Inhibitory effect of caffeine on potentially lethal damage repair in cisplatin-treated human osteosarcoma cells

Human osteosarcoma cells, that were cultured to confluence and maintained under low nutrient conditions, showed potentially lethal damage repair after cisplatin treatment. This repair was inhibited by a non-toxic dose of caffeine. Flow cytometric analysis indicated that cisplatin-treated cells accumulated in the S phase by 24 hr, followed by accumulation in the G2/M phase. Caffeine inhibited the initial accumulation in the S phase and the release of cells from the G2/M block. DNA synthesis was also inhibited by the cisplatin treatment. The addition of caffeine significantly reversed this inhibition. The content of DNA-bound platinum decreased over time after cisplatin treatment. Caffeine did not influence platinum content, nor did it directly affect the DNA excision repair. Cisplatin inhibits DNA synthesis in the S phase, but caffeine reduces this inhibition. Caffeine-treated cells that pass through S phase are incapable of recovery.

Stabilized enzymatic reagents for measuring glucose, creatine kinase and gamma-glutamyltransferase with thermostable enzymes from a thermophile, Bacillus stearothermophilus

Stabilized enzymatic reagents for measuring some components in biological fluids have been successfully developed based on two kinds of thermostable enzymes derived from Bacillus stearothermophilus with separation of the reagent into two complementary solutions. The thermostable glucokinase produced was applied to the measurement of glucose and creatine kinase activity, while the alanine dehydrogenase produced was used for the measurement of gamma-glutamyltransferase activity. The enzymatic reagents were also stabilized by developing two separate reagents with an optimum pH for the main reagent components. The stability of the reagents in liquid form was examined at 10 degrees C. It was clearly shown that the reagents for measuring glucose and creatine kinase activity were stable and retained their full capability for accurate measurement in biological fluids for over one year. The alanine dehydrogenase product was stable for at least 40 days.

Syndrome of inappropriate antidiuresis seen twice in eight years

We present a rare case of a 66-year-old woman with the syndrome of inappropriate antidiuresis (SIAD) accompanied by an empty sella whose symptoms were seen twice in the eight years after the administration of non-steroidal anti-inflammatory drugs (NSAID) or prochlorperazine. No diuresis or suppression of the plasma level of vasopressin (AVP) was observed after water loading upon cessation of the causative agents. Suppression of the renin-aldosterone system and a low plasma level of atrial natriuretic peptide (ANP) were observed during natriuresis. The plasma levels of AVP were increased after water loadings. Restriction of water intake ameliorated the symptoms and reduced hyponatremia. These findings suggest that NSAID or prochlorperazine caused overt SIAD twice in eight years. The water loading test itself stimulated the release of AVP and a suppression of the renin-aldosterone system played a more important role in natriuresis than ANP in this case.

Flexibility and alignment of the cervical spine after laminoplasty for spondylotic myelopathy. A radiographic study

The long term effects of laminoplasty on cervical movement and alignment were investigated by radiography and CT scans in a study of 56 patients with multisegmental myelopathy who had undergone a C3 to C7 open-door laminoplasty. Follow up averaged 5.8 years. Satisfactory neurological improvement occurred in 73%. Cervical flexion decreased by 35% and extension by 57%; the decrease of both movements was statistically significant. Decreased vertebral slip, as well as slightly reduced lordosis, was seen after operation. Increase in measured canal size after operation and at follow up was 48% and 40%; 8% of the expanded canal size was lost at the last follow up. Expansive open-door laminoplasty leads to a better neurological prognosis in this group of patients, while maintaining an increase in canal size and preserving spinal stability.

