[Surgical treatment of right atrial papillary fibroelastoma, originated from the eustachian valve--a case report]

Papillary fibroelastoma is one of the most common benign primary cardiac tumor after myxoma. However, it is rare to originate from Eustachian valve. A 44-year-old woman was pointed out the right atrial tumor during admission for vasospastic angina. On two-dimensional echocardiogram, the tumor was found in the right atrium, and easily moved to the right ventricle. At operation, the tumor originated from Eustachian valve, and was resected together with the valve by means of extracorporeal circulation. The size of tumor was 57 mm in length, and the histological diagnosis was papillary fibroleastoma. The post-operative course was uneventful.

Single photon emission computed tomography in systemic lupus erythematosus with psychiatric symptoms

Single photon emission computed tomography (SPECT) with n-isopropyl-p-[123I]iodoamphetamine (IMP) was performed on 20 patients with systemic lupus erythematosus (SLE). Fifteen of the patients showed areas of hypoperfusion. All nine patients who had florid psychiatric manifestations at the time the SPECT was performed had hypoperfusion areas. Four patients who had abnormal SPECT findings during psychiatric remission had psychiatric exacerbation one to six months after the SPECT. Four patients who had no hypoperfusion during psychiatric remission had good psychiatric prognoses. Two patients who had no history of psychiatric abnormality but showed hypoperfusion had psychiatric manifestations one month after the SPECT. The IMP-SPECT may be useful as a biological marker that represents the activity of cerebral involvement underlying psychiatric manifestations and the presence of subclinical CNS involvement.

Specific binding of endothelin-1 to canine tracheal epithelial cells in culture

We have studied the binding of endothelin-1 (ET-1) to cultured canine tracheal epithelial cells. A single specific binding site for 125I-labeled ET-1 was identified with an apparent dissociation constant (Kd) of 0.2 nM, maximal binding sites (Bmax) of 6.7 x 10(3) sites/cell, and half-maximal inhibition (IC50) of 0.3 nM during a 2-h incubation period. The binding of 125I-ET-1 to these cells was inhibited by the presence of unlabeled ET-1, ET-2, or BQ-123, whereas ET-3 and sarafotoxin S6c did not compete for this binding site. These binding characteristics are consistent with those of the ETA receptor. At 37 degrees C, specific binding continuously increased over 18 h, while at 4 degrees C, it reached a plateau by 2 h. The increase in binding at 37 degrees C was not associated with DNA synthesis but was dependent upon protein synthesis, suggesting that epithelial binding sites were produced continuously under these incubation conditions. Our results indicate that canine tracheal epithelial cells possess specific binding sites for ET-1 with characteristics similar to those of the ETA receptor subtype. Because these cells are demonstrated to both release and bind ET-1, the results further suggest that ET-1 is involved in paracrine and/or autocrine control mechanisms in the airway epithelium.

[Surgical treatment of traumatic rupture of the aortic valve with dove-coo murmur--case report]

Aortic regurgitation due to traumatic rupture of the aortic valve with dove-coo murmur is rare. A 71-year-old man was admitted for cardiac failure due to aortic regurgitation with dove-coo murmur, 4 years after the traffic accident. The aortic valve replacement was performed and his postoperative course was good. The aortic valve was tricuspid valve with the tear in the left side of right coronary cusp, and the size of the tear was 7 mm. The aortic valve was not recognized the findings of inflammatory or rheumatic change in the pathological study.

