Lactate distribution and metabolism during and after anoxia in the turtle, Chrysemys picta bellii

To determine the fate of lactate during and after prolonged anoxia, 14C-labeled lactate was injected into turtles after 2 h of a 6-h submergence at 20 degrees C. 14C activities of plasma and chamber water were tested at intervals during anoxia and also in expired air during 39 h of recovery. Partitioning of label in major body compartments [extracellular fluid (ECF), intracellular fluid (ICF), and shell] and 14C activity and glycogen in selected tissues (heart, liver, and muscle) were measured after anoxia (n = 7) and after recovery (n = 6). Shell 14C and [lactate] were extensively measured on six anoxic turtles. During anoxia all 14C remained in the animal indicating no urine production. At 6 h of anoxia 47% of recovered 14C, presumably still as lactate, was in the ECF, 27% in the ICF, and 30% in the shell. During recovery, plasma [lactate] fell from 35 to 5 meq, but surrounding water and expired air accounted for only 9 and 8%, respectively, of recovered label. The ICF portion grew to 41%, associated with a recovery in tissue glycogen. The shell still had 22% of total label. We conclude that, during recovery from anoxia, lactate is predominantly resynthesized to glycogen, and only a small fraction is directly oxidized. During anoxia, however, lactate is widely distributed in the body, and a surprisingly large and functionally significant fraction resides in the shell.

Monoclonal antibody against the fusion junction of a deletion-mutant epidermal growth factor receptor

A mouse monoclonal antibody (IgG2b), 3C10, was produced against the truncated epidermal growth factor receptor (EGFR), encoded by the (type III) in-frame deletion mutation of 801 nucleotides of EGFR affecting the external domain, known to be expressed in some human glioblastoma. As this mutation newly generates a glycine residue at the fusion point, a 14 amino acid peptide around the fusion junction including this glycine was chemically synthesised and used for immunisation of (B6 x DBA/2) F1 mice. Flow cytometric analysis showed 3C10 antibody staining of a mouse NIH/3T3 transfectant (ERM5) with the type III EGFR deletion-mutant gene, but not one with wild-type EGFR. The antibody immunoprecipitated the truncated EGFR protein with a molecular mass of approximately 140 kDa from ERM5 cells. Immunostaining of glioblastomas revealed binding in the case with the type III EGFR mutation, the five other specimens without the mutation being negative despite overexpression of EGFR in some cases.

Gene organization in the ada-rplL region of Streptomyces virginiae

The gene organization of a 7.4-kb region of the Streptomyces virginiae (Sv) chromosome was determined. The predicted open reading frames (ORFs) and their predicted products, in sequence order, were (i) ada, encoding adenosine deaminase [EC 3.5.4.4], (ii) aat, encoding a protein homologous to aspartate aminotransferase [EC 2.6.1.1], (iii) secE, encoding a protein involved in protein secretion, (iv) vbrA, encoding a NusG-like protein involved in antitermination of transcription as described by Okamoto et al. [J. Biol. Chem. 267 (1992) 1093-1098], and (v) rplKAJL, encoding the large subunits of the ribosomal proteins L11, L1, L10 and L12. Six of the ORFs (secE-rplL) were oriented in the same direction, but the other two (ada and aat) had the opposite orientation. The gene organization of the secE-rplL region in Sv was identical to that in Escherichia coli.

Effects of a highly selective synthetic inhibitor of plasma kallikrein on disseminated intravascular coagulation in rats

We found a new, highly selective plasma kallikrein inhibitor, trans-4-aminomethyl-cyclohexanecarbonylphenylalanine 4-carboxymethylanilide hydrochloride, called PKSI-527 in our laboratories. This study was conducted to evaluate PKSI-527, on thromboplastin (TP)- and endotoxin (LPS)-induced disseminated intravascular coagulation (DIC) in rats. PKSI-527 was infused intravenously at 0.1 mg/kg/min for 250 min. Three of the parameters of the coagulation and fibrinolysis system, fibrinogen level, platelet counts and fibrin(ogen) degradation products (FDP) level were assayed. PKSI-527 prevented the change in the coagulation and fibrinolysis system in LPS-induced DIC, however it was not clearly effective in TP-induced DIC. The parameters of organ failure, such as serum glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), creatine phosphokinase (CPK), lactate, blood urea nitrogen and beta-glucuronidase, were assayed. Although the changes in the fibrinogen level, platelet counts and FDP level were almost the same in both models, the parameters of organ failure apparently increased in LPS-induced DIC more so than in TP-induced DIC. PKSI-527 significantly suppressed the increases in GOT and GPT in LPS-induced DIC. These results indicate that plasma kallikrein may play a significant role in LPS-induced DIC. Therefore, PKSI-527, as a synthetic plasma kallikrein inhibitor may be a valuable tool to explore the mechanism of DIC and the accompanying organ failure.

