Shortened telomere length in hepatocellular carcinomas and corresponding background liver tissues of patients infected with hepatitis virus

The telomere length in 20 surgically resected human hepatocellular carcinomas (HCCs) and adjacent non-cancerous livers with hepatitis virus infection were investigated. All the HCC samples examined demonstrated shorter telomere length than the corresponding non-cancerous liver tissues, the respective average values being 5.4 kbp and 8.8 kbp (P < 0.001). The shortening of telomere length was most prominent in HCCs larger than 30 mm in diameter, and in both tumors and non-cancerous livers it was more marked with hepatitis B virus as compared with hepatitis C virus infection. These results indicate that telomere shortening is associated with not only progression, but also development of HCC, and there is a possible difference in the nature of the association in patients with hepatitis viruses of B and C types.

Hypoplasia of cushion ridges in the proximal outflow tract elicits formation of a right ventricle-to-aortic route in retinoic acid-induced complete transposition of the great arteries in the mouse: scanning electron microscopic observations of corrosion cast models

BACKGROUND

The major morphologic change associated with retinoic acid (RA)-induced complete transposition of the great arteries (TGA), a congenital malformation of the heart, was investigated in a mouse model in which TGA was found in 80% of surviving fetuses.

METHODS

Corrosion casts of embryonic hearts with or without prior exposure to retinoic acid were observed under a scanning electron microscope.

RESULTS

In control hearts, indentations caused by expanded parietal and septal ridges in the outflow tract established right ventricle-to-left ventral pulmonic and left ventricle-to-right dorsal aortic routes before the aorticopulmonary septum completion. In RA-treated hearts, indentations of proximal regions of the parietal and septal ridges were small in the proximal outflow tract, whereas those in the distal regions developed well. These morphological features in the RA-treated hearts elicited right ventricle-to-right ventral aortic and left ventricle-to-left dorsal pulmonic routes in the TGA morphology.

CONCLUSIONS

Hypoplasticity of the proximal regions of parietal and septal ridges in the outflow tract is one of the primary morphological abnormalities of the RA-induced TGA.

Telomere changes in human hepatocellular carcinomas and hepatitis virus infected noncancerous livers

BACKGROUND

Telomeres, at the ends of eukaryotic chromosomes, are defined functionally as necessary for chromosome stability. Chromosome instability induced in part by loss of telomeric DNA has been considered to play a significant role in the development of human cancers. However, little is known about the status of telomeres per se during human hepatocellular carcinoma (HCC) development.

METHODS

The study was conducted to determine the length of terminal restriction fragments (TRFs) at the telomeric ends in 23 HCCs and 23 corresponding noncancerous liver tissues from the same patients harboring hepatitis virus infections, and in 5 samples of noncancerous livers without the hepatitis virus. The latter samples had been obtained as controls at surgery for metastatic liver tumors.

RESULTS

All 23 HCCs demonstrated reduction in TRF length compared with the corresponding noncancerous liver tissues with viral infection. The TRF in the latter cases also demonstrated a significant shortening as compared with the virus free control tissue, the degree being calculated to represent an average of 42 cell divisions. Reduction in TRF length in HCC samples tended to increase with the tumor diameter, although this failed to show statistical significance.

CONCLUSIONS

These results indicate that telomere shortening occurs during HCC development. The fact that this change is already evident in noncancerous liver tissues from patients with viral hepatitis suggests that it may play an important role in the associated generation of tumors.

A distinctive effect of CCCP on the transfer of erythromycin to 1-octanol: a possible model in promoting the intracellular antibiotic-accumulation through lipid in a staphylococcal cytoplasmic membrane

Movement of erythromycin (EM), a basic antibiotic solute (pKa 8.6), in an aqueous buffer (pH7.6) at 37 degrees C into 1-octanol was found approximately twofold greater in the presence of another acidic and lipophilic solute, carbonylcyanide m-chlorophenylhydrazone (CCCP), when compared with the EM-movement in the absence of CCCP. CCCP appears to behave just like a carrier of EM, besides being a well-known inhibitor, such as the uncoupling agent of oxidative phosphorylation. The probability is discussed that such an analogous event takes place in the lipid layers of a bacterial-cell membrane.

Different immunosuppressive effects of liposomal FK506 in liver and kidney transplantation

The efficacy of liposomal FK506 was compared between a canine liver transplantation model and a canine kidney transplantation model. The present study revealed that liposomal FK506 increased immunosuppressive efficacy of FK506 in liver transplantation but decreased in kidney transplantation. Because liposomal FK506 increased FK506 levels in the liver and spleen, and decreased FK506 levels in the kidney, it was suggested that enhanced immunosuppressive efficacy in liver transplantation should be attributed to the local immunosuppressive effects in the hepatic allograft rather than effective suppression of splenocyte activity.

