Pulsatility of brachial artery pressure is associated with an increased risk of coronary artery disease in men

OBJECTIVES

The purpose of this study was to evaluate whether the pulsatility of brachial artery pressure is related to an increased risk of coronary artery disease (CAD). On the basis of vascular mechanics, we recently reported that relative pulse pressure can predict the occurrence of restenosis after percutaneous transluminal coronary angioplasty. We also hypothesized that relative pulse pressure of the brachial arterial pressure waveform is associated with an increased risk of CAD.

DESIGN

A cross-sectional study.

PATIENTS

We enrolled 172 men who had the same cardiac performances.

MAIN OUTCOME MEASURES

We measured their brachial artery pressures with a sphygmomanometer. To quantify the relative magnitude of the pulsatility to diastolic pressure, we made use of the ratio of pulse pressure to diastolic pressure (PP/DP). We investigated the effects of the PP/DP in relation to the risk of CAD.

RESULTS

PP/DP was associated with an increased risk of CAD. The prevalence rates of significant stenosis were 28.1% for the lowest, 43.1% for the middle and 49.1% for the highest tertile of PP/DP levels. The age-adjusted odds ratio of CAD was 2.23 (95% confidence interval 0.98-5.04) for the middle tertile of the PP/DP level and 2.55 (1.10-5.93) for the highest tertile compared with the lowest tertile.

CONCLUSIONS

The pulsatility of the brachial artery pressure was associated with an increased risk of CAD.

Production of dwarf lettuce by overexpressing a pumpkin gibberellin 20-oxidase gene

We investigated the effect of overexpressing a pumpkin gibberellin (GA) 20-oxidase gene encoding an enzyme that forms predominantly biologically inactive products on GA biosynthesis and plant morphology in transgenic lettuce (Lactuca sativa cv Vanguard) plants. Lettuce was transformed with the pumpkin GA 20-oxidase gene downstream of a strong constitutive promoter cassette (El2-35S-Omega). The transgenic plants in which the pumpkin gene was detected by polymerase chain reaction were dwarfed in the T(2) generation, whereas transformants with a normal growth phenotype did not contain the transgene. The result of Southern-blot analysis showed that the transgene was integrated as a single copy; the plants segregated three dwarfs to one normal in the T(2) generation, indicating that the transgene was stable and dominant. The endogenous levels of GA(1) and GA(4) were reduced in the dwarfs, whereas large amounts of GA(17) and GA(25), which are inactive products of the pumpkin GA 20-oxidase, accumulated in these lines. These results indicate that a functional pumpkin GA 20-oxidase is expressed in the transgenic lettuce, resulting in a diversion of the normal pathway of GA biosynthesis to inactive products. Furthermore, this technique may be useful for controlling plant stature in other agricultural and horticultural species.

Pulsatility of ascending aortic blood pressure waveform is associated with an increased risk of coronary heart disease

BACKGROUND

Although it was reported that pulse pressure of the peripheral artery could differentiate patients with coronary heart disease (CHD) from those without CHD, it is not known whether pulsatility of the ascending aortic pressure waveform differentiates patients with CHD from those without CHD. The purpose of this study was to evaluate whether the pulsatility of ascending aortic pressure is associated with an increased risk of CHD.

METHODS

For this study, we enrolled 293 subjects who had chest pain, normal contractions, no local asynergy, and no history of myocardial infarction. We measured the ascending aortic pressure using a fluid-filled system. To quantify the relative magnitude of the pulsatile to mean artery pressure, we normalized the pulse pressure to the mean pressure and referred to this value as the fractional pulse pressure (PPf). We investigated the association between the PPf and the risk of CHD.

RESULTS

The PPf of the ascending aorta was associated with an increased risk of CHD. The multiple-adjusted odds ratio of CHD was 2.93 (95% CI, 1.44 to 5.94) for the middle tertile of the PPf level and was 3.93 (95% CI, 1.74 to 8.85) for the highest tertile compared with the lowest tertile.