Granisetron in the prevention of vomiting induced by conditioning for stem cell transplantation: a prospective randomized study

We conducted a prospective randomized study to compare granisetron, a 5-hydroxytryptamine-3 receptor antagonist with standard anti-emetics (control group) consisting mainly of metoclopramide, in the prophylaxis of emesis induced by conditioning prior to stem cell transplantation. Fifty-eight patients were evaluable for analysis. The number of emetic episodes expressed in terms of patient-days was significantly lower in the granisetron group than in the control group (P < 0.001). During the first 24 h of conditioning, 27 of the 31 patients (87.1%) in the granisetron group achieved control of emesis with less than three emetic episodes (major < or = ) a day compared with 37.0% in the control group (P < 0.001). The same degree of emesis control was maintained throughout the conditioning period in 51.% of patients in the granisetron group compared with 0% in the control group (P < 0.001). Adverse reactions were observed in 11.4% of patients in the granisetron group and in 25.9% in the control group. None of the events were serious. Based on these data, we conclude that granisetron is superior to standard antiemetics in protecting against the vomiting induced by conditioning for stem cell transplantation.

Use of an active center-directed plasmin inhibitor elucidates the multiplicity of plasmin actions

In our studies, designed to synthesize an active center-directed plasmin (PL) inhibitor, N-(4-aminomethylbenzoyl)-4-(3-picolyloxy)-L-phenylalanine n-hexylamide dihydrochloride (PASI-535) was found. We characterized PASI-535 and analyzed the actions of PL, comparing with those of PASI-535 and tranexamic acid (t-AMCHA). (1) PASI-535 strongly inhibited not only fibrinolysis (IC50: 2.9 x 10(-6) M) but also amidolysis (Ki value: 2.9 x 10(-6) M) and fibrinogenolysis (IC50: 4.5 x 10(-6) M) induced by PL. While t-AMCHA which strongly inhibited fibrinolysis (IC50: 6.0 x 10(-5) M), rarely inhibited amidolysis (Ki value: 4.0 x 10(-2) M) and fibrinogenolysis (IC50: 1.0 x 10(-2) M). (2) PL is able to liberate kinins by degrading kininogen. This kinin-generation by PL was inhibited by 2 x 10(-5) M PASI-535. However, it was little inhibited even by 1 x 10(-3) M t-AMCHA. (3) The inhibitory effect of PASI-535 and t-AMCHA on tumor growth was studied. In sarcoma-180 bearing mice, ascites retention and the increase of tumor cells were markedly suppressed by subcutaneous injection of PASI-535, either 30 mg/kg/day or 50 mg/kg/day, for 5 days, and the inhibitory effect was dose-dependent. Although t-AMCHA also reduced both ascites retention and the increase of tumor cells, it needed approximately 40 times (2 g/kg/day) the amount of PASI-535 to exert these effects. PASI-535 may be a useful tool in analyzing the multiplicity of PL actions. Moreover, PASI-535 can be used as an antifibrinolytic drug which has a mechanism of function different from that of t-AMCHA.

Hepatic bile acid synthesis and DNA synthetic rate after partial hepatectomy

The relationship between hepatic DNA synthetic rate and activity of cholesterol 7 alpha-hydroxylase, the rate limiting enzyme for bile acid synthesis, was examined in regenerating liver after partial hepatectomy or sham operation in rats. Hepatic cholesterol 7 alpha-hydroxylase activity was significantly (P < 0.001) suppressed on days 1 and 2, returned to the control level on day 3, and was significantly raised on day 7 after hepatectomy. The rate of DNA synthesis was significantly (P < 0.001) activated during the first 3 days after hepatectomy and returned to the control level on day 7. Enzyme activities regulating hepatic bile acid synthesis and DNA synthesis change inversely during liver regeneration after hepatectomy.