Developmental changes in response to endothelins and receptor subtypes of isolated rat duodenum

The response of isolated duodenum to endothelin-1, -3 and IRL 1620 (Suc-[Glu9,Ala11,15]endothelin-1 (8-21)), a selective endothelin ETB receptor agonist, was studied in both neonatal (1-week-old) and adult rats by recording mechanical activity isotonically. Endothelin-1, -3 and IRL 1620 (1-100 nM) elicited sustained contraction of neonatal duodenum, in a concentration-dependent manner, with a potency order of endothelin-1 = endothelin-3 > IRL 1620. The response to endothelin-1 and -3 (10-1000 nM) of adult duodenum was biphasic, i.e., transient relaxation followed by contraction, with a potency order of endothelin-1 > endothelin-3. The contractile response to endothelin-1 of adult but not neonatal duodenum was significantly antagonized by pretreatment with FR139317 (1 microM), an endothelin ETA receptor antagonist. An endothelin ETB receptor antagonist, RES-701-1 (3 microM), weakly antagonized the IRL 1620-induced contraction of neonatal duodenum. However, RES-701-1 (10 microM) did not affect the response to endothelin-1 of either adult or neonatal duodenum. These results indicate that the duodenal response to endothelins changes from a sustained contraction in neonates to a biphasic response in adults. The contractile response to endothelins of neonatal duodenum is suggested to be mediated through endothelin ETB receptors or possibly RES-701-1-resistant ETB receptor subtypes and contraction of adult duodenum through endothelin ETA receptors. The mechanism of the endothelin-induced response of duodenum was also studied.

The N-terminal portion of growth inhibitory factor is sufficient for biological activity

To determine its active site, growth inhibitory factor (GIF), a central nervous system-specific metallothionein-like protein, was digested with trypsin followed by Staphylococcus aureus protease V8 digestion. Of 5 peptide fragments separated from trypsin-digested GIF by reverse-phase high pressure liquid chromatography and gel filtration, only GIF1-26 or longer peptides showed growth inhibitory activity on cortical neurons in culture. A shorter peptide, GIF5-23, which was obtained by further digestion of GIF1-26 with V8 protease, also showed growth inhibitory activity. However, a synthetic peptide corresponding to GIF5-23 did not show growth inhibitory activity. Metal-free GIF1-26 prepared by acid treatment showed a similar level of growth inhibitory activity to that of metal-containing GIF1-26, indicating that metal in the peptide does not affect the activity. Treatment of metal-free GIF1-26 with beta-mercaptoethanol resulted in the loss of activity. The CD spectrum of beta-mercaptoethanol-treated metal-free GIF1-26 was different from that of nontreated metal-free GIF1-26. These results indicate that the N-terminal portion of GIF is required for growth inhibitory activity and that folding of the peptide via S-metal bonding is critical for biological activity.

Polypoid growth and K-ras codon 12 mutation in colorectal cancer

BACKGROUND

To clarify genetic changes in colorectal tumorigenesis, K-ras codon 12 point mutations were examined in 101 ordinary colorectal carcinomas and 6 that complicated ulcerative colitis (UC) with special attention to growth patterns.

METHODS

The depths of invasion of ordinary carcinoma were submucosa (SMCa) in 39 cases, muscularis propria (PMCa) in 33, and far-advanced in 29. Growth patterns of SMCa and PMCa were classified into three types: polypoid-growth type without central depression (Type 1), polypoid-growth type with central depression (Type 2), and nonpolypoid-growth type. DNA samples were extracted from formalin fixed paraffin embedded sections, and K-ras codon 12 mutations were examined by two-step polymerase chain reaction-restriction fragment length polymorphism.

RESULTS

K-ras mutation frequency was higher in Type 1 SMCa than in nonpolypoid SMCa, 56% (9/16) versus 6% (1/17), respectively, and in PMCa, 78% (7/9) versus 23% (3/13), respectively. In 6 UC carcinomas, a K-ras mutation was detected in only one polypoid carcinoma and none were detected in five nonpolypoid carcinomas.

CONCLUSIONS

These results and the authors' previous study suggest that nonpolypoid carcinomas may be derived from flat adenomas, whose K-ras mutation incidence also was low, and this pathway is different from a genetic model based on the ordinary adenoma-carcinoma sequence through polypoid adenomas.

