Regulation of insulin-like growth factor system components by osteogenic protein-1 in human bone cells

Bone morphogenetic proteins (BMPs) have the unique ability to convert mesenchymal cells into matrix-producing osteoblasts. To understand the mechanism(s) by which a BMP produces a multitude of effects on bone cells, we examined the effects of recombinant human osteogenic protein (OP)-1 (referred to as BMP-7) on the insulin-like growth factor (IGF) regulatory system, an important growth factor system in bone. After 48 h of treatment, OP-1 increased the level of IGF-II (3- and 2-fold, respectively, at 100 ng/ml) in the conditioned medium (CM) of SaOS-2 and TE85 human osteosarcoma cells with osteoblastic characteristics, whereas IGF-I levels were low to undetectable in the CM of either cell type. OP-1 treatment had no significant effect on the messenger RNA (mRNA) level for type 1 and type 2 IGF receptors. In TE85 and SaOS-2 cells, 100 ng/ml OP-1 increased the level of IGF binding protein (BP)-3 more than 10-fold, decreased the IGFBP-4 level by 50%, and increased the level of the 29-32.5 kDa IGFBP-5 3-fold in the CM as determined by analysis with Western ligand blot, Western immunoblot, and RIA. The effect of OP-1 on IGFBP production was time and dose dependent. The OP-1 induced changes in the levels of IGFBPs were associated with decreased IGFBP-3 and -5 protease activity (29% and 71%, respectively) and proportional changes in IGFBP mRNA levels. OP-1 increased the level of IGFBP-3 mRNA (2- and 10-fold, respectively, after 4 and 24 h of treatment at 100 ng/ml) and of IGFBP-5 mRNA (more than 5-fold after 24 h of treatment) but decreased the level of IGFBP-4 mRNA (> 50% after 24 h at 100 ng/ml). OP-1 treatment had no effect on IGFBP-4 protease activity. These results collectively demonstrate that OP-1 can act locally by modulating the IGF regulatory system, suggesting that the mitogenic/differentiative effect of OP-1 on human bone cells may in part be mediated via IGF-II by increasing its secretion, and by regulating the balance between the stimulatory (e.g. IGFBP-5) and inhibitory (e.g. IGFBP-4) classes of IGFBPs both at the level of production (mRNA) and at the level of degradation but not by up-regulating the IGF receptor.

Longitudinal study on the changes of maxillary arch dimensions in Japanese children with cleft lip and/or palate: infancy to 4 years of age

The focus of this study was an analysis of maxillary arch growth changes prior to the time of cheiloplasty up to 4 years of age. Serial dental casts were obtained and measured in 95 children with cleft lip and palate, or both: 7 unilateral cleft lip and alveolus (CLA), 52 unilateral cleft lip and palate (UCLP), 24 bilateral cleft lip and palate (BCLP), and 12 isolated cleft palate (CP). The children were treated at the Kyushu University Dental Hospital. The results are as follows: (1) Prior to cheiloplasty, the maxillary buccal segments in the subjects with cleft lip and palate showed lateral displacement. The premaxilla in BCLP subjects was protruded. (2) Cheiloplasty influenced maxillary anterior arch width, but not posterior width. The operation caused posterior displacement of the premaxilla in BCLP subjects. (3) Palatoplasty affected the growth of the maxillary arch in the transverse and anteroposterior dimensions. (4) A variety of growth patterns observed in the patients (e.g., increasing or decreasing of the maxillary arch dimensions) suggests that maxillary arch dimensions were affected not only by surgery, but also by other individual factors such as genetic facial pattern and severity of the cleft.

