[High-resolution CT of epidermoid carcinoma in peripheral lung fields: radiologic-pathologic correlation]

We correlated high-resolution CT (HR-CT) images of 30 surgically resected epidermoid carcinomas in peripheral lung fields with pathologic findings. We classified peripheral epidermoid carcinomas into three types based on HR-CT findings. All tumors showed a notch along their margin. Type 1 shows scanty speculations without the convergence of surrounding lung structures. Type 2, which has two subtypes, shows a spiculated border with the convergence of peripheral lung structures. Type 2a has fine irregularities in its border, while type 2b has few fine irregularities. The convergence of peripheral lung structures seen in type 2 carcinoma is caused by the presence of scar tissue within tumors. Speculations corresponded to tumor extension or lymphocytic infiltration, sometimes along pulmonary vessels or interlobular septa, and fine irregularities seen in type 2a corresponded to summation of fibrous thickening of alveolar septa. Nine tumors showed varying-sized cavities, which were caused by the circulatory disturbance and/or central necrosis seen in tumor nests. In conclusion, HR-CT images were well correlated with pathologic findings of the resected specimens; however, some type 2a tumors may mimic adenocarcinoma on HR-CT findings.

SMAP, an Smg GDS-associating protein having arm repeats and phosphorylated by Src tyrosine kinase

Smg GDS is a regulator having two activities on a group of small G proteins including the Rho and Rap1 family members and Ki-Ras; one is to stimulate their GDP/GTP exchange reactions, and the other is to inhibit their interactions with membranes. Structurally, it has 11 Arm repeats, a protein interaction motif, found in the Drosophila Armadillo protein, a homolog of mammalian beta-catenin. We have isolated here an Smg GDS-interacting protein from a human brain cDNA library by use of the yeast two-hybrid method and named it SMAP (Smg GDS-associated protein). SMAP was a protein with a Mr of 91,189 and 792 amino acids. SMAP had 9 Arm repeats. Recombinant SMAP interacted with recombinant Smg GDS but did not affect the two activities of Smg GDS on RhoA. SMAP was tyrosine phosphorylated by v-Src, and this phosphorylation reduced the affinity of SMAP for Smg GDS. Tissue and subcellular distribution analyses indicated that SMAP was ubiquitously expressed and highly concentrated at the endoplasmic reticulum area. Searches for sequence homology to SMAP revealed that SMAP was significantly homologous to sea urchin SpKAP115, suggesting that SMAP is a mammalian counterpart of SpKAP115 or its related protein. SpKAP115 is an accessory subunit of sea urchin kinesin II, an ATPase motor that transports vesicles along microtubules. These results suggest that SMAP serves as an adaptor for both Smg GDS and kinesin II or its related protein and links them with both the Smg GDS-regulated small G protein and Src tyrosine kinase signalings.

Localization of Alzheimer-associated presenilin 1 in transfected COS-7 cells

Presenilin 1 (PS 1) is the recently identified gene, located on chromosome 14, of which missense mutations can cause early-onset familial Alzheimer's disease. To understand the normal biological function of presenilin 1, we examined the sub-cellular localization by using a monoclonal anti-presenilin 1 antibody. Immuno-electronmicroscopic and biochemical analysis indicated that presenilin 1 is localized on cellular membrane (plasma, endoplasmic reticulum, and perinuclear) in COS-7 cells overexpressing presenilin 1. Interestingly, the PS 1 immunoreactivity in the plasma membrane was concentrated in the regions with cell-cell contact. This observation suggests a possible role of PS 1 on the cell membrane as a cell adhesion molecule.

Evaluation with MIB1 antibody of proliferative activity in ovarian clear cell adenocarcinoma

The purpose of this study was to determine whether proliferative activity is a prognostic factor in ovarian clear cell adenocarcinoma. The paraffin-embedded sections from eight cases of ovarian clear cell adenocarcinoma were immunostained with monoclonal antibody MIB1 using microwave oven heating for antigen retrieval. The difference in survival (Kaplan-Meier) between patients with high and low MIB1 expression was estimated with the generalized Wilcoxon test. MIB1 positivity ranged from 1.80 to 27.12% with a mean of 11.43%. A cutoff point of 10% dichotomized patients into two groups. The survival of high (> or = 10%) expressing tumors was worse than that of low (< 10%) expressing tumors (p < 0.05). MIB1 immunostaining may have useful prognostic value in ovarian clear cell adenocarcinoma.

