-28864 induces apoptosis by acting on a specific mannose-rich oligosaccharide, presumably (Man)9(GlcNAc)2+.

Pulsed tissue Doppler imaging of left ventricular systolic and diastolic wall motion velocities to evaluate differences between long and short axes in healthy subjects

Our objective was to evaluate in healthy subjects the left ventricular (LV) wall motion velocities along the long and short axes by means of pulsed tissue Doppler imaging (TDI) to clarify the differences in the LV systolic and diastolic function between both axes. Wall motion velocities were recorded at the mid-wall portion of the middle site of the LV posterior wall in the parasternal long-axis view, and at the subendocardial portion of the middle site of the LV posterior wall in the apical long-axis view by pulsed TDI in 35 healthy subjects (mean age 26 +/- 10 years, mean heart rate 72 +/- 7 bpm). In all subjects, the LV pressure curve, its first derivative (dP/dt), the LV wall motion velocity, the phonocardiogram, and the electrocardiogram were simultaneously recorded. The systolic wave of the LV posterior wall motion velocity exhibited 2 peaks: the first and second systolic waves (Swl and Sw2, respectively). The diastolic wave also exhibited 2 peaks, the early diastolic and atrial systolic waves. The Swl along the long axis was greater than either the Sw1 and Sw2 along the short axis or the Sw2 along the long axis. The peak Sw1 along the long axis coincided with the peak dP/dt and was slightly earlier than the peak Swl along the short axis. The onset of Sw1 along the long axis coincided with the onset of the first heart sound. The Sw2 along the short axis was greater than that along the long axis. The early diastolic wave along the short axis was greater than that along the long axis, whereas the atrial systolic wave along the long axis was greater than that along the short axis. Thus, in healthy subjects, shortening of the longitudinal fibers predominated over that of the circumferential fibers during early systole, whereas shortening of the circumferential fibers predominated over the longitudinal fibers during the ejection phase. During diastole, the circumferential fibers predominated in the LV wall expansion at early diastole, whereas the longitudinal fibers predominated at atrial systole. In conclusion, pulsed TDI provided information that is useful in understanding the characteristics of LV wall motion along the long and short axes.

cDNA cloning and mapping of a novel subtype of glutamine:fructose-6-phosphate amidotransferase (GFAT2) in human and mouse

We subcloned human and mouse full-length cDNAs of a novel subtype of glutamine:fructose-6-phosphate amidotransferase (GFAT), which was designated GFAT2 (the previously reported GFAT was named GFAT1). Both the human and the mouse GFAT2 proteins deduced from their open reading frame sequences are composed of 682 amino acids of approximately 77.0 kDa. At the amino acid level, homologies between the human GFAT1 and GFAT2, between the mouse GFAT1 and GFAT2, and between the human GFAT2 and the mouse GFAT2 were 75.6, 74.7, and 97. 2%, respectively. Northern blot analysis using probe specific to human GFAT1 or GFAT2 showed that major transcripts were approximately 3.0 kb in both the human GFAT subtypes. The analysis also revealed different tissue distribution between GFAT1 and GFAT2: GFAT1 was more highly expressed in the placenta, pancreas, and testis than GFAT2; GFAT2 was expressed throughout the central nervous system, especially in the spinal cord, but GFAT1 expression was weak. The locus was mapped to human chromosome 5q and mouse chromosome 11, where a synteny between the two species has been known. GFAT2 can provide insights into understanding the roles of the hexosamine pathway in various tissues, particularly with the development of glucose toxicity and diabetes complications.

Assessment of the temporal relationship between left ventricular relaxation and filling during early diastole using pulsed Doppler echocardiography and tissue Doppler imaging