Lung surfactant protein-A and carcinoembryonic antigen in pleural effusions due to lung adenocarcinoma and malignant mesothelioma

Lung surfactant protein-A (SP-A) is a major phospholipid-associated glycoprotein in surfactant, and is a useful immunohistochemical marker for lung adenocarcinoma. Carcinoembryonic antigen (CEA) has not been immunohistochemically detected in mesothelioma. In pleural effusions due to malignant mesothelioma, very low concentrations of SP-A and CEA can be expected. We studied the value of combined determinations of CEA and SP-A in pleural fluid to distinguish between lung adenocarcinoma and mesothelioma. SP-A and CEA concentrations were measured in pleural effusions from 78 patients with lung adenocarcinoma and 10 with malignant mesothelioma. SP-A concentrations in pleural effusions due to lung adenocarcinoma and mesothelioma were 516 +/- 140 and 16.9 +/- 3.6 ng.ml-1 (mean +/- SEM), respectively. CEA concentrations in pleural effusions due to lung adenocarcinoma and mesothelioma were 239 +/- 92.4 and 1.7 +/- 0.3 ng.ml-1, respectively. SP-A values did not exceed 100 ng.ml-1 in any of 10 mesotheliomas, whilst in 37 of 78 lung adenocarcinomas they did. CEA values did not exceed 10 ng.ml-1 in any of 10 mesotheliomas, whilst in 53 of 78 lung adenocarcinomas they did. Increased values of SP-A and/or CEA were found in pleural effusions from 67 of 78 lung adenocarcinomas. It is concluded that a combination of CEA and SP-A assays in pleural effusions will be helpful for discriminating lung adenocarcinoma from mesothelioma.

Chemical studies on the possible existence of life on Mars

Although there is no direct evidence yet for the existence of life on Mars, it is reasonable to conclude that the emergence of life on Earth, which appears to have been controlled by universal laws of physics and chemistry, may have been repeated elsewhere in the universe. The dual approach of synthesis and analysis in our experimental studies has provided ample evidence in support of this hypothesis.

Interleukin-1 gene expression in transient retinal ischemia in the rat

PURPOSE

To determine in rats whether there are time-dependent changes in interleukin-1 alpha (IL-1 alpha) and interleukin-1 beta (IL-1 beta) gene expression in transient retinal ischemia and to localize their mRNAs in the retina.

METHODS

Retinal ischemia was induced in Sprague-Dawley rats by ligating the optic nerve. Two hours later, the ligature was released and reperfusion occurred. The levels of IL-1 alpha and IL-1 beta gene expression in the sensory retina were then compared at various times after reperfusion by a semiquantitative polymerase chain reaction method. Localization of their expressed mRNAs was examined by in situ hybridization histochemistry.

RESULTS

Little expression of IL-1 alpha and IL-1 beta genes was observed in normal retina. IL-1 alpha gene expression rapidly increased (about 30-fold greater than that of the control) as early as 1 hour after cessation of ischemia, reached a peak (about 50-fold) at 3 to 12 hours, and then gradually decreased to near baseline levels. IL-1 beta gene expression began to increase 2 hours later than did that of IL-1 alpha and had two peaks. IL-1 beta gene was found by in situ hybridization histochemistry to be expressed by retinal glial cells, endothelial cells, and neutrophils infiltrating the retina and vitreous. No gene expression was found in the control retinas.

CONCLUSIONS

Expression of IL-1 alpha and IL-1 beta genes was dramatically upregulated during reperfusion after induced retinal ischemia. IL-1 beta gene was expressed by retinal glial cells, endothelial cells, and neutrophils recruited into the retina. From these results, it appeared that IL-1 may have an important role in retinal ischemia-reperfusion injury.