Uterine cervical clear-cell adenocarcinoma with a choriocarcinomatous component: a case report

A 55-year-old woman presented with vaginal bleeding. A tumor was found in the cervix; it was composed of 2 distinctive elements: a clear-cell adenocarcinoma and a choriocarcinoma. Histologic findings suggested that the choriocarcinomatous element was derived from a preexisting clear-cell adenocarcinoma through a metaplastic process.

[Social network and social support for married women and their spouses]

This study investigated various psychological aspects of social networks of married women and their spouses A survey data for 259 women and 185 men were analyzed, and main findings were as follows: 1. With marriage, support agents of women and men change extensively in their social networks. Wives have more variety in support agents within their social network, through children to their friends' parents. On the other hand, husbands' agents are likely to be confined to their wives and children. 2. Wives and husbands are similar in that their first choice for seeking advice is their spouse. A friend is the second choice for both of them. While parents, brothers and sisters serve as wives' third choice, there is no third for husbands. 3. Enrichment of wives' social network, based on a well-functioning relationship with husbands, leads to a lower degree of social isolation experienced by them.

Rat primary T cells expressing HTLV-I tax gene transduced by a retroviral vector: in vitro and in vivo characterization

We prepared a recombinant retroviral vector expressing the human T-lymphotropic virus type-I tax gene. Infection of WKA/H rat splenocytes yielded T-cell lines which proliferated continuously in media supplemented with exogenous interleukin-2 (IL-2) after the control cells ceased to grow. The phenotype of these cells closely resembled that of typical adult T-cell leukemia cells and tax-immortalized human T cells; i.e., positive for CD3, CD4 and IL-2 receptor alpha-chain. Chromosomal analysis revealed that about 10% of the tax-transduced T cells had several chromosomal abnormalities. We also performed in vivo characterization of tax-transduced splenocytes by injecting them into newborn syngeneic rats soon after in vitro infection. Maintenance of the injected tax-transduced cell population and in vivo expression of the tax gene was confirmed in the splenocytes of the injected rats by polymerase chain reaction. However, development of obvious disease was not observed in these rats for up to 18 months after inoculation. These results indicate that tax is capable of immortalizing rat mature CD4+ T cells in vitro but may be insufficient for full transformation of these cells in vivo. Our in vivo system using retrovirally tax-transduced rat T cells could facilitate investigation of the additional genetic events that cooperatively transform T cells transduced with tax gene.

Lymphedema due to chronic penile strangulation: a case report

A 62-year-old man was admitted with swelling of the penis caused by long term use of a penis enlarging ring. For the previous 20 years, he had noticed small pruritic nodules on his penis. He had no micturitional or ejaculatory impairment. The penis had a diameter of 6 cm, a length of 10 cm, and was covered with thickened skin. The penis and the scrotal skin were covered with scattered, small, hemispheric nodules and papules ranging in size from 2 mm to 1 cm. Pathologic examination of the biopsied specimen from a nodule revealed enlargement of the lymphatic vessels of the dermis and fibrosis. This was compatible with lymphedema due to chronic strangulation by the ring. Scar resection and full thickness skin grafting was performed to prevent malignant changes in the lesions.

[Effect of vitamin D receptor gene polymorphism on vitamin D therapy for postmenopausal bone loss]

In order to assess the effect of vitamin D receptor (VDR) gene polymorphisms on vitamin D3 therapy for postmenopausal bone loss. Thirty-four Japanese postmenopausal women, administered vitamin D3 (Alfarol 1.0 microgram/day) and Ca (2.0 g/day) for 18 months, were analyzed by RFLP. Bone mineral density (BMD) at the lumbar spine (L2-4) and Os-calcis were measured every 6 months by dual energy X-ray absorptiometry (DXA) and single energy X-ray absorptiometry (SXA). VDR gene allelic polymorphisms were assessed by Bsm 1 endonuclease restriction after specific PCR amplification. Genotypic polymorphism was defined as BB, bb and Bb. The genotypes were BB in 1 (3.1%), Bb in 13 (40.6%), and bb in 18 (56.3%). The women in these two major VDR genotype groups (Bb and bb) were similar in their backgrounds (in terms of age, body mass index, and BMD in premedication), but the VDR genotype was associated with the percent of change in BMD after treatment. In Group-Bb, the mean percent increases in L2-4 BMD were 3.2%, 4.9% and 4.1% at 6, 12 and 18 months. In contrast, in Group-bb they were 0.8%, 1.8% and 1.2% at the same points. Analysis of VDR alleles may prove useful in selecting the vitamin D therapy for osteopenia before treatment.