CONCLUSION

Ascending aortic pulsatility is related to an increased risk of CHD.

Diurnal variations of post-exercise parasympathetic nervous reactivation in different chronotypes

The purpose of this study was to investigate the diurnal variation and chronotype differences, i.e., in morning-types and evening-types, in post-exercise vagal reactivation. Twelve healthy male college students who were classified as morning-type (6) and evening-type (6), based on responses to a questionnaire, participated in this study. Postexercise vagal reactivation was assessed as the time constant of the beat-by-beat heart rate decrease for the first 30 sec after exercise (T30) at an intensity lower than the ventilatory threshold. The subjects performed 3-min cycle ergometer exercise at an intensity corresponding to 80% of the ventilatory threshold after a 1 min warm-up exercise in the morning (7:00 - 8:00) and evening (17:00 - 18:00) to obtain the T30. A significant interaction (chronotype-by-time) effect was found for T30. The morning value of the T30 in evening-type subjects was significantly larger than their evening value and the morning value in morning-type subjects. There was no significant interaction effect for heart rate and oxygen uptake during exercise. These results suggest that diurnal variation in post-exercise vagal reactivation is different between morning-type and evening-type, and post-exercise vagal reactivation in evening-type individuals is sluggish in the morning.

Percutaneous peptide immunization via corneum barrier-disrupted murine skin for experimental tumor immunoprophylaxis

H-2K(b)-restricted tumor epitope peptides, including tyrosinase-related protein 2 residues 181-188 (TRP-2) and connexin 37 residues 52-59 (MUT1), were applied to permeability barrier-disrupted C57BL/6 (B6) mouse skin from which the stratum corneum of the epidermis had been removed by tape-stripping. This procedure primed tumor-specific cytotoxic T lymphocytes (CTLs) in the lymph nodes and spleen, protected mice against subsequent challenge with corresponding tumor cells, and suppressed the growth of established tumors. Preventive and therapeutic effectiveness was correlated with the frequency of tumor-specific CTL precursors. MHC class II Ia(b+) cells separated from tape-stripped skin, compared with those from intact skin, exhibited a strong antigen-presenting capacity for CTL, suggesting that CTL expansion after peptide application is primarily mediated by epidermal Langerhans cells. Thus, percutaneous peptide immunization via barrier-disrupted skin provides a simple and noninvasive means of inducing potent anti-tumor immunity which may be exploited for cancer immunotherapy.

Distribution of mefE and ermB genes in macrolide-resistant strains of Streptococcus pneumoniae and their variable susceptibility to various antibiotics

From February to October 1995, 62 erythromycin-resistant strains of Streptococcus pneumoniae isolated at Yamanashi Red Cross Hospital were tested to determine their susceptibility to various macrolides, subjected to resistance induction tests by the disc diffusion method and analysed for genes encoding resistance to macrolides (ermB and mefE). On the basis of resistance induction testing, the isolates were classified as having either inducible (59.7%) or non-inducible (40.3%) macrolide resistance. The ermB gene was always detected in resistance-inducible type isolates, either alone or in combination with mefE. The mefE gene alone was found only in non-inducible type isolates. Isolates with non-inducible resistance (those with only the mefE gene) had an intermediate level of resistance to 14-membered macrolides, and were susceptible to rokitamycin, a 16-membered macrolide. According to NCCLS guidelines, 9.6% of S. pneumoniae strains were judged to be susceptible to penicillin, 62.9% of reduced susceptibility and 27.4% penicillin resistant. No correlation was detected between the presence of particular macrolide-resistance genes (ermB, ermB + mefE, or mefE) and resistance to penicillin G.

