Twins under shift work: a case study of sleep log data

Two pairs of female twins (one pair monozygotic (MZ) and one pair dizygotic (DZ) attended an evening class at the same college and worked at the same factory under a rotating shift schedule. All the subjects agreed to keep sleep logs for 30 days. Values for rising time were quite similar within each pair especially during the morning-shift schedule, while during afternoon shift and holidays, rising time appeared more similar in the MZ pair, but their bedtime seemed rather different. Morningness-Eveningness score and the amplitude of the circadian sleep and wakefulness (based on an autocorrelation of the data) seemed more similar in the MZ pair. Morningness-Eveningness score is known to be closely correlated with the phase position of subjects endogenous biological rhythms, e.g., body core temperature. Characteristics of genetic control in phase and amplitude of circadian rhythm measured by the above-mentioned procedure might possibly be detectable even under the constraints of shift-work schedule.

Inhibition of Ca2+ channel current by mu- and kappa-opioid receptors coexpressed in Xenopus oocytes: desensitization dependence on Ca2+ channel alpha 1 subunits

1. Desensitization of mu- and kappa-opioid receptor-mediated inhibition of voltage-dependent Ca2+ channels was studied in a Xenopus oocyte translation system. 2. In the oocytes coexpressing kappa-opioid receptors with N- or Q-type Ca2+ channel alpha 1 and beta subunits, the kappa-agonist, U50488H, inhibited both neuronal Ca2+ channel current responses in a pertussis toxin-sensitive manner and the inhibition was reduced by prolonged agonist exposure. 3. More than 10 min was required to halve the inhibition of Q-type channels by the kappa-agonist. However, the half-life for the inhibition of N-type channels was only 6 +/- 1 min. In addition, in the oocytes coexpressing mu-opioid receptors with N-type or Q-type channels, the uncoupling rate of the mu-receptor-mediated inhibition of N-channels was also faster than that of Q-type channels. 4. In the oocytes coexpressing both mu- and kappa-receptors with N-type channels, stimulation of either receptor resulted in a cross-desensitization of the subsequent response to the other agonist. Treatment of oocytes with either H-8 (100 microM), staurosporine (400 nM), okadaic acid (200 nM), phorbol myristate acetate (5 nM) or forskolin (50 microM) plus phosphodiesterase inhibitor did not affect either the desensitization or the agonist-evoked inhibition of Ca2+ channels. 5. These results suggest that the rate of rapid desensitization is dependent on the alpha 1 subtype of the neuronal Ca2+ channel, and that a common phosphorylation-independent mechanism underlies the heterologous desensitization between opioid receptor subtypes.

A role for histamine receptors in rheumatoid arthritis

Although neurotransmitters and various chemical mediators play an important role in the pathogenesis of rheumatoid arthritis (RA), precise underlying mechanisms have yet to be determined. Histamine is a classical mediator of inflammation and three types of receptors are known. We investigated the presence and functions of histamine receptors of lymphocytes, bone marrow cells, synovial fibroblasts, and chondrocytes in experimentally-induced arthritis and human RA. The function of H2 receptors in peripheral blood lymphocytes and bone marrow cells were down regulated as measured by increments of intracellular cAMP and IL-6 production. Synovial fibroblasts from RA patients did not respond to H2 agonist to synthesize hyaluronic acid. It is evident that H2 receptors are down-regulated in lymphocytes, bone marrow cells, and synovial fibroblasts. The reduced function of H2 receptors in collagen-induced arthritis was normalized by transfer of the receptor-bearing lymphocytes and bone marrow cells. These data suggest that histamine is involved in the pathogenesis of RA.