The study investigated the temporal relationship between left ventricular (LV) relaxation and filling during early diastole. The transmitral flow (TMF) velocity by pulsed Doppler echocardiography and LV wall motion velocity by pulsed tissue Doppler imaging (TDI) were evaluated in 57 patients with various heart diseases and 33 normal controls. The patients were classified into 2 groups according to the ratio of the peak early diastolic to atrial systolic TMF velocity (E/A): (1) the high A group included 44 patients with an E/A < or = 1, and (2) the pseudonormalization group included 13 patients with an E/A > 1. The isovolumic relaxation time (IRT) from the aortic component of the second heart sound (IIA) to the onset of the E wave of the TMF was measured. The peak early diastolic velocity of the LV posterior wall (Ew) and time from the IIA to the onset of the early diastolic wave (IIA-Ewo) were determined from the LV wall motion velocity assessed by pulsed TDI. The Ew was lower in the pseudonormalization and high A groups than in the control group. The IIA-Ewo was significantly longer in the pseudonormalization and high A groups than in the control group. The time constant of the LV pressure decay at isovolumic diastole (tau) correlated negatively with the Ew, and correlated positively with the IIA-Ewo in all groups. The IIA-Ewo was equal to or shorter than the IRT in control subjects, and was longer than the IRT in patients in the pseudonormalization group. In conclusion, the temporal relationship between LV relaxation and filling during early diastole varied according to the subjects' hemodynamic status. Analysis of TMF by pulsed Doppler echocardiography and LV wall motion velocity by pulsed TDI was useful for detailed evaluation of early diastolic LV hemodynamics.

Isolation and identification of peptidic alpha-glucosidase inhibitors derived from sardine muscle hydrolyzate

We report here the isolation of alpha-glucosidase (AGH) inhibitory peptides derived from sardine muscle hydrolyzate, which was prepared by digestion with Bacillus licheniformis alkaline protease. As a result of reversed-phase HPLC purification, two AGH inhibitory peptides were isolated from a DEAE-Sephadex A-25 column eluate. The peptides were identified as follows: Val-Trp (IC50 = 22.6 mM) and Try-Tyr-Pro-Leu (IC50 = 3.7 mM). AGH inhibitory studies of Try-Tyr-Pro-Leu and its derivatives demonstrated the importance of the tri-peptide chain length as well as the hydrophobic aromatic amino acid tyrosine at the N-terminus, aliphatic amino acids at the C-terminus, as well as an amide proton from the peptide chain at the middle position of the tri-peptide to develop AGH inhibition activity.

Left ventricular systolic wall motion velocities along the long and short axes measured by pulsed tissue Doppler imaging in patients with atrial fibrillation

Pulsed tissue Doppler imaging was performed to measure systolic left ventricular (LV) posterior wall motion velocity along the long and short axes and to evaluate the relationships between the systolic variables and the maximum first derivative (peak dP/dt) of the LV pressure curve and the 2 preceding R-R intervals in 39 patients with atrial fibrillation (AF). The study group consisted of 22 patients with AF only, 17 patients with dilated or ischemic cardiomyopathy and AF, and 25 healthy control subjects in sinus rhythm. The systolic component of the LV posterior wall motion velocity was divided into the first (Sw1) and second (Sw2 ) systolic waves. The peak Sw1 along the long axis was greater than either that along the short axis or the peak Sw2s along the long and short axes in the control and AF-only groups. The peak Sw1 along the long axis was lower in the AF-only group than in the control group, and those along the short and long axes were lower in the dilated AF group than in the other groups. The peak Sw1 almost coincided with the peak dP/dt. The peak Sw1 along the long axis correlated closely with the peak dP/dt, and the ratio of the preceding R-R interval to the interval before the preceding ("prepreceding") R-R interval in both AF groups, particularly in the dilated AF group, and the slopes of their relationships were steeper in the dilated AF group than in the AF-only group. The peak Sw2 along the short axis was greater than that along the long axis in the control and AF-only groups. The peak Sw2 along the long axis was lower in the AF-only group than in the control group, and those along the short and long axes were lower in the dilated AF group than in the other groups. The peak dP/dt was lower and the LV end-diastolic pressure was higher in the dilated AF group than in the other groups. In conclusion, peak Sw1 along the long axis is useful for the evaluation of isovolumic myocardial LV contractility, and the interval-force relation and the Frank-Starling mechanism are important factors of beat-to-beat variability in systolic LV function in patients with AF.

Inhibitory effect of alpha-glucosidase inhibitors varies according to its origin

The inhibitory effect of alpha-glucosidase (AGH) inhibitors against its origins (baker's yeast and rat, rabbit, and pig small intestines) was investigated. All inhibitors used in this study showed quite different inhibitory activities according to AGH origins. Voglibose, acarbose and glucono-1,5-lactone strongly inhibited mammalian AGHs, whereas no or less inhibition was observed in yeast AGH. On the contrary, (+)-catechin, a good inhibitor against yeast AGH (IC(50) = 1.3 x 10(-)(1) mM) as well as voglibose (IC(50) = 2.6 x 10(-)(2) mM), did not retard the mammalian AGH activity. Subsequent inhibition study with various food components revealed that all of foods except for green (IC(50) = 0.735 mg/mL) and oolong teas (IC(50) = 1.34 mg/mL) showed no inhibitory activity against rat AGH, whereas they inhibited yeast AGH. Consequently, the magnitude of AGH inhibition was greatly affected by its origin, and more attention relating to AGH origin would be needed to evaluate in vitro AGH inhibitory effect.