Role of eicosanoids but not nitric oxide in the platelet-activating factor-induced increase in vascular permeability in mouse skin

We investigated the role of endogenous eicosanoids and nitric oxide (NO) in the platelet-activating factor (PAF)-induced increase in vascular permeability in mouse skin. Subcutaneous injection of PAF (45-180 pmol/site) induced a dose-related increase in vascular permeability at the injection site. The vascular permeability induced by PAF (180 pmol/site) was significantly inhibited by pretreatment with an intraperitoneal injection of 1-O-hexadecyl-2-acetyl-sn-glycero-3-phospho (N,N,N-trimethyl) hexanolamine (PAF receptor antagonist) (5 and 25 mg/kg) and indomethacin (cyclooxygenase inhibitor) (10 mg/kg), whereas it was not affected by concurrent intravenous administration of NO synthase inhibitors NG-nitro-L-arginine methyl ester (10 mg/kg) or methylene blue (100 micrograms/kg) nor by topical injection of NG-nitro-L-arginine methyl ester. The inhibitory effect of indomethacin was partially reversed by topical administration of prostaglandin E2. These results suggest that PAF increases venular permeability by activating PAF receptors and that plasma extravasation is potentiated by the release of prostanoids which cause arteriolar dilatation. However, NO is not involved in the effect of PAF in mouse skin.

Expression rate of cytokine mRNA in the liver of chronic hepatitis C: comparison with chronic hepatitis B

This study was carried out to test the hypothesis that, in chronic hepatitis (CH), inflammatory processes, including viral replication, host immune response, and hepatocyte destruction, are regulated by a cytokine network in the liver. Expression of the mRNA of the cytokines IL1-beta, IL2, IL4, IL5, IL6, TNF-alpha, and IFN-gamma, the lymphocyte markers CD4 and CD8, and the HLA class I molecule, beta 2-microglobulin (B2MG) in the liver tissue of 20 CH(C) cases and 9 CH(B) patients was investigated by the reverse transcription polymerase chain reaction (RT-PCR) method. TNF-alpha, CD4, and B2MG mRNA were detected in 100% of cases of in both CH(B) and CH(C). The expression rates of IL1-beta, IL2, IL4, IFN-gamma, and CD8 mRNA were 80%, 40%, 25%, 40%, and 80% in CH(C) and 88.9%, 44.5%, 30%, 55.6%, and 100% in CH(B). IL6 mRNA was detected only in CH(B), in 22.2% of cases, IL5 mRNA was not detected in either CH(B) or CH(C). IL2, IL4, and IFN-gamma mRNA were expressed significantly more frequently in patients who had high serum ALT and a high histological activity index (HAI) score. There was no difference in cytokine expression between CH(B) and CH(C), except in IL6, suggesting the existence of a common immunopathogenesis for CH(B) and CH(C). In chronic viral hepatitis, IL1-beta and TNF-alpha appear to play a major role in immune responses and IL2, IL4, and IFN-gamma seem to be associated with increased cytotoxic T cell response.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of morphine on aluminium fluoride and dibutyryl-cyclic AMP induced reduction of field potentials in hippocampal slices

Effects of morphine and aluminum fluoride on field potentials evoked in hippocampal pyramidal cells were investigated revealing the physiological significance of adenylate cyclase in morphine action. Dibutyryl-cyclic AMP (db-cAMP) reduces the amplitude of potentials, while morphine enhances it. Morphine was without effects on db-cAMP induced reduction of potentials. Aluminum fluoride, known to activate GTP binding proteins, also reduced potentials and this was antagonized by morphine. Furthermore, N-[2-(methylamino)ethyl]-5-isoquinolinesulphonamide dihydrochloride (H-8), a protein kinase A inhibitor, enhanced potentials. When GABA synthesis was inhibited by 3-mercaptopropinoic acid, both morphine and db-cAMP was without effect. These results suggested the inhibition of adenylate cyclase by morphine which might be related with the reduction of GABA release in hippocampal slices.