Photohapten TCSA painting plus UVA irradiation of murine skin augments the expression of MHC class II molecules and CD86 on Langerhans cells

Hapten painting of skin is known to augment the expression of major histocompatibility complex (MHC) class II, CD54, and CD86 on Langerhans cells. We investigated whether painting with 3,3',4',5-tetrachlorosalicylanilide (TCSA), the representative photohapten, and subsequent irradiation with ultraviolet A (UVA) alter the expression of these surface molecules on epidermal Langerhans cells (LC). BALB/c mice were painted with 5 microl of 0.1% TCSA on the earlobes and irradiated with 16 J/cm2 (at 365 nm) of UVA. Epidermal cells were prepared from these earlobes 24 h later, and the levels of MHC class II, CD54, CD80, and CD86 on these cells were analyzed by flow cytometry. As compared with untreated earlobes, the levels of MHC class II and CD86 on LC were markedly augmented and those of CD54 and CD80 were slightly elevated in earlobes treated with TCSA/UVA. Since neither TCSA painting nor UVA exposure alone enhanced the expression, both treatments were essential for enhancement. A dot plot analysis showed the presence of subpopulations of LC expressing MHC class II and CD86 at high levels. The percentage of these highly expressing LC was increased with increasing concentrations of TCSA and doses of UVA up to 1% and 24 J/cm2, respectively. In addition, keratinocyte expression of CD54 was also augmented by TCSA plus UVA. These results suggest that photohaptens, with following UVA exposure, augment the expression of immunologically functional molecules on LC as do ordinary haptens, leading to effective sensitization and elicitation of contact photoallergy.

Increases in levels of brain-derived neurotrophic factor mRNA and its promoters after transient forebrain ischemia in the rat brain

Expression of brain-derived neurotrophic factor (BDNF) may play a role in the mechanism of neuronal cell death after cerebral ischemia. We investigated the changes in levels of mRNAs encoding BDNF and its promoters in the rat brain after transient forebrain ischemia. Transient forebrain ischemia was induced by occlusion of bilateral common carotid arteries and systemic hypotension for 8 min. The alterations in BDNF gene expression in the hippocampus and in the cerebral cortex were examined by in situ hybridization using a mouse BDNF cDNA probe and cDNA probes including exon-specific promoters. BDNF transcripts were rapidly enhanced after the ischemic insult, both in the hippocampus and the cerebral cortex. NBQX suppressed the enhanced gene expression of BDNF markedly in the dentate gyrus (DG). In contrast, MK-801 had little effect on BDNF expression. In the piriform cortex, MK-801 or NBQX reduced the expression only moderately. After the ischemic insult, promoter specific BDNF 5'-exon I and exon III were increased remarkably in the DG. The increase in exon I in DG was suppressed partially by MK-801 and NBQX, while the increase in exon III in CA3 was suppressed by MK-801 but that in DG was not suppressed by either antagonist. In the piriform cortex, exon III was increased remarkably and this increase was not influenced by either agonist. These results suggest that the gene expression of BDNF was enhanced by transient ischemia both in the hippocampus and the cerebral cortex and that the cerebral ischemia stimulated at least two different promoter- and neuron type-specific pathways regulating expression of the BDNF gene mediated by glutamate receptors of non-NMDA type and NMDA type.

Rat liver theta-class glutathione S-transferases T1-1 and T2-2: their chromatographic, electrophoretic, immunochemical, and functional properties