Clinical study of IgA antibody against hepatitis C virus core antigen in patients with type C chronic liver disease

Immunoglobulin A class antibody to hepatitis C virus core antigen (IgA anti-HCc) was measured in the serum of 128 patients with type C chronic liver disease. Fifty-eight patients (45.3%) were seropositive. IgA anti-HCc was detected in only one of 20 patients with chronic persistent hepatitis; however, 52.3% (46/88) of patients with chronic active hepatitis and 55% (11/20) of patients with liver cirrhosis were seropositive. Histological examination revealed that 22 (71.0%) of 31 patients with severe disease activity were seropositive compared to 35 (44.9%) of 78 patients with moderate (P < 0.05) and one (5.3%) of 19 patients with mild (P < 0.01) histological changes. IgA anti-HCc was measured sequentially in 65 patients who underwent interferon therapy. There was a significant difference between responders and other patients in the mean ratio of IgA anti-HCc titers one month after therapy. Three months after therapy, IgA anti-HCc was detectable in only two of 15 responders who were IgA anti-HCc seropositive at the start of therapy. In contrast, IgA anti-HCc reappeared three months after therapy despite a temporary decrease to undetectable levels in all nonresponders. We conclude that IgA anti-HCc is a useful marker to identify the presence of active type C liver disease and that the disappearance of IgA anti-HCc three months after interferon therapy predicts a good response in treated patients.

[Relationship between regional flow reserve supplied by the great saphenous vein graft and regional left ventricular wall motion: a Doppler guide wire study]

The relationship between regional flow reserve supplied by a great saphenous vein graft and myocardial infarction and anterior wall motion assessed by left ventriculography was studied in 28 patients with no stenosis in the great saphenous vein graft and the peripheral site of the recipient left anterior descending coronary arteries. The proximal segment to the anastomosis was totally or subtotally occluded. The resting graft blood flow velocity was measured using a Doppler guide wire, then 0.56 mg/kg of dipyridamole was injected for 4 minutes intravenously and the resultant increase in graft blood flow velocity was recorded. The regional flow reserve of the anterior wall supplied by great saphenous vein grafts in 11 patients with anterior myocardial infarction (MI group) was significantly lower than that in 17 patients without myocardial infarction (non-MI group) (1.5 +/- 0.3 vs 2.6 +/- 0.7, p < 0.01). The flow reserve supplied by great saphenous vein grafts in 11 patients with normal anterior wall motion was 2.8 +/- 0.7, 10 with hypokinesis 1.9 +/- 0.3, and with akinesis 1.3 +/- 0.3. Reduced anterior wall motion induced a significant decrease in the flow reserve of the anterior wall supplied by the great saphenous vein graft (p < 0.01). The anterior wall motion score of four segments assessed by left ventriculography showed a significant correlation with the flow reserve of the anterior wall supplied by the great saphenous vein graft (y = -0.24 x + 3.7, r = 0.75, p < 0.001). The results show infarcted myocardium was an important influence on coronary flow reserve.

Epidermoid cyst with sweat ducts on the torso

We report a case of an epidermoid cyst arising on the upper chest that had a remarkable histologic pattern composed of structures resembling eccrine ducts in the horny layer and an acrosyringium. The expression of carcinoembryonic antigen (CEA) was also demonstrated immunohistochemically within these ductal structures. Eccrine ducts have been reported recently, in epidermoid cysts located in the palmoplantar region. The cyst described here suggests that epidermoid cysts derived from eccrine ducts may also appear on the torso.

An updated study of mortality among workers at a petroleum manufacturing plant

This study evaluated mortality among 9796 white male workers at a petroleum-manufacturing plant. The main purpose was to examine recent patterns in leukemia mortality, for which an increase had been reported in an earlier investigation. Compared to U.S. white men, the cohort had an excess of leukemia in 1940-1979 (38 observed/23 expected; standardized mortality ratio = 168; 95% confidence interval = 119-230). In the 1980s, there was a deficit of leukemia (8 observed/14 expected; standardized mortality ratio = 55; 95% confidence interval = 24-108). However, this was balanced by an excess of myelofibrosis and myelodysplasia (4 observed, < 1 expected). These results indicate that any occupational leukemogenic exposures at the plant have been reduced to a point at which they are insufficient to cause leukemia. Hourly workers also had an excess of deaths from mesothelioma in the 1980s (8 observed, about 2.5 expected), possibly because of exposure to asbestos in the past.