Lysophospholipase L2 of Vibrio cholerae O1 affects cholera toxin production

The implication in cholera toxin (CT) production of the newly identified gene, lypA, that encodes the lysophospholipase L2 of Vibrio cholerae, was investigated. Introduction of lypA into the V. cholerae O1 mutant (NF404), which has a Tn5-insertion in lypA and has lost CT as well as haemolysin production, restored the lysophospholipase activity and CT production but not the haemolytic activity. Inactivation of the lypA gene of the wild-type strain by chromosomal integration of a plasmid containing a portion of the lypA gene decreased the lysophospholipase L2 activity and the production of CT but not the haemolytic activity. Furthermore, constructed mutants of E1 Tor-biotype and Classical-biotype strains which have a defective lypA failed to produce CT and exhibited decreased enterotoxicity in the ligated rabbit ileal loop test. These results suggest that lypA is possibly required for the expression of CT and may play a role in pathogenicity of V. cholerae.

Ketamine inhibits nitric oxide production in mouse-activated macrophage-like cells

We have investigated the effects of ketamine on nitric oxide produced by activated macrophages using a murine macrophage-like cell line, J774. Cells were incubated for 18 h under stimulation with lipopolysaccharide and interferon-gamma or lipoteichoic acid and interferon-gamma, with various concentrations of ketamine (6-600 mumol litre-1). Nitric oxide production was assessed by measuring nitrite, a stable by-product of nitric oxide breakdown, in the medium. Other N-methyl-D-aspartate receptor antagonists, MK-801 (150 mumol litre-1) and dextromethorphan (150 mumol litre-1) were also tested. In addition, we studied the effects of ketamine on production of tumour necrosis factor-alpha by activated macrophages. Ketamine inhibited nitrite production dose-dependently with both lipopolysaccharide- and lipoteichoic acid-activated macrophages by up to approximately 65% at the highest ketamine concentration (600 mumol litre-1). Neither MK-801 nor dextromethorphan had an inhibitory effect. Ketamine also suppressed production of tumour necrosis factor-alpha. The data show that ketamine inhibited nitric oxide production by activated macrophages probably, in part, via inhibition of production of tumour necrosis factor-alpha, an autocrine stimulatory factor for nitric oxide production, but not via the NMDA receptor pathway, which is involved in neuronal nitric oxide production.

Characterization of human presenilin 1 using N-terminal specific monoclonal antibodies: Evidence that Alzheimer mutations affect proteolytic processing

The majority of cases of early-onset familial Alzheimer disease are caused by mutations in the recently identified presenilin 1 (PS1) gene, located on chromosome 14. PS1, a 467 amino acid protein, is predicted to be an integral membrane protein containing seven putative transmembrane domains and a large hydrophilic loop between the sixth and seventh membrane-spanning domain. We produced 7 monoclonal antibodies that react with 3 non-overlapping epitopes on the N-terminal hydrophilic tail of PS1. The monoclonal antibodies can detect the full-size PS1 at Mr 47000 and a more abundant Mr 28000 product in membrane extracts from human brain and human cell lines. PC12 cells transiently transfected with PS1 constructs containing two different Alzheimer mutations fail to generate the 28 kDa degradation product in contrast to PC12 cells transfected with wild-type PS1. Our results indicate that missense mutations in this form of familial Alzheimer disease may act via a mechanism of impaired proteolytic processing of PS1.