Subtle increase in leukocyte counts in association with drinking and smoking habits

Peripheral leukocyte counts were examined in venous blood of more than 800 male workers exposed to toluene, xylenes, a combination of the two, or neither. Information on the social habits of smoking and drinking was obtained in an occupational health interview. The analysis showed that smoking (15 cigarettes/day on average) induced a significant increase (by 7%) in leukocyte counts, and that an additional increase was induced when the drinking habit was coupled with smoking. Drinking alone tended to increase the leukocyte counts but the effect was statistically nonsignificant, possibly because the number of nondrinking smokers was limited. The study stresses the importance of paying attention to smoking and drinking habits when evaluating hematological parameters such as peripheral leukocyte counts in solvent-exposed workers.

Alteration in gastric nerve fibers containing gastrin-releasing peptide in relation to the gastrin-producing cell population after truncal vagotomy in a rat model

The fine structural alteration in the gastric nerve fibers containing gastrin-releasing peptide (GRP) was studied in relation to the dynamics of gastrin-producing cells (G-cells) after truncal vagotomy in a rat model. The circulating gastrin levels were markedly elevated from the 1st day after vagotomy and the number of G-cells with positive immunoreaction for G17 and G34(1-15) was significantly increased in the vagotomized group. On the 3rd day after vagotomy, the G-cells showed conspicuous ultrastructural changes characterized by hypertrophy of the Golgi complexes and increased numbers of secretory granules. The GRP-positive nerve fibers formed a fine network in the gastric wall and were densely distributed in the oxyntic mucosa close to the blood vessels and showing varicosities composed of either small clear or GRP-positive large vesicles containing an electron-dense core. In the oxyntic mucosa of the vagotomized rats, axonal swelling of the nerves occurred on the 3rd day, and a depletion of GRP immunoreactivity was evidenced by a markedly decreased number of large-cored vesicles on the 7th day, when the serum GRP levels were also found to be markedly elevated. These findings indicate that the alteration in gastric nerve fibers containing GRP after truncal vagotomy may be related to hypergastrinemia and antral G-cell hyperplasia in the rat gastric mucosa.

[Analysis of T cell subsets in autoimmune hemolytic anemia patients]

To clarify a role of immunoregulatory T cells in the pathophysiology of autoimmune hemolytic anemia (AIHA), we investigated T cell subsets in the peripheral blood of 15 patients with AIHA by two color analysis using flow cytometry. Consequently both CD4+ cells and CD4+CD45RA+ cells decreased in proportion, irrespective of the disease activity (active or remission phase). CD4+CD45RA+ cells are regarded as naive T cells. Incidentally the ratio of CD45RA+ cells in CD4+ cells also fell in the low level in active phase, but it recovered to the normal ratio in remission. On the other hand, CD8+ cells and CD8+ +S6F1+ cells that may represent activated cytotoxic T lymphocytes increased in active phase and then both entered the normal range in remission. These findings suggest that AIHA could be caused partly by the alternative balance of CD4+CD45RA+ cells probably constituting a member of IRT and moreover by the activation of CTL.

Myocardial microdialysis of salicylic acid to detect hydroxyl radical generation during ischemia

We examined in vivo monitoring of hydroxyl radical (.OH) generation during myocardial ischemia for 30 min by occluding the left anterior descending (LAD) in dog heart using a microdialysis technique. The hydroxyl radical reacts with salicylate and generates 2,3- and 2,5-dihydroxybenzoic acids (DHBA) which can be measured electrochemically in picomole quantity by a high pressure liquid chromatography-electrochemical (HPLC-EC) procedure. When the premature ventricular contraction (PVC) occurred at almost 25 sec intervals, marked elevation of the levels of 2,3- and 2,5-DHBA was observed in the heart dialysate of 30-min ischemia. This study demonstrated the generation of .OH in the canine heart subjected to 30-min ischemic insult.