[Hyperbaric oxygen treatment for macular edema after retinal vein occlusion--fluorescein angiographic findings and visual prognosis]

It has been reported that hyperbaric oxygen treatment improves visual function in patients with chronic macular edema associated with retinal vein occlusion. This study was designed to investigate relationship between visual prognosis and characteristics of macular edema. From fluorescein angiography performed prior to the therapy, areas of capillary closure and fluorescein leakages were quantitatively evaluated within 1 disc diameter from the fovea. In 27 eyes for which good angiograms were available, 19 eyes were classified as having mild ischemia 1 (area of capillary closure < 25%) and 8 eyes were classified as having severe ischemia (closure area < or = 25%). Of the 27 eyes, 14 showed visual improvement after the therapy. While only one eyes (13%) had visual improvement in the severe ischemic group, 11 eyes (58%) showed visual improvement in the mild ischemic group. The degree of fluorescein leakage before the therapy had no effect on visual outcome. The degree of macular ischemia was found to be a more significant factor influencing visual prognosis after the treatment than the degree of macular edema.

Effective production of the hepatitis C virus core antigen having high purity in Escherichia coli

The amino-terminal half of putative nucleocapsid (core) protein (amino acids 1-115) of hepatitis C virus (HCV) was directly overproduced in Escherichia coli under the control of the tac promoter. Overproduction of core antigen was achieved by inserting several target genes and by optimizing the culture conditions, whereas a large amount of directly expressed and purified core antigen has not yet been reported. Although the level of expression was comparable to that of the conventional E. coli fused expression system, our recombinant proteins contain only HCV amino acid sequence. Using recombinant E. coli, overproduced large-scale culture system was achieved in jar-fermenter. A highly purified sample of the expressed protein was obtained by ion-exchange and gel permeation column chromatography in the presence of 8 M urea. From a 3.5 l culture, approximately 440 mg of recombinant core protein was obtained after a two-step purification procedure. An enzyme-linked immunosorbent assay developed using the highly purified antigen satisfactorily diagnosed hepatitis C.

Quantitative evaluation of leukocyte dynamics in retinal microcirculation

PURPOSE

Leukocyte rheology may play a key role in microcirculation because leukocytes have unique properties, such as large cell volume, high cytoplasmic rigidity, and low deformability. However, only a few methods are available to study the dynamic behavior of leukocytes in retinal microcirculation. The authors developed a new method to analyze directly movements of leukocytes in the retinal vessels of primates.

METHODS

Acridine orange, which has been used as a nuclear stain in histochemistry and cytochemistry, was injected intravenously into cynomolgus monkeys for a vital staining of leukocytes. The fundus image was generated with the argon blue laser and a scanning laser ophthalmoscope. The images were recorded on a magnetic tape and evaluated with a personal computer-based image analysis system.

RESULTS

Each leukocyte was recognized as a single fluorescent dot moving in the retinal vessels. It was possible to analyze the spatial and temporal dynamics of individual leukocytes in the capillaries. Some leukocytes passed through the capillaries, plugging transiently under the physiological condition. Leukocytes that stayed in the same position for a few minutes may have stuck to the endothelium as a result of leukocyte-endothelial interactions. In the postcapillary vessels, leukocytes tended to be displaced from the center stream toward the vessel walls. The mean flow velocity of leukocytes in the perifoveal capillary was 0.92 +/- 0.32 mm/sec.

CONCLUSIONS

This study clearly demonstrated that rheologic behaviors of leukocytes in the retinal microcirculation can be studied through the vital staining with acridine orange in vivo. The authors' results suggest a potential role of leukocytes in retinal vascular flow disturbances. This study may open the door to the investigation of leukocyte hemodynamics in the retinal microcirculation in vivo.