Spontaneous immortalization of cultured skin fibroblasts obtained from a high-dose atomic bomb survivor

Two immortal fibroblastic cell strains (substrains) were established by culturing healthy skin cells obtained from a high-dose atomic bomb survivor (female, age 76 years, 5.14 Gy) for more than 4 years. Designated FM-U and FM-M, the two substrains share the same marker chromosome, t(5q-;6p+), but are karyotypically different, possessing hypodiploid chromosome numbers (39-43) in the former and hypertriploid (69-76) in the latter. Thus far, the two strains have passed through 117 and 156 subcultures or more than 230 and 310 cumulative population doublings, respectively, each passage requiring 4-6 days in the former and 3-4 days in the latter. In the process of immortalization, sequential rearrangement among various chromosomes presumably due to telomeric and interstitial telomeric fusions took place following the telomere shortening, particularly in the senescence and postsenescence phase cells. Of particular interest is the fact that loss of heterozygosity (LOH) of the p53 gene was demonstrated in these immortalized cell populations. In addition, the allelic patterns of the LOH of p53 differed. Further evidence indicative of infinite proliferation was demonstrated in both strains, such as the telomere elongation and the significantly low frequency of cells possessing dicentric chromosomes.

Comparative study of regional cerebral blood flow values measured by Xe CT and Xe SPECT

The regional cerebral blood flow (rBCF) values measured by stable xenon-enhanced computed tomography (Xe XT) and by radioactive xenon-133 single photon emission computed tomography (Xe SPECT) were compared in 16 patients with cerebral infarct. On the non-lesion side Xe SPECT recorded 10.7% higher rCBF values than Xe CT in the anterior cerebral artery territory, while Xe CT recorded 9.6% higher values than Xe SPECT in the middle cerebral artery territory. These differences were not statistically significant. Although the rCBF values were almost the same, no correlation was found between the two methods in the posterior cerebral artery territory and the basal ganglia. Only hemispheric CBF on the non-lesion side showed the same value and a good correlation between the Xe CT and the Xe SPECT. There was a good correlation in the hemispheric CBF values on the lesion side, too. The difference of rCBF between the non-lesion side and the lesion side was expressed smaller in the Xe SPECT than in the Xe CT. This is in agreement with the previous reports that Xe SPECT overestimates the flow in the low flow areas. The higher rCBF values in the anterior cerebral artery territory measured by the Xe SPECT was ascribed to the artifact from the radioactivities in the inhalation mask and the air passages as reported previously. In conclusion, there is no good correlation between the rCBF values measured by the Xe CT and by the Xe SPECT. Only hemispheric CBF shows a good correlation between the two methods.

Morphologic and histologic characterization of cardiac myxomas by magnetic resonance imaging

The purpose of this study was to assess the role of ECG-gated spin-echo (SE) magnetic resonance (MR) images, cine MR images, and gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced MR images for the morphologic and histologic diagnosis of atrial myxomas. Four patients with left atrial myxoma were imaged with a 1.5-T MR imager. The T1-weighted images and the cine MR images were obtained before injection of Gd-DTPA. After the injection of Gd-DTPA, the T1-weighted images were obtained again. Gd-DTPA-enhanced images of the myxomas were histologically compared with the extracted specimens. The tumors were represented more clearly on the cine MR images as low-intensity areas than on the SE images as high-intensity areas. On post-Gd-DTPA images, the 2 tumors were homogeneously enhanced and the other 2 were inhomogeneously enhanced. The locus of enhancement on post-Gd-DTPA images fitted with histologic myxoma or inflammation, and the unenhanced region reflected the necrosis or cystic changes in the specimens, respectively. The morphologic diagnosis of cardiac myxomas by MRI first should be done with SE images, and when the images are unclear, the cine MR images must be supplemented to depict the tumor clearly. Moreover, Gd-DTPA-enhanced MRI could elucidate histologic characteristics in myxomas.

[Effect of thrombolysis on rupture of the left ventricular free wall following acute myocardial infarction]