Electrophysiologic effects of quinaprilat in dogs during acute myocardial ischemia and following reperfusion

BACKGROUND

There have been few studies concerning the electrophysiologic changes associated with the use of angiotensin-converting enzyme inhibitors in patients with acute myocardial infarction. We examined the electrophysiologic effects of quinaprilat in dogs during acute myocardial ischemia and following reperfusion.

METHODS

The left anterior descending coronary artery was occluded for 10 min and reperfused for 10 min. Animals received intravenous quinaprilat (3 micrograms/kg per min, quinaprilat group) or saline (control group). We measured the ventricular effective refractory period and intra-myocardial conduction time within the left anterior descending coronary artery region (ischemic region) during myocardial ischemia and following reperfusion, and determined the frequency of ventricular fibrillation.

RESULTS

The effective refractory period in the ischemic region decreased during myocardial ischemia and decreased further immediately after reperfusion in the control group. The intra-myocardial conduction time in the ischemic region increased during myocardial ischemia but rapidly shortened after reperfusion in the control group. In the quinaprilat group, however, no significant differences were evident between the ischemic and non-ischemic regions in either the effective refractory period or the intra-myocardial conduction time during myocardial ischemia or following reperfusion. The percentage shortening of the effective refractory period and the percentage prolongation of the intra-myocardial conduction time in the ischemic region were significantly lower in the quinaprilat group than in the control group during myocardial ischemia and following reperfusion. The frequency of ventricular fibrillation during myocardial ischemia and following reperfusion was significantly lower in the quinaprilat group (21%) than in the control group (74%; P < 0.01).

CONCLUSIONS

Quinaprilat protects against electrophysiologic abnormalities, and may decrease arrhythmias during acute myocardial ischemia and following reperfusion.

Bone mineral density in postmenopausal women with endometrial cancer

OBJECTIVE

The aim of the study was to investigate the relationship between endometrial cancer and bone mineral density (BMD).

MATERIALS AND METHODS

A total of 55 postmenopausal Japanese women with well-differentiated adenocarcinoma and 284 age-matched healthy women were studied. Baseline characteristics including age, age at menopause, years since menopause (YSM), weight, height, body mass index (BMI), prior menstrual history, parity, and fertility were recorded for each subject. Lumbar spine BMD (L2-4), and body fat indices including body fat mass amount and percent body fat were measured by dual-energy X-ray absorptiometry. These variables were compared between the two groups. In all subjects (n = 339), correlations of BMD with the presence of endometrial cancer, baseline characteristics, and body fat indices were investigated, using univariate and multiple regression analyses.

RESULTS

BMD, weight, BMI, body fat mass amount, and percent body fat were significantly higher in women with endometrial cancer. Other baseline characteristics did not differ between the two groups. Age at menopause, height, weight, BMI, percent body fat, and body fat mass amount were positively correlated with BMD, while age and YSM were inversely correlated with BMD. After adjusting for age, YSM, and height, the presence of endometrial cancer was still correlated with BMD (P < 0.05). However, after adding body fat mass amount to these three adjusted variables, there was no correlation between the presence of endometrial cancer and BMD.

CONCLUSION

Women with endometrial cancer have a high BMD. This is attributable to high body fat mass amount in this disease.