A method was established for simultaneously isolating Theta-class glutathione (GSH) S-transferases (GSTs) T1-1 and T2-2 as homogeneous proteins from rat (r) liver cytosol. The established method of using an 8-aminooctyl Sepharose 4B column to separate rGSTT1-1 from rGSTT2-2 at the final stage of their purification was a modification of the method previously reported for the isolation of rGSTT2-2 (Hiratsuka et al., J. Biol. Chem., 265, 11973-11981, 1990). Specific substrates used for purification of the Theta-class rGSTs were dichloromethane for T1-1 and 5-sulfoxymethylchrysene for T2-2. rGSTsT1-1 and T2-2 existed at a ratio of 1:7 at a total concentration of 0.5% of that of the cytosolic protein. Purified rGSTsT1-1 and T2-2 were separated as single bands at 28 and 26.5 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and as single peaks at retention times of 36 and 34 min, respectively, by reverse-phase partition high-performance liquid chromatography on a microBondasphere column eluted with a linear gradient of acetonitrile in water containing trifluoroacetic acid. Western blot analysis indicated that rabbit antisera raised against rGSTsT1-1 and T2-2 intensely reacted with the corresponding antigens, but showed no detectable reactivity with the different isoforms of Theta-class rGSTs as well as with representative hepatic rGSTs of other classes. The Theta-class rGSTs showed higher GSH peroxidase activity than rGSTA1-2 toward hydroperoxides of cumene, arachidonic acid, and linoleic acid. Cumene hydroperoxide was a better substrate for rGST T1-1 than for rGST T2-2, while the fatty acid hydroperoxides were the better substrates for rGST T2-2 than for rGST T1-1.

Altered permeability and disordered cutaneous immunoregulatory function in mice with acute barrier disruption

In vivo and in vitro T-cell-activating ability of murine epidermal cells (EC) was investigated in acutely barrier-disrupted skin by extraction of epidermal lipids with acetone or removal of corneocytes by tape stripping. Contact sensitivity (CS) to 2,4-dinitrofluorobenzene (DNFB) and picryl chloride (PCl) and contact photosensitivity (CPS) to tetrachlorosalicylanilide (TCSA) were significantly augmented when challenged or sensitized at sites treated with acetone 24 h before, compared with the intact skin. CS to DNFB was also enhanced by tape stripping, but not by water rubbing, suggesting that physical stress or a toxic effect of acetone was not responsible for the augmentation. Semi-quantification of TCSA-EC photoadducts showed markedly increased permeability of hapten in the epidermis 24 h after acetone treatment. Bioactive IL-1alpha was more pronounced in barrier-disrupted than in intact skin. Lymph node T cells from PCl-sensitized mice proliferated significantly more in a hapten-specific and co-stimulatory molecule-dependent manner in response to trinitrophenylated (TNP) EC from acetone-treated skin than to those from untreated skin. Immunofluorescence staining of epidermal sheets and flow cytometric analysis of dispersed EC showed that subpopulations of Langerhans cells (LC) in acetone-rubbed or tape-stripped skin expressed major histocompatibility complex class II CD54 and CD86 molecules at levels higher than the rest of LC and LC from water-treated or untreated epidermis. Therefore, not only increased permeability of hapten through the epidermis but also altered immune functions of EC potentiate T-cell activation in acute barrier disruption. Such augmentation of immune reactivity may be critical to elimination of environmental noxious agents that penetrate easily into the barrier-disrupted epidermis.

Measurement of lactate levels in serum and bile using proton nuclear magnetic resonance in patients with hepatobiliary diseases: its utility in detection of malignancies

Proton nuclear magnetic resonance (1H-NMR) has been utilized for qualitative and quantitative measurement of the components of nonhomogeneous biological specimens, as it can analyze sensitively the chemical structure of organic compounds without pretreatment of the materials. Levels of lactate in serum and bile were measured by 1H-NMR in healthy volunteers and patients with non-malignant or malignant diseases of the liver and biliary tract, and the usefulness of such measurements for the diagnosis of hepatobiliary malignancies was determined. The mean (+/- SD) serum lactate levels were 0.52 +/- 0.33 mmol/l in five healthy volunteers, 1.38 +/- 1.59 mmol/l in 30 patients with non-malignant diseases and 2.95 +/- 2.00 mmol/l in 21 patients with malignant diseases, the differences among the three groups being significant. Biochemical enzymatic measurement of serum lactate levels revealed no such difference. In bile, the spectrum of lactate was observed in all of 16 patients with malignant diseases, but in none of two healthy volunteers and 12 patients with non-malignant diseases. The mean time required for the measurement was 36.77 min for serum and 6.40 min for bile. The measurement of lactate levels in serum and bile using 1H-NMR may be useful for the detection of hepatobiliary malignancies.