Symptomatic arachnoiditis ossificans of the thoracic spine. Case report

This report describes a man aged 65 years who developed spastic paraparesis secondary to arachnoiditis ossificans in the thoracic spine. Over 35 years previously, in Southeast Asia, the patient had received repeated lumbar punctures in the treatment of meningitis possibly associated with malarial fever. He had multiple arachnoidal ossifications located at levels from T6 to T9 dorsal to the spinal cord which were well delineated by computed tomography. The lesions were completely extirpated by dorsal route surgery, and the patient had marked neurological improvement after surgery. Histology confirmed that the lesions showed mature bone that formed with an osseous marrow and trabeculae, and the lesions exhibited clusters of arachnoidal cells as well as the proliferation of osteoblasts surrounding the ossified area. Early diagnosis and surgical intervention, however, are mandatory in such cases, if the patient is to attain an acceptable degree of recovery.

The role of calcium deposition in the ligamentum flavum causing a cauda equina syndrome and lumbar radiculopathy

Our report concerns five patients who underwent lumbar decompressive surgery for cauda equina syndrome and radiculopathy secondary to degenerative stenosis associated with calcium deposition in the ligamentum flavum. The resected ligamentum flavum showed diffuse to massive calcium crystal deposition with a histologically marked degeneration in the elastic fibres. Energy dispensive radiographic microanalysis confirmed the crystal to be calcium pyrophosphate dihydrate in all patients, hydroxyapatite mixed in three and calcium orthophosphate mixed in one. The deposition appeared to be a change that is associated with the degenerative process in the ligament and, in some cases having marked deposition in a localised event, it causes or aggravates the neurological symptoms.

Revision surgery for lumbar disc herniation. An analysis of 45 patients

We reviewed 45 patients who had undergone repeated open operations for lumbar disc herniation. There were 26 men and 19 women with a mean follow up of 4.3 years. Twenty-four patients had had one previous discectomy, 12 had 2, and 9 had 3 or more; 11 needed a fusion without instrumentation. Residual or re-extruded disc hernias, either sub- or transligamentous, were frequently found at revision. Good to excellent results were obtained in 64%. Those who had a first-time revision had earlier improvement and better results. Complete removal and a thorough search for herniated disc material is essential when carrying out the initial operation for extruded or sequestrated herniation. At revision, removal of as much as possible of the remaining nucleus and annulus, but with minimal invasion of the posterior elements, is crucial for improving the outcome.

Compound heterozygous mutations affecting both hepatic and erythrocyte isozymes of pyruvate kinase

Novel erythrocyte pyruvate kinase gene defects were found in a patient without a family history of consanguinity. The polymerase chain reaction products of the R-type pyruvate kinase cDNA from the propositus contained two point mutations of Ser80 (TCC)-->Pro (CCC) and Arg490 (CGG)-->Trp (TGG). Allele-specific polymerase chain reaction of the genomic DNA revealed that this patient was a compound heterozygote. The mobilities of the patient's L- and R-type pyruvate kinase by thin-layer polyacrylamide gel electrophoresis were abnormal. The results are consistent with the fact that these mutations are within exons common to the hepatic and erythrocyte isozymes.

Epidural pressure measurements. Relationship between epidural pressure and posture in patients with lumbar spinal stenosis

STUDY DESIGN

The relationship between epidural pressure and lumbar posture was assessed in patients with lumbar spinal stenosis.

OBJECTIVES

This study was performed to assess the relationship between epidural pressure and lumbar posture in patients with lumbar spinal stenosis.

METHODS

The study was performed on 10 patients who had cauda equina symptoms at the L4-L5 level. The catheter transducer was inserted into the epidural space through L5-S1 interlaminar space and placed at the L4-L5 disc level. This transducer was connected with an amplifier and a recorder. Epidural pressure was continuously measured in various postures.

RESULTS

Local epidural pressure at the stenotic level was low in lying and sitting postures, and high in standing postures. Pressure was increased with extension, but decreased with flexion. The highest pressure was 116.7 +/- 38.4 mm Hg in standing with extension.

CONCLUSION

Epidural pressure was significantly related to posture. These pressure changes correlated with the development of cauda equina symptoms. The increase of epidural pressure by posture may induce compression of the cauda equina. These pressure changes may explain the postural dependency in eliciting symptoms.