Rupture of the left ventricular free wall is one of the most serious sequels of acute myocardial infarction (AMI) and results in hospital death. The effectiveness of thrombolytic therapy for AMI to prevent rupture of the left ventricular free wall was studied retrospectively in 31 patients (2.6%) among 1,210 consecutive patients admitted to our hospital within 48 hours after the onset of AMI. All patients were divided into three groups: 758 without reperfusion therapy (conventional group), 113 who underwent direct percutaneous transluminal coronary angioplasty (direct PTCA group), and 339 who received thrombolytic therapy with or without PTCA (thrombolysis group). No rupture was found in the direct PTCA group. No significant difference could be found in the incidence of the rupture between the conventional group (19 patients, 2.5%) and the thrombolysis group (12 patients, 3.5%). When early rupture and late rupture are defined as occurring less and more than 48 hours from the onset of AMI, 14 early ruptures (1.8%) and 5 late ruptures (0.7%) were found in the conventional group, and 9 early ones (2.7%) and 3 late ones (0.9%) in the thrombolysis group. There was no significant statistical difference between the two groups. The incidence of the rupture according to the result of the reperfusion therapy was much higher in the unsuccessful group (five patients, 7.8%; p < 0.02) than in the successful group (seven patients, 2.5%; p < 0.002). All ruptures in the successful group appeared early; but only two early rupture cases (3.1%) out of five were found in the unsuccessful group. The mean interval between the thrombolysis and the rupture was 3.9 +/- 1.2 hours in the successful group, which was much shorter than that of the unsuccessful group (67.1 +/- 28.5 hours; p < 0.05). We conclude that thrombolytic therapy, if successful, may be effective to decrease late rupture of the left ventricular free wall, but may be ineffective to prevent early rupture.

Cytokines in bronchoalveolar lavage fluid in patients with high altitude pulmonary oedema at moderate altitude in Japan

BACKGROUND

The precise mechanism of high altitude pulmonary oedema (HAPE) remains unclear. The purpose of this study was to evaluate the role of cytokines and P-selectin in the development of HAPE which occurred at moderate altitude in Japan.

METHODS

The following cellular and biochemical markers and chemotactic cytokines were measured in the bronchoalveolar (BAL) fluid from four patients with HAPE at 2857-3180 m in the Japanese Alps: total proteins, albumin, lactate dehydrogenase (LDH), and interleukin (IL)-1 alpha, IL-1 beta, IL-1 receptor antagonist (ra), IL-6, IL-8, IL-10, tumour necrosis factor (TNF)-alpha, and the soluble form of P-selectin.

RESULTS

At admission there were significant increases in the levels of total cells, especially macrophages and neutrophils, total protein, albumin and LDH when compared with 13 healthy individuals. Furthermore, the levels of IL-1 beta, IL-6, IL-8, and TNF-alpha were also considerably increased but returned quickly to the normal ranges or were not detected after recovery. The levels of IL-1 alpha, IL-10, and P-selectin did not change.

CONCLUSIONS

These results suggest that an inflammatory process almost identical with acute respiratory distress syndrome (ARDS) may occur in HAPE, but that these changes are transient and are not associated with any increase in P-selectin levels in the BAL fluid.

Effects of angiotensin-converting enzyme inhibitor alacepril in patients with stable effort angina during chronic isosorbide dinitrate treatment

Nitrate tolerance has been reported to be reversed by certain types of angiotensin-converting enzyme (ACE) inhibitors. We examined whether alacepril, a new long-acting oral ACE inhibitor, has beneficial effects against exercise-induced angina in patients with stable effort angina after substantial isosorbide dinitrate (ISDN) treatment. Thirteen men with stable effort angina were treated with oral ISDN (80 mg/d) for >3 weeks. After this period, efficacy of single oral administration of either alacepril (50 mg) or its placebo on exercise-induced angina and electrocardiographic changes was examined by treadmill exercise test in a double-blind crossover design. Alacepril significantly improved the exercise duration by 9.1% (p=0.03), the time to 1 mm ST-segment depression by 19% (p<0.01), and the maximal ST-segment depression by 33% (p=0.015) compared with placebo. Alacepril did not significantly alter the rate-pressure product, a marker of myocardial oxygen demand, during exercise test compared with placebo. Plasma renin activity was significantly increased (p<0.05) after administration of alacepril, indicating that alacepril significantly blocked ACE activity in our patients. In conclusion, a single oral administration of the ACE inhibitor alacepril (50mg) elicited beneficial effects against exercise-induced myocardial ischemia in patients with stable effort angina during chronic nitrate treatment. These effects may be mediated by increased coronary blood flow.

Threshold for spontaneous pattern formation in reflection-grating-dominated photorefractive media with mirror feedback

A theoretical analysis is presented of spontaneous pattern formation in a system consisting of a photorefractive medium and a feedback mirror. A threshold condition for the pattern formation is derived from a new set of coupling equations with the assumption that reflection gratings are dominant. It is shown that the pattern formation can occur with only energy coupling. The direction of the sideband beams is calculated as a function of the mirror position, and the result is compared with that of an experiment with a KNbO(3) crystal.