Induction of cancer, actinic keratosis, and specific p53 mutations by UVB light in human skin maintained in severe combined immunodeficient mice

To study the mechanism and risk of human skin cancer from solar light, we exposed human skin transplanted to severe combined immunodeficient mice to daily doses of UVB for periods of approximately 2 years. We have succeeded for the first time in inducing cancer and solar (actinic) keratosis in human skin by UVB. Of 18 normal skins exposed to doses of 7.3 x 10(5) to 1.8 x 10(6) J/m2, 14 actinic keratoses (77.8%) and 3 squamous cell carcinomas (16.7%) developed, whereas neither actinic keratosis nor cancer was observed in 15 human skins not exposed to UVB. Each human skin showed a different susceptibility, and skins sensitive for actinic keratosis were also sensitive for cancer induction. Among p53 mutations at various sites, mutation at codon 242 (C TGC --> C CGC; Cys --> Arg) was specifically observed in both skin cancers and actinic keratoses. Furthermore, double or triple mutations were induced in all UVB-induced skin cancers and in three of eight actinic keratoses. Most of the mutations (17 of 20) occurred at dipyrimidine sites.

Clinical significance of asymptomatic sinus abnormalities on magnetic resonance imaging

OBJECTIVE

To investigate the prevalence of abnormalities of the paranasal sinus detected by magnetic resonance imaging (MRI) in asymptomatic subjects.

DESIGN

Prospective study.

SETTING

Outpatient clinic.

PATIENTS

A total of 325 patients who underwent MRI for suspected intracranial disease. Of those, 257 patients lacked nasal or sinus symptoms.

RESULTS

Sinus abnormalities were seen on MRI in 153 (47.1%) of 325 patients, including 107 (41.6%) of the 257 asymptomatic patients. Subjects older than 50 years had a significantly higher frequency of sinus abnormalities on MRI (49.8%) vs those younger than 50 years (39.5%) (P < .05). The maxillary sinus abnormality was observed in 99 patients (38.5%) and the ethmoid sinus abnormality was observed in 52 (20.2%) (P < .01). The most common abnormality was mucosal thickening in the maxillary and ethmoid sinuses.

CONCLUSION

A high prevalence of sinus abnormalities was detected in asymptomatic subjects on MRI.

Inhibition of thymocyte apoptosis by berberine

To find anti-apoptotic substances in plant resources, a microassay method for estimating DNA fragmentation was established using fluorochrome 3,5-diaminobenzoic acid dihydrochloride. Examination was made of various herbal medicines for inhibitory effects on glucocorticoid-induced apoptosis in thymocytes. Several Kampo medicines, e.g. Oren-gedoku-to and San'o-shashin-to, were found to inhibit dexamethasone-induced apoptosis in murine thymocytes. Some of these medicines contain Coptidis rhizoma (CR) as the major constituent, and the CR extract showed the most potent inhibitory activity on thymocyte apoptosis of more than 200 species of herbal extracts. The inhibition of apoptosis by CR extract was confirmed by the trypan blue exclusion test, lactate dehydrogenase release measurement, and morphological evaluation by electron microscopy. The benzodioxolo-benzoquinolizine alkaloid, berberine, and five berberine-type alkaloids, isolated from CR extract, had an inhibitory effect, whereas no effect was noted for the aporphin-type alkaloid magnoflorine. The inhibitory action of berberine was also demonstrated on etoposide- and camptothecin-induced apoptosis.

Reduced sialylation of glycoproteins in nasal glands of patients with chronic sinusitis

This study was conducted to investigate the sialylations of glycoproteins in the nasal glands of patients with chronic sinusitis. Sialic acids were detected using lectin histochemistry, and the mRNA of sialyltransferase was evaluated by in situ hybridization histochemistry. Sambucus nigra agglutinin (SNA), which recognizes terminal sialic acids, strongly stained the glandular mucous cells of normal subjects, but not those of patients with chronic sinusitis. In situ hybridization histochemistry showed that the expression of alpha2,6 sialyltransferase mRNA was decreased in the secretory cells of patients with chronic sinusitis. Our present results suggest that a reduction in sialyltransferase activity at the mRNA level in the nasal glands may lead to the persistence of chronic sinusitis.