Photohaptenic properties of fluoroquinolones

Although quinolone antibacterial agents have both phototoxicity and photoallergenicity, the latter's potency has been poorly investigated compared with the former's. Some of the photoallergic chemicals serve as photohaptens, which lead to T-cell-mediated immune reactions after photobinding to protein by UVA radiation. We examined the photohaptenic potential of fluoroquinolones, including lomefloxacin (LFLX), ciplofloxacin, norfloxacin, ofloxacin, levofloxacin, fleroxacin, enoxacin and sparfloxacin (SPFX). The absorption spectra of the quinolones were altered by UVA irradiation, with an exception of SPFX that seems to be photostable toward UVA. Bovine serum albumin and murine epidermal cells were coupled with these fluoroquinolones other than SPFX by exposure to UVA. Subcutaneous inoculation of fluoroquinolone-photomodified epidermal cells induced and elicited a delayed-type hypersensitivity reaction in mice. However, epidermal cells incubated with LFLX without UVA exposure also induced and elicited a significant hypersensitivity reaction to a lesser degree than LFLX-photomodified epidermal cells. Furthermore, there was cross-reactivity between LFLX-photomodified epidermal cells and simply LFLX-incubated cells. This suggests that cells can be weakly modified with LFLX even in the dark and that UVA irradiation promotes this modification. Our study demonstrated that fluoroquinolones have photohaptenic properties to which their photoallergenicity is probably ascribed.

Hair cycle-dependent changes in skin immune functions: anagen-associated depression of sensitization for contact hypersensitivity in mice

To assess whether hair follicle cycling influences skin immunity, we examined the association between highly synchronized hair follicle cycling and experimental contact hypersensitivity in C57BL/6 mice. Hair cycle synchronization was performed by depilation of hair shafts on the back with telogen skin. Mice were sensitized on the lower back skin with picryl chloride between 0 and 25 d, after anagen induction by depilation, and challenged on the earlobes with picryl chloride 5 d later. The magnitude of contact hypersensitivity was significantly decreased in mice sensitized on day 1, was minimal on day 3 (early anagen), and slowly increased thereafter, reaching level comparable to day 0 on day 25 (telogen). The significantly depressed contact hypersensitivity response in anagen skin was confirmed in mice with spontaneously developed follicles. Lymph node cells taken from mice sensitized with picryl chloride on days 0, 1, and 3 after depilation were cultured in vitro in the presence of syngeneic, haptenized, Langerhans cell-enriched epidermal cells. Marked proliferative responses of lymph node cells to haptenized cells were found in mice not only of day 0, but also of days 1 and 3, suggesting that immune T cells exist even lymph node cells of the low-responsive mice. Flow cytometric analyses demonstrated that the number of intraepidermal Langerhans cells and their functions, including the expression of major histocompatibility complex class II, CD54, and CD86, and mixed epidermal cell lymphocyte reactions, were not changed in skin on days 0,1, and 3. These findings demonstrated that contact hypersensitivity is induced most effectively via skin with telogen hair follicles and that the depressed response in early anagen skin is not simply due to failure in Langerhans cell function or sensitization of T cells.

Inhibition of gibberellin-induced elongation growth of rice by feruloyl oligosaccharides

The biological activity of cell wall-derived feruloyl oligosaccharides was investigated using a modified micro-drop bioassay. A feruloyl arabinoxylan trisaccharide (FAXX) and a feruloyl arabinoxylan tetrasaccharide (FAXXX) were found to inhibit the gibberellin-induced elongation of dwarf rice (Oryza sativa L., cv, Tan-ginbozu) that had been treated with uniconazole (S-3307), an inhibitor of the biosynthesis of gibberellins. An arabinoxylan trisaccharide (AXX) was ineffective. The growth-inhibitory effect of feruloyl oligosaccharides depended on their feruloyl and glycosyl moieties. The amount of esterified diferulic acid residues in the cell walls of the second leaf sheath of rice seedlings that had been treated with FAXX was almost same as that of controls. Feruloyl oligosaccharides did not inhibit the incorporation of [14C]leucine into acid-precipitable proteins by suspension-cultured maize cells, whereas cinnamic acid and its derivatives strongly inhibited such incorporation.