[Evaluation of the residual functional reserve and the early regeneration after the hepatic resection using asialoglycoprotein receptor imaging agent]

99mTc-DTPA-galactosyl human serum albumin (99mTc-GSA) is a newly developed liver imaging ligand which specifically binds to asialoglycoprotein receptor on the hepatic cell surface. We investigated whether 99mTc-GSA scintigraphy was able to be used as indexes for the residual functional reserve and the early regeneration of the hepatocyte after the hepatic resection. Four patients with metastatic liver cancer, 3 patients with hepatocellular carcinoma, and 1 patient with cholangiocellular carcinoma were studied. Basically, each patient was examined 4 times (before, 3, 10, 20 days after the operation). Immediately after i.v. injection of 185 MBq (3 mg) of 99mTc-GSA, serial images and dynamic data were obtained. Serial changes of HH15, as an index of blood clearance of the tracer calculated from the uptake ratio of heart at 15 minutes to that at 3 minutes, and LHL15, as an index of hepatic accumulation calculated from the uptake ratio of liver to liver plus heart at 15 minutes after the injection were analyzed before and after hepatectomy. Three out of 4 lobectomy patients which showed increased HH15, and decreased LHL15 as compared with the preoperative data were considered to be decreased residual hepatic functional reserve. The remaining one lobectomy patient showed increased HH15, but increased LHL15 inversely. One patient of two partial resections of hepatocellular carcinoma with liver cirrhosis demonstrated transiently decreased HH15, and increased LHL15. Two patients with metastatic liver cancer (one partial resection, six partial resections) showed decreased HH15, and increased LHL15. Postoperatively increased hepatic accumulation was presumed to be increased functioning hepatocyte or transiently increased asialoglycoprotein receptor on the cell surface by up-regulation. 99mTc-GSA scintigraphy might be helpful for non-invasive method to detect the residual functional reserve and the early regeneration of the hepatocyte after the hepatic resection.

In vivo responsiveness of thyroid glands to TSH in normal and novel 'growth-retarded' mice: transient elevation in normal mice and impairment in 'growth-retarded' mice

The in vivo responsiveness of thyroid glands to TSH at various ages in novel 'growth-retarded' (grt/grt) mice derived from Snell's dwarf (DW/J) mice and in their normal counterparts were analysed by determining serum T4 concentrations before and after the administration of exogenous TSH. The serum T4 concentration in normal mice increased in response to TSH at 2, 4 and 12 weeks of age but not at 1 week of age. A transient augmentation of such thyroidal responsiveness to TSH was apparent in normal mice at 2 weeks of age, when the serum T4 level exhibits a peak and the pubertal growth of mice starts. In contrast to normal mice, at any age examined from 2 to 12 weeks after birth, exogenous TSH did not influence serum T4 concentrations in the grt/grt mice at all. On the other hand, serum TSH concentrations in young grt/grt mice were highly elevated compared with those in normal mice and they were normalized by a 2-3 week's treatment with T3. Morphological studies demonstrated degenerated thyroid glands in the grt/grt mice. These results suggest that the severe hypothyroidism and consequent growth retardation in growth-retarded mice are due to impairment of the thyroid glands of the mutant mice in producing and/or secreting thyroid hormones in response to TSH.

[Noninvasive two-dimensional analysis of iridial circulation using the laser speckle phenomenon]

We have developed an apparatus using the laser speckle phenomenon for noninvasive two-dimensional measurement of the peripheral circulation of the iris. The normalized blur of the speckle pattern (NB-value) was adopted as an index of the blood velocity in the tissue. It was found that the average NB-value of the pigmented rabbit iris was gradually increasing from pupil margin to periphery. The coefficient of variation of the NB-value in the middle area of the iridial width was the smallest. The coefficient of reproducibility of the NB-value measured in the same area twice at 5-minute intervals was 8.8%, and that at 24-hour intervals was 14.1%. The NB-value of the iris showed a good correlation (r = 0.57, p < 0.0072 n = 20) with the iridial blood flow rate measured at the same time by the microsphere technique when intraocular pressure was adjusted to 20 mmHg or 40 mmHg. This result suggests that the NB-value can be useful for quantitative assessment not only of the blood velocity but also of the blood flow rate in the iridial tissues.