Tissue oxygen saturation of human hepatic grafts after reperfusion: paradoxical elevation in poor graft function

The present study investigated the pathophysiology of primary nonfunction (PNF) of grafted livers with regard to hepatic tissue oxygenation. Hemoglobin oxygen saturation in hepatic tissue (H-So2) after reperfusion was determined using near-infrared spectroscopy. Graft tissue oxygen consumption was also estimated according to Fick's principle. Six grafts with PNF were compared with 40 functioning grafts. One PNF graft with extremely low and heterogeneous H-So2 after reperfusion was found to contain multiple intrahepatic portal thrombi. However, five other PNF grafts showed no lower and, on the contrary, more homogeneous H-So2 at the end of the operation. As a whole, mean H-So2 was negatively correlated and the coefficient of variation (CV) of H-So2 was positively correlated with graft tissue oxygen consumption at the end of the operation; grafts whose H-So2 showed a secondary decrease had better initial function. In later relaparotomy, the H-So2 of the five PNF grafts was significantly higher and more homogeneous than that of the functioning grafts. These results suggest that H-So2 level reflects tissue oxygen consumption as well as oxygenation, and that the dissociation of both factors can occur in hepatic graft reperfusion. Not only low and heterogeneous H-So2 but also high and homogeneous H-So2, suggesting some shunt mechanism, can be signs of poor graft function.

[Proposals for the objective indices for evaluating the differentiation of leukemic cells by all-trans retinoic acid in the patients with acute promyelocytic leukemia]

All-trans retinoic acid (ATRA) is widely used as a differentiation-inducing agent for acute promyelocytic leukemia (APL). However, one of the problems with this therapy is the difficulty in evaluating the extent of differentiation of leukemic cells. To determine objective indices for differentiation which can be used for judging complete remission, we treated 18 patients with acute promyelocytic leukemia, and performed sequential analysis of bone marrow, karyotype, RAR alpha gene rearrangement and PML-RAR alpha fusion gene transcript. The karyotype, RAR alpha rearrangement and PML-RAR alpha transcript returned to a normal pattern on days 31, 2, 34.8 and 47.6, respectively. We defined and analyzed maturation index (MI) by bone marrow findings as follows; (metamylocyte + band neutrophil + segmented neutrophil) (%)/(myeloblast + promyelocyte + myelocyte) (%). MI increased along with the differentiation of leukemic cells, and the days for MI exceeding 2 well correlated with the normalization of karyotype. These results suggested that MI can be used as an index of differentiation during ATRA therapy.

A retrotransposon-like sequence linked to the S-locus of Nicotiana alata is expressed in styles in response to touch

We have identified a family of repetitive sequences in the genome of Nicotiana alata named Tna1 (Transposon of N. alata). The first element we characterised was a genomic clone for the N. alata s6-ribonuclease (S6-RNase), a gene required for self-incompatibility in this species. The DNA sequence of this element resembles the integrase domain of retrotransposons of the gypsy class and is most similar to a retrotransposon from Lilium henryi. A transcript present in N.alata styles (self-incompatibility genotype S6S6) hybridized to Tna1 and accumulated in the style following either pollination or touching. This transcript was cloned from a cDNA library and was encoded by second, partial Tna1 elements. Neither the transcribed sequence nor the original Tna1 element contain an open reading frame or is likely to be able to transpose. The second element was mapped using a population of N.alata plants segregating for alleles of the self-incompatibility locus and is closely linked to the S6-allele. The Tna1 element is present in a number of Nicotiana species and appears to have been active at least twice during the evolution of this genus.

Proteins that interact with GTP in Streptomyces griseus and its possible implication in morphogenesis

By cross-linking with [alpha-32P]GTP or [gamma-32P]GTP with or without UV treatment, several proteins of Streptomyces griseus were shown to interact with GTP in specific ways. After gel electrophoresis, 19 bands of radioactivity were found; 12 bands were assigned as GTP-binding proteins and 6 bands as phosphorylated proteins. One band was assumed to be a guanylylated protein. The profile of radioactive bands was similar between cells prepared from liquid or solid culture, but markedly different between growth phases. A mutant (strain M-1) defective in aerial mycelium formation, which was originally found as a decoyinine-resistant isolate, was found to have a different profile of phosphorylated proteins.