Aberrant appearance of lung surfactant protein A in sera of patients with idiopathic pulmonary fibrosis and its clinical significance

Pulmonary surfactant protein A (SP-A) is known to be a major phospholipid-associated glycoprotein in pulmonary surfactant, which is specific to the lung. In this study, the SP-A concentrations in sera of patients with various lung diseases were determined using an enzyme-linked immunosorbent assay. Patients with idiopathic pulmonary fibrosis (IPF) and pulmonary alveolar proteinosis (PAP) exhibited prominently high concentrations of serum SP-A compared to those of other lung diseases and healthy volunteers, although there were significant increases in serum SP-A concentrations in patients with pulmonary tuberculosis, chronic pulmonary emphysema, diffuse panbronchiolitis and bacterial pneumonia compared to those of healthy volunteers. Successive measurement in 2 patients with IPF showed that serum SP-A levels reflect the disease activity of IPF. In patients with IPF, serum SP-A concentrations were significantly correlated with those of serum lactate dehydrogenase, whereas there were no significant correlations of serum SP-A concentrations with erythrocyte sedimentation rate, arterial oxygen saturation, vital capacity and carbon monoxide diffusing capacity. Determination of serum SP-A will contribute to diagnosing IPF and PAP, and may reflect the disease activity of IPF.

[Assessment of coronary stenosis severity using a Doppler guide wire in vivo: is the continuity equation applicable to moderate to severe coronary artery stenosis?]

The usefulness of a Doppler guide wire was evaluated in the estimation of coronary stenosis severity in patients with moderate to severe coronary stenosis using the continuity equation. The maximal coronary flow velocities (V) proximal to the stenosis (p), at the stenosis (s), and distal to the stenosis (d) were measured using a Doppler guide wire (12-MHz, 0.018-in) in 12 patients with mild coronary stenosis (less than 50% diameter stenosis: group A) and 12 patients with moderate to severe coronary stenosis (more than 50% diameter stenosis: group B). Percent diameter stenosis (%DS) was calculated from Vp/Vs by: %DS = (1 - square root of Vp/Vs) x 100 (%) (Vp = the maximal velocity proximal to the stenosis; Vs = the peak velocity at the stenotic site) Percent DS was calculated from Vd/Vs by: %DS = (1 - square root of Vd/Vs) x 100 (%) (Vd = the peak velocity distal to the stenosis) Regression of Doppler-derived %DS from Vp/Vs compared to quantitative coronary angiographic % DS were: Group A: y = 0.83x + 3.0 (r = 0.79), Group B: y = 0.63x + 9.4 (r = 0.81), Overall: y = 0.63x + 9.6 (r = 0.91) Regression of Doppler-derived %DS from Vd/Vs compared to quantitative coronary angiographic %DS were: Group A: y = 0.98x - 1.0 (r = 0.81), Group B: y = 0.67x + 14.6 (r = 0.84), Overall: y = 0.79x + 7.6 (r = 0.91) The continuity equation method using a Doppler guide wire underestimates coronary stenosis severity in patients with moderate to severe coronary stenosis, although Doppler-derived %DS is correlated with angiographic %DS.

[Pulsed Doppler findings of the pulmonary vein flow in mitral stenosis]

Left atrial function was assessed by transesophageal echocardiography in 8 patients with mitral stenosis and sinus rhythm (MS group), and 16 age-matched normal controls (C group). Pulsed Doppler findings of left upper pulmonary vein flow were classified into first and second forward waves during systole (S1, S2), forward wave during diastole (D), and backward flow during left atrial contraction (PVA). Peak velocity (P) and time-velocity integral (TVI) of each wave and acceleration and deceleration slope of S2 wave (S2-Ac, S2-Dc) were obtained. TVI-S2 and P-D in the MS group were significantly lower than those in the C group (TVI-S2: 4 +/- 2 vs 12 +/- 3 cm, P-D: 27 +/- 13 vs 41 +/- 12 cm/sec). S2-Ac and S2-Dc in the MS group were significantly higher than those in the C group (S2-Ac: 456 +/- 116 vs 323 +/- 118 cm/sec2, S2-Dc: 380 +/- 102 vs 165 +/- 48- cm/sec2). There were no differences in S1 and PVA. Lower TVI-S2 in the MS group suggests decreased reservoir function of the left atrium. Lower TVI-S2 in the MS group was caused by increased S2-Ac and S2-Dc which suggests increased left atrial preload and deterioration of left atrial compliance. Decreased P-D in the MS group reflects dysfunction of mitral valve opening.