Schmorl's nodes and low-back pain. Analysis of magnetic resonance imaging findings in symptomatic and asymptomatic individuals

Magnetic resonance imaging (MRI) findings in cases with symptomatic and asymptomatic Schmorl's nodes have been analysed. In all symptomatic cases, the vertebral body marrow surrounding the Schmorl's node was seen as low signal intensity on T1-weighted images and as high signal intensity on T2-weighted images. It was confirmed by histological examination that the MRI findings indicated the presence of inflammation and oedema in the vertebral bone marrow. These MRI findings were not seen in asymptomatic individuals. Inflammatory changes in the vertebral body marrow induced by intraosseous fracture and biological reactions to intraspongious disc materials might cause pain. We postulate that after fracture healing and subsidence of inflammation, the Schmorl's nodes become asymptomatic, in analogy with old vertebral compression fractures. MRI is not only useful in detecting the recently developed Schmorl's nodes but also in differentiating between symptomatic and asymptomatic Schmorl's nodes.

Osteoplastic laminoplasty for cervical myeloradiculopathy secondary to ossification of the posterior longitudinal ligament

Forty-seven patients with cervical myeloradiculopathy due to ossification of the posterior longitudinal ligament were treated by laminoplasty. The spinal canal from C3 to C7 was opened en bloc unilaterally and a spacer bone graft inserted to separate the floating laminae. The average follow up was 7.3 years (range 5 to 11 years). Favourable results were obtained in 35 patients and even though they had serious postoperative symptoms those with advanced neurological symptoms before operation showed considerable improvement. Late results were poor in patients who had greater than 50% compromise of the spinal canal by the ossified lesion. Laminoplasty is a safer method of obtaining favourable late results in patients with involvement of more than 3 vertebrae, but in those with a more severe compromise of the spinal canal by ossification, additional anterior decompression may be necessary later.

Inhibition of puromycin-induced renal injury by a superoxide dismutase derivative with prolonged in vivo half-life

To know the possible involvement of reactive oxygen species and the site(s) of their action in puromycin aminonucleoside (PAN)-induced renal injury, two types of superoxide dismutase (SOD) derivatives were synthesized: one (SM-SOD) circulates bound to albumin with a half-life of 6 h and the other (AH-SOD) linked with hexamethylenediamines rapidly undergoes glomerular filtration and accumulates in renal proximal tubule cells without being excreted in urine. When injected intravenously to the rat, PAN induced a marked proteinuria, increased plasma levels of cholesterol and triglyceride, and suppressed the growth of animals. Intravenously administered SM-SOD significantly inhibited such changes induced by PAN. However, native SOD which rapidly undergoes urinary excretion failed to inhibit the renal injury caused by PAN. Though AH-SOD markedly accumulated in renal proximal tubule cells, it also failed to inhibit the renal injury. These results suggested that superoxide and/or its hazardous metabolite(s) in and around the renal glomerulus, but not in tubule cells, may play critical roles in the pathogenesis of PAN-induced renal injury.

Anterior decompressive surgery for cervical ossified posterior longitudinal ligament causing myeloradiculopathy

This paper reviews 88 patients (74 males and 14 females) who underwent anterior decompression and fusion for symptomatic ossified posterior longitudinal ligament of the cervical spine. Follow up averaged 8.5 years. Eighteen patients underwent one-vertebra, 59 two-vertebra, and 11 three-vertebra decompression with interbody fusion. The preoperative severity of symptoms significantly affected neurological recovery. Patients with three-vertebra spondylectomy showed significantly little neurological improvement. The return of patients to their previous activities as monitored at follow up was related to their preoperative neurological status. MRI findings appeared to be relevant to neurological recovery. Our findings suggest that anterior decompression is to be recommended for patients with less advanced preoperative symptoms and the involvement of one or two vertebrae.