Grapefruit component interacting with rat and human P450 CYP3A: possible involvement of non-flavonoid components in drug interaction

Active components in grapefruit juice, which modulate a cytochrome P450 (CYP3A) activity, were investigated. CYP3A-catalyzed 6beta-hydroxylation of testosterone in livers of rat and human was inhibited by the addition of an ethyl acetate-extract of grapefruit juice. Several components of grapefruit juice, including naringin, naringenin, limonin and obacunone, also showed inhibitory effects in human liver microsomes. However, the amounts of these components in grapefruit juice are too low to account for the inhibition by the ethyl acetate-extracts. Analyses with HPLC indicate the existence of inhibitory components in the extract, which are distinct from these known compounds and are specific to grapefruit juice. These results suggest that hydrophobic components other than flavonoids, probably coumarin derivatives, are responsible for the inhibitory effect of grapefruit juice.

Does corpus luteum locally affect follicular growth negatively?

In this study bilateral ovarian follicular growth during the luteal phase was investigated in relation to the ovary where ovulation occurred. The diameter of the largest follicle in the contralateral ovary without corpus luteum and in the ipsilateral ovary with corpus luteum was measured using vaginosonography in a total of 66 natural cycles of 27 normally cycling women undergoing treatment with intrauterine insemination (IUI). None of the women received ovarian stimulation or luteal support. Follicles from 2 to 11 mm in diameter were measured in early luteal phase (day +1 to +4), mid-luteal phase (day +5 to +9) and late luteal phase (day +10 onwards). The mean diameters of the largest follicle in the contralateral ovary without corpus luteum during the early, mid- and late luteal phases were 6.81 +/- 1.33 (mean +/- SD), 6.14 +/- 1.29 and 5.71 +/- 1.17 mm respectively, while those of the ipsilateral ovary with corpus luteum were 6.48 +/- 1.40, 5.65 +/- 1.47 and 4.98 +/- 1.19 mm respectively. While there was no significant difference during the early luteal phase, the mean diameter of the largest follicle in the ipsilateral ovary with corpus luteum was significantly smaller than that of the contralateral ovary without corpus luteum during the mid-luteal phase (P < 0.004) and the late luteal phase (P < 0.0005). These results indicate that the corpus luteum locally affects neighbouring follicular growth negatively during the luteal phase of the menstrual cycle, with the most pronounced effect expressed in the mid- and late luteal phases.

Urologic abnormalities in Menkes' kinky hair disease: report of three cases

Menkes' kinky hair disease is a rare congenital disorder of copper metabolism with X-linked recessive inheritance. It is well known that it is frequently associated with urologic abnormalities. The authors experienced three such cases, but each of them was different. Multiple bladder diverticula, right vesico-ureteral reflux, and right hydronephrosis were noted on the first baby boy. In the second case, hematomas in the left kidney, pelvis, ureter and the adipose capsule, which were thought to be the abnormality of vessels, were noted in the neonatal period. In the third body, multiple bladder diverticular were noted at the age of 1 year. One year, 10 months later, a spontaneous rupture at the huge diverticulum occurred.

Recombinant interferon-alpha-2a for treatment of chronic hepatitis C: results of a multicenter randomized controlled dose study

To compare the efficacy of low and relatively high dosages of recombinant interferon (IFN)-alpha-2a in Japanese patients with chronic hepatitis C, as well as to characterize the type of patients who will respond well to a low-dosage treatment, 88 patients with histologically proven chronic hepatitis C were randomly assigned to two treatment groups; one treated with IFN-alpha-2a 6 MU daily for 2 weeks followed by 6 MU three times weekly for 22 weeks (6-MU group), and another given the same initial treatment followed by 3 MU three times weekly for 22 weeks (3-MU group). The rate of sustained normalization of ALT 6 months after the cessation of treatment was 33% in the 3-MU group and 40% in the 6-MU group (p = 0.64). In addition, there was no difference in elimination of serum HCV-RNA 6 months after the cessation of treatment between the 3-MU group (26%) and 6-MU group (29%). Multivariate stepwise regression analysis revealed that serum HCV-RNA level (p = 0.0035) and platelet count (p = 0.0009) were independent variables useful in predicting a sustained response of ALT. The sustained response rate of ALT in patients with a serum HCV-RNA level less than 10(5) copies/ml and serum platelet level above 15 x 10(4)/microliter was 71%, whereas that in patients with a serum HCV-RNA level above 10(5) copies/ml and serum platelet level less than 15 x 10(4)/microliter was 12%. These results indicate that a high rate of sustained response to IFN therapy can be expected in chronic hepatitis C patients with a low serum level of HCV-RNA and a high level of platelets, even if treated with a low dose of IFN.