Synthesis and pharmacological activities of novel bicyclic thiazoline derivatives as hepatoprotective agents. I. 8-Ethoxycarbonyl-5,6-dihydrothiazolo[2,3-c][1,4]thiazine derivatives

A series of bicyclic thiazoline derivatives (4a-s) was synthesized and evaluated for hepatoprotective activity against galactosamine-induced and monoclonal antibody-induced acute liver injuries in rats. The structure-activity relationships were investigated. Among the compounds synthesized, ethyl 3-(N-methylcarbamoyl)-5,6-dihydrothiazolo[2,3-c][1,4]thiazin e-8- carboxylate (4p) exhibited remarkable hepatoprotective activity and lower toxicity. This compound suppressed galactosamine-induced hepatic injury at 100 mg/kg by gavage and further prevented monoclonal antibody-induced hepatic injury at 30 mg/kg by intraperitoneal injection, as evaluated by measuring changes in serum transaminase activities.

Increased carcinoembryonic antigen concentrations in sera and bronchoalveolar lavage fluids of patients with pulmonary alveolar proteinosis

Pulmonary alveolar proteinosis (PAP) is a rare disease in which alveoli are filled with lipoproteinaceous materials. We measured carcinoembryonic antigen (CEA) concentrations in bronchoalveolar lavage (BAL) fluids and sera from patients with PAP and from healthy volunteers (HV). Significantly increased CEA values were found in BAL fluids and sera from patients with PAP compared with those from HV. BAL fluid CEA values significantly correlated to serum CEA values in patients with PAP. Serum CEA values significantly correlated to serum lactate dehydrogenase activity and alveolar-arterial PO2 difference values in patients with PAP. Successive measurements of serum CEA showed that serum CEA values reflect the disease activity of PAP. The determination of serum CEA is useful for evaluating disease severity of PAP.

Design of a new disposable ERG electrode

A new electrode for electroretinography (ERG) has been produced. The new device made of gold filament was applied as corneal and noncorneal electrod. Flash ERG and pattern ERG were recorded in normal subjects using this new electrode and compared with those made by available electrodes. There were so significant differences in amplitude and latency between the new electrode placed on the cornea and the JET-type electrode. For pattern ERG there were no significant differences between the new electrode placed in the lower fornix and a gold-foil-type electrode. As this new electrode is less expensive and more comfortable than the available electrodes, it is clinically useful.

Plasma concentrations of atrial natriuretic peptide in cardioembolic stroke with atrial fibrillation

The aim of the present study was to determine whether the level of plasma atrial natriuretic peptide (ANP), an indicator of atrial stretching, correlates with the formation of a thrombus in the left atrium during cardioembolic stroke with atrial fibrillation. Plasma concentrations of immunoreactive ANP and thrombin-antithrombin III complex (TAT) were measured in five age-matched groups including: 16 patients with acute cardioembolic stroke and atrial fibrillation (group 1), 26 patients with chronic cardioembolic stroke and atrial fibrillation (group 2), 27 patients with atrial fibrillation without previous stroke (group 3), 21 patients with acute lacunar stroke (group 4), and 27 healthy controls. The plasma ANP levels were higher in group 1, regardless of the stage, than those estimated at chronic stage in group 4 and in healthy controls. There were no stage-related differences between groups 1, 2 and 3. Plasma levels of ANP in group 2, a high risk group of cardioembolic stroke, were higher than in group 3, a low risk group. There was no correlation between plasma levels of ANP and mean blood pressure, pulse rate or plasma levels of TAT in any group. These results indicate that the determination of plasma ANP concentration is useful to distinguish a high risk patient from a low risk patient and also a cardioembolic stroke patient from a lacunar stroke patient. They also underscore the difficulties in recognizing left atrial thrombus formation by determining the plasma ANP concentration in cardioembolic stroke.