Liver injuries induced by herbal medicine, syo-saiko-to (xiao-chai-hu-tang)

Four patients treated with the herbal medicine syo-saiko-to (xiao-chai-hu-tang) exhibited acute drug-induced liver injury. The latent period was one and a half to three months. All of the patients showed a rise in aminotransferases after readministration or challenge test. The liver histology revealed centrilobular confluent necrosis or spotty necrosis, microvesicular fatty change, acidophilic degeneration, and a granuloma. Cholestasis was seen in two patients. The results of the [13C]aminopyrine breath test, performed in one patient, were low before the challenge test and even lower after the challenge. These findings suggest that the herbal medicine syo-saiko-to may induce acute injury or the hepatocellular pattern with variable cholestasis.

Index of assessing functional status in elderly Japanese men

We attempted to propose the equation of assessing the functional status of elderly adult Japanese men. A number of physical and motor performance measurements were collected from a group of 104 male volunteer subjects (mean age 76.4 +/- 5.8 years). Factor analysis with varimax criterion was applied to all the data. Five factors extracted were interpreted as follows: (1) coordination of the body, (2) flexibility of the trunk, (3) static balance, (4) muscular strength and endurance, and (5) cardiorespiratory fitness. Furthermore, the factor score was computed for each individual by each factor. Each of the five factors were weighted in accordance with its relative contribution to the total variance (or the size of eigenvalue). The weighted combination of factor scores was summed to generate an index of functional status (IFS). Next, IFS scores were computed for each individual and normalized to T scores. Then, a multiple linear regression analysis was performed with the factor analytically derived IFS scores as the dependent variable: IFS = -0.625X1 + 0.604X2 + 0.346X3 + 0.223X4 + 0.465X5 + 0.082X6 + 0.114X7 + 0.199X8 + 0.019X9 + 0.071X10 + 19.76; where X1 = walking around two chairs in a figure 8 (sec), X2 = manipulating pegs in a pegboard (num), X3 = vertical jump (cm), X4 = sit and reach (cm), X5 = estimated maximal oxygen uptake (ml/kg/min), X6 = balancing on one leg with eyes open (sec), X7 = grip strength (kg), X8 = trunk flexion from a standing position (cm), X9 = leg muscle endurance in a semi-squat position against a wall (sec), and X10 = balancing on one leg with eyes closed (sec) Thus, information on the 10 variables from five domains was statistically combined to a single score. The above equation was cross-validated in the other group of elderly men (n = 54). The mean IFS obtained for this group (50.0 +/- 8.3) was not significantly different from the validation group (50.0 +/- 10.0). It is apparent that the IFS has the potential to serve as another useful measure of high order, daily living activities.(ABSTRACT TRUNCATED AT 250 WORDS)

[Endocrine chemotherapy for prostatic cancer]

We carried out a randomized joint study on endocrine therapy and endocrine chemotherapy for prostatic cancer at our department and 17 affiliated institutions. Of 80 patients entered, 39 patients were treated with chlormadinone acetate alone (group A) and 41 patients were treated with chlormadinone acetate in combination with UFT (group B). After excluding 10 inappropriate patients, Stage C was observed in 14 patients in group A and 13 in group B, and stage D in 20 patients in group A and 23 in group B. Side effects were observed in 8.8% (3/34) in group A and 22.2% (8/30) in group B without a significant difference. The anti-tumor effects (response rate) and clinical effects with respect to each item did not significantly differ between the two groups. The non-recurrence rate and survival rate were significantly higher in group B than in group A. These findings suggest the usefulness of endocrine chemotherapy using UFT.