Increased expression of inducible and endothelial constitutive nitric oxide synthases in rat colon tumors induced by azoxymethane

Nitric oxide (NO) is an important bioregulatory mediator involved in a variety of biological processes under both physiological and pathological conditions. To assess whether NO production is altered in colon carcinogenesis, the expression levels and localization of two isoforms of NO synthase, inducible NO synthase (iNOS) and endothelial constitutive NO synthase (eNOS), were examined by immunoblot and immunohistochemical methods in normal colonic mucosa and colon carcinomas induced by azoxymethane in male F344 rats. All colon carcinoma tissues examined were found to have an increased expression of iNOS and eNOS proteins as compared to normal colonic mucosa. In particular, the pronounced staining of iNOS protein localized to the luminal surface of carcinoma epithelial cells was not detectable in normal colon epithelium. The neovasculature in tumor tissues also demonstrated intense eNOS immunoreactivity in endothelial cells. These findings indicate that NO production is markedly elevated in azoxymethane-induced rat colon carcinomas, suggesting that regulatory pathways involving this mediator have some biological relevance to colon carcinogenesis in this model.

Demonstration of antibodies against human papillomavirus type-11 E6 and L2 proteins in patients with recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis (RRP) is highly prevalent in Thailand, with the human papillomavirus (HPV) type-11 being the most widespread. In this study, we isolated the HPV type-11 (HPV-11) genome from subjects with RRP and subcloned the E6 and L2 open reading frames (ORFs) with the expression vectors pEX1 and pEX3. The recombinant E6/beta-gal and L2/beta-gal fusion proteins were expressed in E. coli. Using the recombinant proteins, we demonstrated the presence of antibodies against HPV-11 E6 and L2 in RRP patients by Western blot analysis. The prevalence of seropositivity for HPV-11 E6 and L2 were 5% (1/20) and 10% (2/20), respectively. Although RRP is caused by infection on the mucosal surface, it appears that an immune response occurs against viral proteins expressed in the epithelial lesions.

Cultured retinal pericytes stimulate in vitro angiogenesis of endothelial cells through secretion of a fibroblast growth factor-like molecule

Interaction between cultured endothelial cells (EC) and pericytes (PC) was studied in vitro to clarify the mechanism of diabetic proliferative retinopathy. Conditioned medium (CM) from retinal PC strongly increased the proliferation and moderately stimulated migration of retinal EC. Moreover, CM from PC caused stimulation of angiogenesis of retinal EC and umbilical cord vein EC in vitro at the same extent as basic fibroblast growth factor (bFGF). PC also stimulated angiogenesis by EC in mixed cultures. The angiogenic, proliferative and migration activities in CM from PC were inhibited by an antibody to bFGF. These data suggest that PC play an important role in angiogenesis through secretion of an FGF-like molecule.

[Low preoperative PaO2 in patients with ovarian and endometrial cancer]

We investigated preoperative PaO2 and changes of PaO2/FIO2 (P/F) during the operation in 40 patients with gynecologic malignancies (ovarian cancer (O group) = 14 cases, endometrial cancer (E group) = 14 cases, cervical cancer (C group) = 12 cases). Preoperative chest X-ray and respiratory function test of our patients were within normal ranges (% VC > or = 80, % FEV 1.0 > or = 70). There were no differences among 3 groups in age, height, weight, % VC, or % FEV 1.0. Preoperative PaO2 values in the O group and E group were significantly lower than the normal value (100--age/4). Preoperative PaO2 and P/F values in the O group were significantly lower in comparison with those in the C group. We suggest, therefore, that it is necessary to measure preoperative PaO2 in patients with ovarian and endometrial cancer.