Difference in the diastolic left ventricular wall motion velocities between aortic and mitral regurgitation by pulsed tissue Doppler imaging

We evaluated the difference in the diastolic left ventricular (LV) wall motion velocity between chronic isolated aortic and mitral regurgitation (AR and MR, respectively) by recording subendocardial motion velocity patterns at the middle site of the LV posterior wall in the parasternal (along the short axis) and apical (along the long axis) long-axis views of the left ventricle with pulsed tissue Doppler imaging. We studied 33 patients with AR and 35 with MR, showing moderate to severe regurgitation, and 34 healthy controls (C). The end-diastolic LV dimension along the short axis was greater in the AR and MR groups than in the C group, and that along the long axis was greater in the AR group than in the MR and C groups. There were no significant differences in percent LV fractional shortening along the short axis among the 3 groups, whereas that along the long axis was significantly smaller in the AR group than in the MR and C groups. The peak early diastolic wall motion velocity (Ew) and the time to Ew from the aortic component of the second heart sound (S2 -Ew) along the long axis were significantly lower and longer, respectively, in patients with AR than in the 2 other groups. The Ew and S2 -Ew along both the short and long axes were significantly higher and shorter, respectively, in patients with MR than in the 2 other groups. The peak early diastolic velocity of the transmitral flow correlated positively with Ew along the short axis in all patients with AR and correlated positively with Ews along the long and short axes in all patients with MR. In conclusion, early diastolic LV filling was associated with expansion of the LV wall along the short axis but with decreased excursion along the long axis in patients with AR, whereas that in patients with MR was associated with expansion of the LV wall along both the long and short axes. Pulsed tissue Doppler imaging was useful for evaluation of diastolic LV function along the long and short axes in patients with diastolic LV volume overload.

Left ventricular diastolic properties of hypertensive patients measured by pulsed tissue Doppler imaging

Examination of left ventricular (LV) diastolic dysfunction in hypertensive patients has been based on parameters obtained from the transmitral flow velocity during pulsed Doppler echocardiography. However, these parameters are affected by loading conditions. We evaluated LV diastolic function along the longitudinal and transverse axes by pulsed tissue Doppler imaging (TDI) in 50 hypertensive (HT) patients and 36 age-matched healthy volunteers (N). Transmitral flow velocity was recorded by pulsed Doppler echocardiography. LV posterior wall motion velocity along the longitudinal and transverse axes also was recorded by pulsed TDI. In both groups, peak early diastolic velocity of the LV posterior wall (Ew) along the transverse axis (N: 15.8+/-5.2 cm/s, HT: 12.2+/-4.4 cm/s) was higher than that along the longitudinal axis (N: 12.7+/-3.1 cm/s, HT: 9.5+/-3.3 cm/s). Peak atrial systolic velocity of the LV posterior wall (Aw) along the longitudinal axis (N: 9.1+/-1.8 cm/s, HT: 9.7 +/-2.6 cm/s) significantly exceeded that along the transverse axis (N: 8.0+/-2.2 cm/s, HT: 8.4+/-2.4 cm/s) in both groups. The Ews were lower and the Aws were higher along both axes in the patient group than in the control group. The time intervals from the aortic component of the second heart sound to the peak of the early diastolic wave (IIA-Ews) along both the transverse (N: 142+/-18 ms, HT: 154+/-19 ms) and longitudinal (N: 151 16 ms, HT: 162+/-20 ms) axes were longer in the patient group. In 29 patients, Ews along both axes correlated negatively (transverse: r = -0.80, P < .0001; longitudinal: r = -0.71, P < .0001) and IIA-Ews correlated positively (transverse: r = 0.81, P < .0001; longitudinal: r = 0.74, P < .001) with the time constant of the LV pressure decay during isovolumic diastole. The Aws along both axes in the 24 patients without pseudonormalization in transmitral flow velocity correlated positively (transverse: r = 0.60, P < .001; longitudinal: r = 0.74, P < .0001) with the LV end-diastolic pressure. In conclusion, LV relaxation and filling along the longitudinal and transverse axes were impaired in many patients with hypertension. Pulsed TDI was useful for evaluating LV diastolic dynamics in this disease.

Relationship between flow dynamics in the left atrium and hemostatic abnormalities in patients with nonvalvular atrial fibrillation