Cutaneous chronic graft-versus-host disease localized to the field of total lymphoid irradiation

A 20-year-old woman with aplastic anemia underwent bone marrow transplantation from an HLA-identical sibling after total lymphoid irradiation (TLI) and cyclophosphamide (CY). The post-transplant course was uneventful. CYA was discontinued on day 221. Three weeks later, the patient developed cutaneous GVHD precisely localized to the field of TLI. No other organs were involved. Immunohistochemical staining of the affected skin was strongly positive for ICAM-1, PECAM-1 and ELAM-1; normal skin was only weakly positive for ICAM-1. CYA was restarted, and the skin lesions disappeared. TLI may contribute to an unusual presentation of cutaneous GVHD associated with specific expression of adhesion molecules.

[Hypertrophic obstructive cardiomyopathy with ruptured chordae tendineae: a case report]

A 61-year-old man with hypertrophic obstructive cardiomyopathy and ruptured chordae tendineae but subsequent disappearance of the obstruction received mitral valve replacement 4 years after the diagnosis of ruptured chordae tendineae. Chordal rupture should be recognized as one of the important causes of mitral regurgitation in patients with hypertrophic obstructive cardiomyopathy.

[The effects of information relevance to speaker vs. hearer on the use of comment expressions and interrogative sentences in the Japanese language]

This study examined how the relevance of information to the speaker and the hearer affected the use of comments and interrogative sentences. Subjects read scenarios and rated the necessity of an expression (Experiment 1) or the naturalness of expressions (Experiment 2) in each of the situations. Experiment 1 investigated the use of comments, which preceded the information, to show the speaker's uncertainty about the information contents (subjects: 138 undergraduates). The less the information was relevant to the speaker and/or the more it was relevant to the hearer, the more the comments were judged to be necessary. Experiment 2 investigated the use of interrogative sentences, declarative sentences, and declarative sentences + a sentence final particle 'ne' (subjects: 96 undergraduates). Interrogative sentences were judged to be the most natural in the conditions where the information was relevant to the hearer and not to the speaker, whereas declarative sentences were judged to be the most natural where the information was relevant to the speaker and not to the hearer. Declarative sentences + 'ne' showed intermediate patterns of use between interrogative sentences and declarative sentences.

Glaucoma triple procedure comprising trabeculotomy with a fornix-based scleral flap

A new triple surgery procedure was applied to 20 primary open-angle glaucomatous (POAG) eyes. This technique comprises trabeculotomy with narrow (2-3 mm) fornix-based scleral flap, combined with extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens (PC-IOL) implantation. As to surgical results, at two years postsurgery 53% (9/17) of the eyes were controlled under 21 mm Hg without medication, 35% (6/17) with topical medication alone. Eighteen (90%) eyes showed improved visual acuity of two or more Snellen lines. No serious postoperative complications occurred. There was no significant difference in postoperative astigmatism as compared with ordinary ECCE and PC-IOL surgery. Trabeculotomy with fornix-based scleral flap offers the advantage of simple and safe surgery when combined with ECCE and PC-IOL implantation.

Decreased sensitivity to beta-adrenergic stimulation of the ventricular cells isolated from the spontaneously hypertensive rat heart

1. The stimulatory effects of isoproterenol on the L-type Ca2+ current (ICa) were compared between the control (WKY) and hypertensive (SHR) rat heart cells, using the patch-clamp method. 2. The current density and the shape of the current-voltage relationship for ICa were not different between the two groups. However, the maximal percentage increase in response to isoproterenol was smaller in SHR (+91% in SHR and +81% in WKY), and the ED50 was significantly higher in SHR (0.081 mu mol/L in SHR and 0.020 mu mol/L in WKY). IBMX, a potent phosphodiesterase inhibitor, significantly increased the isoproterenol-stimulated ICa in SHR, but not in WKY. These results suggest an impaired cAMP production in SHR heart cells.