[Reconstructive surgery for head and neck cancers under multiple facility cooperation system]

The problems with the system for reconstructive surgery for head and neck cancers in our department where plastic surgeons are regularly invited from distant facilities were discussed. Especially, the importance of preoperative discussion between the plastic surgeons and ENT doctors was stressed. The computer system with Internet will play an important role in exchanging information such as CT scans and MRI scans between the plastic surgeons and ENT doctors. Moreover, the establishment of a system to prevent postoperative troubles such as closure of anastomosed vessels was stressed. Twenty-seven re-vascularized free flaps had been transferred with a 96.3% success rate (26 of 27 cases). We concluded that the system for reconstructive surgery under the multiple facility cooperation system worked well.

Evaluation of left atrial appendage function by measurement of changes in flow velocity patterns after electrical cardioversion in patients with isolated atrial fibrillation

We investigated temporary changes in left atrial appendage (LAA) flow velocity patterns in patients undergoing electrical cardioversion for chronic isolated atrial fibrillation, and evaluated the role of active LAA contraction in directing blood flow to the left atrial main chamber and left ventricle. The study consisted of 26 patients with chronic isolated atrial fibrillation treated with electrical cardioversion and 20 normal controls in sinus rhythm. Using transthoracic and transesophageal Doppler echocardiography, we recorded transmitral, pulmonary venous, and LAA flow velocity patterns before, 24 hours, and 1 week after cardioversion in all subjects. In the 15 patients who underwent successful cardioversion, the maximal LAA area 24 hours after cardioversion was smaller than the area before cardioversion, whereas LAA ejection fraction during atrial systole and peak atrial systolic emptying velocity of the LAA flow were lower 24 hours after cardioversion than those in the control group. One week after cardioversion, maximal LAA area and LAA peak atrial systolic emptying velocity were restored to levels approximately equivalent to those in the control group, although LAA ejection fraction was lower than in the control group. Maximal LAA area and LAA peak atrial systolic emptying velocity correlated negatively and positively with LAA ejection fraction, respectively, 24 hours and 1 week after cardioversion. These results suggest that LAA and the left atrial main chamber show stunning 24 hours after cardioversion, and the atrial systolic emptying wave of LAA flow is generated by active LAA contraction.

Hyaluronic acid inhibits interleukin-1-induced superoxide anion in bovine chondrocytes

OBJECTIVE

To examine the effect of hyaluronic acid (HA) on the induction of superoxide anion by IL-1 in chondrocytes.

MATERIALS AND METHODS

Bovine articular chondrocytes were treated with different concentrations of IL-1. A chemiluminescent probe (L-012) was added to the medium and chemiluminescence detection was used to measure super oxide anion.

RESULTS

IL-1 caused induction of superoxide anions in a dose-dependent manner. HA (10-100 micrograms/ml) countered superoxide induction caused by 20 ng/ml of IL-1.

CONCLUSIONS

HA can afford protection against cartilage degradation, probably acting as a free-radical scavenger.

Modulation of apolipoprotein gene expression in fatty liver of obese rats: enhanced APOA-IV, but no APOB expression by a high sucrose diet

OBJECTIVE

Hepatic lipoprotein production is important to the understanding of mechanisms involved in the development of fatty liver and hyperlipidemia. Previously, we have reported that hepatic fatty acid synthesis and apolipoproteinB transcription are increased in obese rats. Here, we describe the effects of a high sucrose diet on hepatic fatty acid synthesis and apolipoprotein gene expression in obese rats.

DESIGN

Obese rats with ventromedial hypothalamic lesions were fed on a high sucrose diet (30.3% of cal) or lab chow for 11 weeks.

RESULTS

Serum triglycerides and plasma immuno-reactive insulin concentrations were further increased in the obese rats fed a high sucrose diet. The experimental diet increased the activity of hepatic acetyl-CoA carboxylase, the rate limiting enzyme for hepatic fatty acid synthesis, and triglycerides content, concurrent with an increase abundance of apolipoproteinA-IC mRNA in the obese rats. Despite further accumulation of hepatic triglycerides there was no further increase in hepatic apolipoproteinB mRNA abundance in the obese rats fed the high sucrose diet.