To investigate the relationship between left atrial (LA) flow dynamics and hemostatic markers in nonvalvular atrial fibrillation (AF), 45 patients with nonvalvular AF who had not received anticoagulants were evaluated by transesophageal echocardiography. We determined the LA appendage flow and the presence of LA spontaneous echo contrast (SEC) or thrombus. We measured plasma levels of thrombin-antithrombin III complex (TAT), fibrinopeptide A, D-dimer, beta-thromboglobulin, and platelet factor 4 in peripheral blood as hemostatic markers. The patients were divided into a low-velocity group (n = 19; sum of peak emptying and filling LA appendage flow velocities < 40 cm/s) and a high-velocity group (n = 26; > or = 40 cm/s). The maximum LA diameter was significantly greater and the LA expansion fraction was significantly smaller in the low-velocity group than in the high-velocity group. LA SEC or thrombus was observed in 11 patients (58%) in the low-velocity group, but not in any patients in the high-velocity group (p < 0.001). The plasma levels of TAT, fibrinopeptide A, D-dimer, beta-thromboglobulin, and platelet factor 4 were significantly higher in the low-velocity group than in the high-velocity group. The plasma levels of TAT, fibrinopeptide A, beta-thromboglobulin, and platelet factor 4 were significantly higher in 8 patients without LA SEC or thrombus in the low-velocity group than in 26 patients in the high-velocity group. Patients with nonvalvular AF accompanied by an enlarged and dysfunctioning LA and a decreased LA appendage flow velocity had increased intravascular coagulation-fibrinolysis activity and platelet activation. These abnormalities may be closely related to the thrombogenetic state in patients with nonvalvular AF.

Glucosylquestiomycin, a novel antibiotic from Microbispora sp. TP-A0184: fermentation, isolation, structure determination, synthesis and biological activities

Glucosylquestiomycin, a novel N-glucopyranoside of questiomycin A, was isolated from the culture broth of Microbispora sp. TP-A0184. The absolute configuration of the sugar was determined as D-configuration by chemical synthesis. The new antibiotic showed antibacterial activity against gram-positive and -negative bacteria and yeasts and cytotoxic activity against U937 cells.

Menstrual disorders in patients undergoing chronic hemodialysis

OBJECTIVE

To investigate the etiology of menstrual disorders in patients undergoing chronic hemodialysis (CHD).

METHODS

The menstrual histories, along with hormonal, biochemical, and hematological data, were investigated in 25 reproductive-aged CHD patients.

RESULTS

All subjects had had regular menstrual cycles before entering CHD therapy. Of the 20 women who developed amenorrhea after beginning CHD therapy, 8 showed a return to their regular cycles and 6 improved to oligomenorrhea, 3 months to 66 months later, while 6 remained amenorrheic. The serum prolactin (PRL) levels were significantly higher in the patients (n = 9) with normogonadotropic amenorrhea or oligomenorrhea than in patients (n = 13) with regular cycles (53.6 +/- 36.2 vs 27.8 + 15.2 ng/ml, p < 0.05). The serum LH levels were high in both groups. In a cross-sectional study, the serum PRL levels gradually decreased with longer duration of dialysis.

CONCLUSIONS

Patients undergoing CHD are likely to develop menstrual disorders. Hyperprolactinemia in part contributes to these menstrual disorders. However, menstrual disorders in CHD patients tend to improve during long-term follow-up, because of the gradual decrease in serum PRL levels during long-term CHD therapy.

Regional left ventricular wall motion abnormalities in myocardial infarction and mitral annular descent velocities studied with pulsed tissue Doppler imaging

We evaluated global left ventricular (LV) systolic function from mitral annular systolic motion velocities measured by pulsed tissue Doppler imaging in patients with previous myocardial infarction (MI) and LV regional wall motion abnormalities. The subject group consisted of 45 patients with wall asynergies, 3 with ischemic cardiomyopathy, 8 with dilated cardiomyopathy, and 15 healthy control subjects. The peak systolic descent velocity (Sw) and the time from the electrocardiographic Q wave to the peak of the systolic wave (Q-Sw) were measured at 6 mitral annular sites obtained from 2-dimensional apical long-axis, 4-chamber, and 2-chamber echocardiograms; these variables were compared with the LV ejection fraction (EF) calculated from the left ventriculogram. The mean Sw at the sites corresponding to the infarct regions was significantly lower and the mean Q-Sw was significantly longer in the MI groups than in the control group. The mean Sw and Q-Sw at all 6 sites in the ischemic and dilated cardiomyopathy groups were significantly lower and longer, respectively, than those of the control group. There were significant correlations between the EF and the means of the Sw and Q-Sw values at the sites corresponding to the infarct regions in the MI groups. In the ischemic and dilated cardiomyopathy groups, significant correlations existed between the EF and the means of the Sw and Q-Sw values at all 6 sites. Thus the parameters obtained from mitral annular systolic motion velocities with pulsed tissue Doppler imaging reflect LV asynergy corresponding to the infarct regions in patients with MI, and global LV systolic function may be evaluated with these parameters.