[Aplastic anemia complicated with secondary hemochromatosis after allogenic bone marrow transplantation]

We report a case of aplastic anemia complicated with secondary hemochromatosis after allogenic bone marrow transplantation (BMT). A 29-year-old man was diagnosed as having aplastic anemia at the age of 8. At the age of 28, BMT was performed from his HLA-identical sister. Total volume of blood transfusion before BMT was about 28,000 ml, and in three months after BMT was 8,000 ml. The transplantation was successful, but one month after BMT, dry eyes, skin pigmentation and hepatomegaly appeared. Serum bile duct enzymes and ferritin also increased remarkably. Moreover after thirteen months, glucose tolerance impaired seriously. Abdominal computed tomography (CT) revealed atrophic pancreas and an increased CT density in the liver and the tail of the pancreas. A large amount of iron deposition were also found in liver and stomach biopsy specimens. We concluded that diabetes mellitus was due to secondary hemochtomatosis in the present case. There is a possibility that tissue damage due to iron deposits may have been accelerated through BMT in this patient with a history of many blood transfusions.

Serum 7 alpha-hydroxycholesterol as a new parameter of liver function in patients with chronic liver diseases

To examine bile acid synthesis in chronic liver diseases, serum total 7 alpha-hydroxycholesterol level was measured by gas-liquid chromatography-mass spectrometry in patients with cirrhosis (n = 23), patients with chronic hepatitis (n = 21), and control subjects (n = 18). The serum 7 alpha-hydroxycholesterol levels were significantly lower in patients with cirrhosis than the controls (78 +/- 59 pmol/mL vs. 237 +/- 97 pmol/mL; mean +/- SD). However, in patients with chronic hepatitis, the level was fully retained (262 +/- 102 pmol/mL). Serum 7 alpha-hydroxycholesterol levels of 17 patients with cirrhosis classified as Child B and C ranged from 33 to 69 pmol/mL, and all were less than the normal range (between 104 and 466 pmol/mL), however, those levels of some patients classified as Child A were within the normal range. Serum 7 alpha-hydroxycholesterol levels significantly correlated with serum albumin, cholinesterase, total bile acid, direct bilirubin, alkaline phosphatase, indocyanine green (ICG) retention rate, hepaplastin test, and lecithin-cholesterol acyltransferase activities. We conclude that bile acid synthesis is well preserved in patients with chronic hepatitis and that it is decreased in most patients with cirrhosis. Serum 7 alpha-hydroxycholesterol may be a new parameter of liver function testing to assess hepatic bile acid synthesis in patients with chronic liver diseases.

Plasma endotoxin in typhoid fever

Plasma endotoxin contents of the patients with sepsis or typhoid fever were measured by two sophisticated chromogenic limulus tests; Endospecy and Toxicolor tests. Endospecy test is the endotoxin-specific test and Toxicolor is responsible for both endotoxin and (1,3)-beta-D-glucan. Plasma was pretreated by our new PCA method which resolved the problem as to the detection of a lesser amount of plasma endotoxin when pretreated by the conventional PCA method. Although Toxicolor values have been reported to exceed more than the Endospecy value, under complicated pathophysiological situations, almost all specimens of these patients had a similar value, except in one expired septic shock case. In 18 typhoid fever cases, Salmonella typhi was isolated only from the bile in 5 cases, however endotoxemia occurred in 11 cases (61.1%). Within the first 4 days, the incidence of endotoxemia was higher (10/14, 71.4%). These results suggest that endotoxin assay seemed to be a useful tool for the diagnosis of typhoid fever.

Placement of the urethral stent made of shape memory alloy in management of benign prostatic hypertrophy for debilitated patients

PURPOSE

A new urethral stent made of shape memory alloy was placed to relieve prostatic obstruction in 17 patients in whom other approaches were contraindicated.

MATERIALS AND METHODS

All patients were unable to tolerate intervention with sedation and positioning. Placement of the shape memory alloy stent mounted on a 16F Foley catheter is similar to insertion of a urethral catheter except for the heat-sensitive expansion.

RESULTS

Each device was easily implanted with the patient on a flat examination table. There was no migration or incrustation of the shape memory alloy stent during the indwelling period.

CONCLUSIONS

Clinical results demonstrate that the shape memory alloy urethral stent might be the only choice for management of prostatic obstruction in debilitated patients.