Effects of rapid burnout type gypsum-bonded investment on performance of castings. Part 1. Surface aspects and fit of crowns

Rapid burnout type gypsum-bonded investment materials were developed to shorten the time required for dental casting procedures. With these materials, molds can be prepared by rapid heating at 700 degrees C for 30 min from 30 min after the start of mixing. When the investment block was rapidly heated at 700 degrees C, no fractures were observed in the rapid burnout type investments with one exception, while a conventional cristobalite investment broke into pieces shortly after being placed in the furnace. Casting fins were sometimes induced only for the material which showed fracturing on rapid heating. No practical problems were found in the surface roughness of the castings. The 30 min-setting expansion was significantly different among the materials although there were no differences in thermal expansion, and the material showing greater 30 min-setting expansion was efficient to obtain better fit of the crown as in the conventional casting procedures.

Alteration of G protein levels in antigen-challenged guinea pigs

To elucidate the mechanism(s) of altered responses of various receptors observed in asthma, we examined levels of G proteins in lung membranes isolated from guinea pigs at various stages of experimental asthma. We found that levels of Gi2 alpha and Gq alpha increase after multiple exposures to aerosolized antigen but not after a single exposure. Levels of Gi1 alpha, Gs alpha and G beta did not change under these experimental conditions. Tracheas from these animals exhibited hyperresponsive muscarinic bronchoconstriction and hyporesponsive beta adrenoceptor-mediated relaxation of endothelin-preconstricted tracheas as measured by an ex vivo isometric assay. No changes in numbers or affinities of membrane M3 muscarinic and beta-2 adrenergic receptors were detected as measured by binding of [3H]QNB and [125I]CYP, respectively. The impairment of beta adrenoceptor-mediated relaxation of tracheas isolated from animals treated by multiple challenges was reversed by the pretreatment of tracheas with pertussis toxin. On the other hand, the carbamylcholine-stimulated GTPase activity was higher in lung membranes isolated from animals in the multiple challenge group and was blocked by anti-Gq alpha protein antibody. Taken together, our present observations suggest that an underlying mechanism of altered receptor responses associated with asthma is in part due to increased expression of Gi2 alpha and Gq alpha proteins, leading to altered coupling of receptors to effector systems.

Biocompatibility of a heparin-bonded membrane oxygenator (Carmeda MAXIMA) during the first 90 minutes of cardiopulmonary bypass: clinical comparison with the conventional system

We clinically compared a heparin-bonded Carmeda MAXIMA membrane oxygenator to a nonheparin-bonded MAXIMA in 20 patients undergoing coronary artery bypass grafting or valve replacement. Reductions of fibrinogen, factor XII, and high molecular weight kininogen were greater in the MAXIMA group. Serum C3a and free hemoglobin were lower in the Carmeda group. The level of C4a, though remarkably lower than that of C3a, was higher in the Carmeda group then in the MAXIMA group. Both oxygenators performed well in terms of blood gas exchange. We conclude that the heparin-bonded Carmeda oxygenator offers superior biocompatibility during cardiopulmonary bypass.

Involvement of endogenous nitric oxide in non-adrenergic, non-cholinergic contraction elicited by [Met5]-enkephalin in rat isolated duodenum

To investigate the possible neuromodulatory role of nitric oxide (NO) in the gastrointestinal tract, an examination was made of the effects of NG-nitro-L-arginine (L-NOARG), an inhibitor of NO synthase, on the intestinal response to [Met5]-enkephalin (ENK) by recording the mechanical activity of the isolated duodenum from rats. [Met5]-enkephalin elicited a biphasic response of the duodenum, i.e. transient relaxation followed by contraction. The relaxation induced by ENK was blocked by naloxone, an opioid receptor antagonist, but not by tetrodotoxin (TTX). The contractile response of the duodenum to ENK was blocked by TTX but not by naloxone. The contractile response was not affected by hyoscine, a muscarinic antagonist, or guanethidine, an adrenergic neuron blocking agent, indicating mediation by non-adrenergic, non-cholinergic (NANC) nerves. The contractile but not the relaxant response to ENK was blocked by L- but not D-NOARG. The contractile response was also inhibited by methylene blue, an inhibitor of both NO synthase and guanylate cyclase, and by indomethacin, a cyclooxygenase inhibitor. Thus, endogenous NO and prostaglandins are involved in the contractile response to ENK. Endogenous NO may modulate the release of excitatory NANC transmitters via a prejunctional mechanism.