Increased production of transforming growth factor-beta 2 from cultured human retinal pigment epithelial cells by photocoagulation

PURPOSE

To examine whether laser photocoagulation increased production of growth factors and cytokines, especially transforming growth factor-beta 2 (TGF-beta 2), by cultured human retinal pigment epithelial (RPE) cells.

METHODS

Dot blot analysis was performed to identify the changes using the conditioned medium of cultured human RPE cells with or without laser photocoagulation. The following growth factors and cytokines were examined: TGF-beta 1, TGF-beta 2, platelet-derived growth factor-BB, epidermal growth factor, interleukin-1 beta, tumor necrosis factor-alpha, and basic fibroblast growth factor. Immunostaining of the photocoagulated RPE cells was also performed by using the antibodies. Growth inhibition assay using mink lung epithelial cells (CCL-64) was employed both to quantitate active and latent forms of TGF-beta 2 secreted in the conditioned media and to determine the type of TGF-beta by using a neutralizing antibody.

RESULTS

In dot blot analysis, among the growth factors and cytokines examined, production of TGF-beta 2 was changed most markedly by laser photocoagulation. This result agreed with the immunocytochemical staining pattern. Photocoagulated RPE-conditioned medium inhibited [3H]-thymidine incorporation of CCL-64. The inhibitory activity was blocked by a neutralizing antibody to TGF-beta 2. Production of active TGF-beta 2 was increased from 1.0 pg/cm2 +/- 0.6 pg/cm2 per 24 hours to 11.0 pg/cm2 +/- 1.0 pg/cm2 per 24 hours by laser photocoagulation, and that of total TGF-beta 2 was increased from 11 pg/cm2 +/- 1.0 pg/cm2 per 24 hours to 100 pg/cm2 +/- 20.1 pg/cm2 per 24 hours.

CONCLUSIONS

Laser photocoagulation of cultured RPE cells increases their production of TGF-beta 2. It thus seems possible that the TGF-beta 2 produced by the RPE cells plays an important role in the processes that occur after laser photocoagulation.

Posterior lenticonus, corneal opacity, glaucoma and preretinal membrane in a young woman

A case of posterior lenticonus with corneal opacity, glaucoma and preretinal membrane is presented. Gonioscopic findings and slit-lamp examination suggested that angle closure due to a large volume of the lens may have caused high intraocular pressure levels. Also, refractive error, exotropia and bilateral nystagmus were accompanied by posterior lenticonus in this case. Our case demonstrates a rare combination of abnormalities involving various ocular structures.

Plasma lipoprotein (a) levels and fibrinolytic activity in acute myocardial infarction

To evaluate the effects of lipoprotein (a) [Lp (a)] on the fibrinolytic system in patients with acute myocardial infarction (AMI) who underwent thrombolytic therapy with recombinant tissue-type plasminogen activator, we examined serial changes in plasma levels of Lp (a), plasminogen activator inhibitor (PAI) activity, alpha 2-plasmin inhibitor-plasmin complex (PIC) and thrombin antithrombin III complex (TAT) in venous plasma samples from 25 patients with AMI for 3 weeks. Plasma Lp (a) levels were significantly increased 5, 7, and 14 days after admission and tended to decrease by the 21st day. On the other hand, the ratio of PIC/TAT was significantly increased on the 7th day and remained high for 3 weeks (p < 0.01), while plasma PAI activity was significantly decreased on the 5th day after admission (p < 0.01). Thus, plasma fibrinolytic function is impaired in the early phase after AMI, and gradually improves over the course of 3 weeks. The increase in plasma Lp (a) levels is, therefore, not accompanied by a significant decrease in plasma fibrinolytic function in patients with AMI.