Shepherd's crook deformity with an intracapsular femoral neck fracture in fibrous dysplasia

A shepherd's crook deformity with an intracapsular femoral neck fracture in the fibrous dysplasia of a 19-year-old woman is reported. The deformity and fracture were treated by bone grafting using a single fibula through the femoral neck to its head, and corrective valgus osteotomy. Blood flow measurement using electrochemically generated hydrogen clearance was useful in evaluating avascular necrosis of the femoral head affected by tumorous tissue. Osteosynthesis combined with a fibular graft, and corrective valgus osteotomy after proper evaluation of the blood flow in the femoral head, is a reliable procedure for the treatment of shepherd's crook deformity associated with an intracapsular femoral neck fracture.

Sequential activation of Raf-1 kinase, mitogen-activated protein (MAP) kinase kinase, MAP kinase, and S6 kinase by hyperosmolality in renal cells

In the renal medulla during antidiuresis, the extracellular fluid becomes hyperosmotic. Madin-Darby canine kidney (MDCK) epithelial cells adapt in hyperosmotic conditions and serve as a useful tissue culture model for cellular responses to hyperosmolality. We demonstrate that hyperosmolality stimulates phospholipase C, Raf-1 kinase mitogen-activated protein (MAP) kinase kinase, MAP kinase, and S6 kinase activities and that it increases phosphorylation of Raf-1 kinase, and p42 MAP kinase in MDCK cells. Stimulation of these kinases is osmolality-dependent (from 300 to 600 mosm/kg H2O). The time course of activation is sequential; the peak stimulation for Raf-1 kinase is at 5 min, at 10 min for MAP kinase kinase and MAP kinase, and at 20 min for S6 kinase. The activation of Raf-1 kinase and MAP kinase is inhibited by phorbol 12-myristate 13-acetate pretreatment in the presence of calphostin C or H-7. Tyrosine kinase inhibitors (genistein, herbimycin) do not significantly suppress hyperosmolality-induced MAP kinase activity. The increase of Ins-1,4,5-P3 levels by hyperosmolality suggests that activation of these kinases is mediated at least partially via activation of phospholipase C. Thus, hyperosmolality stimulates the serine/threonine kinases, Raf-1 kinase, MAP kinase kinase, MAP kinase, and S6 kinase, via predominantly protein kinase C-dependent, tyrosine kinase-independent pathways in MDCK cells.

Renal protective effect of efonidipine hydrochloride (NZ-105), a new calcium antagonist, in spontaneously hypertensive rats

1. We investigated the renal protective effect of efonidipine hydrochloride (NZ-105) in spontaneously hypertensive rats (SHR). SHR were given a diet containing 0.075% NZ-105 from 8 weeks old for 20 weeks. 2. 24-hr urinary protein excretion in the control SHR (drug-free diet) increased with age (from 77.3 mg/kg/day at 8 weeks old to 385.4 mg/kg/day at 28 weeks old), while that in NZ-105-treated SHR was maintained at almost the same level as that in Wistar-Kyoto rats (WKY), matched control animals throughout the experimental period. 3. The histological changes of the kidney were examined by light microscopy at the end of the treatment period. In control SHR, swelling and hyalinization of glomeruli, dilatation of renal tubules containing hyaline casts and arteriolosclerosis were revealed. The long-term administration of NZ-105 markedly suppressed these changes. 4. The kidney weights and plasma creatinine concentration in control SHR were higher than those in WKY, while they were significantly reduced in NZ-105-treated SHR. The long-term administration of NZ-105 also suppressed the elevation of systolic blood pressure and the increases of plasma renin activity and aldosterone concentration. 5. These findings suggest that NZ-105 inhibits the development of proteinuria and progressive kidney damage in SHR and may become a useful antihypertensive drug with the renal protective effect.