Morphological changes of human mandibular bone during fetal periods

Standardized photographs (lateral and basal view) of fetal mandibles (n = 80) were taken. Outline segments (from gnathion to condylion, on the coronoid process and from infradentale to gnathion in lateral view; and on the inferior margin in basal view) were analyzed into sine curves, according to Fourier series. Using the calculated Fourier coefficients, we statistically examined how mandibular shape changed with fetal growth. Materials were classified into four groups on the basis of the body length (BL): 100 < or = BL < 200 mm (BL1, n = 20); 200 < or = BL < 300 mm (BL2, n = 20); 300 < or = BL < 400 mm (BL3, n = 20); and 400 < or = BL < or = 500 mm (BL, 4 = 20). Statistical analyses were all done on these stature groups. On the outline from gnathion to condylion, the constant and the first term phase showed statistically greater values in BL4 than in the other groups, as assessed by t-test. The first term phase for the coronoid process significantly decreased with increments in stature in the canonical disciminant analysis. On the outline from infradentale to gnathion, although the cumulative contributions of the first two terms were constant (about 85%) in all four groups, the relative contributions with growing stature decreased in the first term and increased in the second term. The mean of the phase in the first term indicated slightly more than -90 degrees in BL1, and was less than -90 degrees in BL2 to BL4. The averages of the second term phases presented little change from BL1 to BL3, and were close to -100 degrees. From the canonical discriminant analysis, the constant was great and the first term amplitude was small in BL1 and BL4, and the constant was small and the first term amplitude was great in BL2 and BL3. Also, the second term amplitude in BL4 indicated a significantly bigger volume than in BL3. The constant for the inferior margin manifested statistically significant increments in BL2 to BL4, as assessed by t-test. We interpret the results as follows: 1. On the outline from gnathion to condylion, anteroinferior shift occurs in BL4, resulting in an acute gonial angle. The change of angle during the prenatal period precedes the postnatal findings that bring about a progressive decrease in the gonial angle. 2. The tip of the coronoid process indicates a forward shift with increasing fetal body stature.(ABSTRACT TRUNCATED AT 400 WORDS)

Possible role of nitric oxide in 5-hydroxytryptamine-induced increase in vascular permeability in mouse skin

In order to test the hypothesis that a 5-hydroxytryptamine (5-HT)-induced increase in vascular permeability results from a cascade triggered by activation of the synthesis of nitric oxide (NO), the vascular permeability was investigated using the Pontamine sky blue leakage method in male mice. Subcutaneous injection of 5-HT induced a dose-related increase of vascular permeability at the injection site. The vascular permeability induced by 5-HT was inhibited by pretreatment with intraperitoneal injection of ketanserin (5-HT2A antagonist) and methysergide (5-HT1/2A antagonist), less efficiently by 1-(2-methoxyphenyl)-4-[4-(2-phthalimido)butyl] piperazine (NAN-190) (5-HT1A antagonist), but not by granisetron (5-HT3 antagonist). Increase in vascular permeability induced by 5-HT was inhibited by concurrent intravenous administration of NO synthase inhibitors NG-nitro-L-arginine methyl ester (L-NAME) and methylene blue but not by the inactive enantiomer NG-nitro-D-arginine methyl ester (D-NAME). These results suggest that 5-HT increases vascular permeability by activating the 5-HT receptors and that endogenous NO is involved in this effect of 5-HT.