CONCLUSION

These data suggest that the synthesis of hepatic fatty acids but not of apolipoproteinB is further increased in obese rats fed the high sucrose diet, and that apolipoproteinA-IV gene expression may be modulated in response to alterations in hepatic triglycerides flux.

Cross sectional echocardiographic demonstration of the mechanisms of abnormal interventricular septal motion in congenital total absence of the left pericardium

OBJECTIVE

To investigate the influence of the absence of the pericardium on the left ventricular wall, particularly on interventricular septal motion, using M mode and cross sectional short axis echocardiography in patients with congenital total absence of the left pericardium.

METHODS

21 patients with, congenital total absence of the left pericardium were divided into three groups according to the interventricular septal motion; systolic type (n = 6) with paradoxical motion during systole, diastolic type (n = 11) with abnormal posterior motion during mid to late diastole, and mixed type (n = 4) with paradoxical motion during systole and abnormal posterior motion during diastole.

RESULTS

On cross sectional short axis echocardiograms of the left ventricle, in the diastolic type the degree of angular displacement of the papillary muscles during end diastole to end systole showed excessive anticlockwise rotation about the long axis of the left ventricle without marked anteroposterior displacement. In the systolic type, there was shift of the left ventricle towards the anteromedial portion in systole and towards the posterolateral portion in diastole without significant rotation. There was a significantly positive correlation between the degree of angular displacement and the amplitude of diastolic interventricular septal motion during mid to late diastole in all patients.

CONCLUSIONS

There was abnormal interventricular septal motion during systole and diastole in patients with total absence of the left pericardium. Abnormal systolic motion was induced by anteroposterior displacement of the left ventricle, and abnormal diastolic motion by left ventricular rotation about the long axis of the heart during the cardiac cycle. Analysis using cross sectional echocardiography was useful for elucidating the mechanisms of abnormal interventricular septal motion.

The 'sail sound' and tricuspid regurgitation in Ebstein's anomaly: the value of echocardiography in evaluating their mechanisms

We describe a patient with Ebstein's anomaly in whom Doppler echocardiography was used to clarify the mechanism responsible for 'sail sound' and tricuspid regurgitation associated with this condition. Phonocardiography revealed an additional early systolic heart sound, consisting of a first low-amplitude component (T1) and a second high-amplitude component (T2, 'sail sound'). In simultaneous recordings of the tricuspid valve motion using M mode echocardiography and phonocardiography, the closing of the tricuspid valve occurred with T1 which originated at the tip of the tricuspid leaflets, while T2 originated from the body of the tricuspid leaflets. Using color Doppler imaging, the tricuspid regurgitant signal was detected during pansystole, indicating a blue signal during the phase corresponding to T1 and a mosaic signal during the phase corresponding to T2 at end-systole. Thus, 'sail sound' in patients with Ebstein's anomaly is not simply a closing sound of the tricuspid valve, but a complex closing sound which includes a sudden stopping sound after the anterior and/or other tricuspid leaflets balloon out at systole.

[Evaluation of changes in destructive spondylarthropathy (DSA) in long-term dialysis patients]

This study was undertaken to evaluate destructive spondylarthropathy (DSA) in patients long-term dialysis. The patients were investigated by plain X-ray examinations twice with a three-year interval, and the changes in severity of the illness in 66 patients undergoing dialysis for over 5 years were defined. Group A (9 patients) consisted of patients with progression in grades during the three years, while group B (57 patients) consisted of patients without deterioration. There was no differences in the two groups in age, duration and the modality of dialysis. However, in group A, the level of plasma beta 2-microglobulin (beta 2M) was 33.5 +/- 14.6 micrograms/ml at the first observation, and 33.1 +/- 15.1 micrograms/ml at the second (NS). In group B, the level of plasma beta 2M was 45.6 +/- 8.13 micrograms/ml at the first observation, and 39.7 +/- 9.18 micrograms/ml at the second (p <0.05). No improvement in DSA was observed. The result of this study suggests that DSA will not improve once it has become overt, and the management for lowering the level of beta 2M may prevent the occurrence and progression of DSA.