[Prognosis of the surgical treatment for non-Hodgkin lymphoma originating from chronic tuberculous empyema--analysis of 11 cases with pleuropneumonectomy]

In total 19 cases of non-Hodgkin lymphoma originating from the wall of chronic tuberculous empyema, pleuropneumonectomeic were performed since 1979, with the aim of total cures for not only lymphoma but empyema in 11 cases. Of these cases extraresections (5 of thoracic cages, 4 of diaphragms, 2 of axillar lymph nodes, each of adventitia of descending aorta and esophagus, of the liver, of the left adrenal grand) were added to extirpate tumors completely. The mean operating time was 6 degrees 55', the mean blood loss during operations was 3090 ml, but in the 3 most recent cases it was less than under 1000 ml using electrocartesy-cutting technique under direct observation. Although preoperative radiations were done to 4 cases to decrease invasive area of tumors and postoperative radiation was done to 1 case, there were no adjuvant chemotherapies. The indicative limitation for resections from the point of ventilatory functions was the same as that of pleuropneumonectomy for ordinary chronic tuberculous empyema. There were 2 cases with serious postoperative complications. One suffered from ARDS and died on the 14th postoperative day, and another developed acute respiratory failure and MOF. But the other 9 cases kept good postoperative courses with a few recurrences of minor empyema. The prognoses for 10 remaining cases is excellent. Only one case died from local recurrence in of lymphoma 27 months later, but all other 9 cases have revealed no recurrence in any places, and the 5 year survival rate based on Kaplan-Meier method of 10 cases is 85.7%. By the way no cases could survive one year later in unresected group. So under the poor prognosis of treatment with radiation or chemotherapy for non-Hodgkin lymphoma originating from chronic tuberculous empyema, we conclude that the complete resection of tumor and empyema, so called pleuropneumonectomy, is the best way to cure this disease.

Evaluation of surgical resection for small hepatocellular carcinomas

BACKGROUND

The surgical results for small hepatocellular carcinomas (HCCs) are not necessarily satisfactory. The resectional therapy for small HCC was evaluated to elucidate its benefits and limitations.

PATIENTS AND METHODS

Data were analyzed concerning 52 patients having small HCC of <3 cm in diameter and <3 nodules, who underwent hepatic resections from 1978 to 1989.

RESULTS

Cumulative and disease-free survival at 5 years after resection were 57% and 37%, respectively. Histologic features, such as differentiation of HCCs, pseudocapsular invasion, and ploidy pattern of nuclear DNA, appeared to be good prognostic indicators. The survival rate of the large-resection group (number of resected segments greater than number of tumor-occupying segments) was significantly better than that in the small-resection group (84% versus 48% at 5 years, P<0.05).

CONCLUSIONS

Surgical resection of small HCCs is a safe and effective therapy. A large resection appears to provide better patient survival and tumor-free survival compared to a small resection.

Costimulation of fibronectin receptor promotes Fc gamma R-mediated rescue of IL-3-dependent bone marrow-derived cells from apoptosis

The IL-3-dependent murine bone marrow-derived cell line FDC-P2/185-4 (185-4) undergoes apoptosis when IL-3 is withdrawn from the culture medium. However, a high concentration of aggregated mouse IgG prevents apoptosis of 185-4 cells by an autocrine mechanism, producing IL-3. An analysis of flow cytometry revealed that 185-4 cells expressed Fc gamma RIII on their surface and that these effects of IgG are inhibited by anti-Fc gamma RIII mAb. These results indicated that the effect of IgG is mediated by low affinity Fc gamma RIII. In contrast, a low concentration of mouse IgG cannot prevent the apoptosis of 185-4 cells, but in the presence of fibronectin (FN), cell survival is prolonged. It is generally accepted that the interaction of cells with FN is mediated by several integrins such as alpha 5 beta 1 (VLA-5) or alpha 4 beta 1 (VLA-4), and analysis of flow cytometry showed that 185-4 cells express these integrins on their surface. Furthermore, these effects of FN are blocked specifically by RGD peptide or anti-VLA-4 mAb. These findings indicated that FN induces the costimulatory signal through integrin receptor and enhances the proliferative effect through Fc gamma RIII by a low concentration of IgG. The findings presented here suggested that the engagement of FN-integrin receptors on 185-4 cells increases the sensitivity of the cells for cellular activation of IgG. Since inflammatory cells in the microenvironment are surrounded by extracellular matrix proteins, it is possible that adhesion molecules play important roles in inflammatory states such as autoimmune diseases caused by increased levels of IgG.

Pulmonary hypertension in patients with complete transposition of the great arteries: midterm results after surgery

Postoperative results of surgical repair of complete transposition of the great arteries (TGA) with pulmonary hypertension (PH) in 19 patients in whom mean pulmonary arterial pressure was >50 mmHg or the pulmonary/systemic arterial pressure ratio was >0.8 were examined. TGA with intact ventricular septum was diagnosed in 10 patients and TGA with ventricular septal defect in 9. At the time of corrective surgery (arterial switch 10, atrial switch 9), patients ranged in age from 7 months to 14 years (mean 2.4 years). Seventeen patients (89%) survived with New York Heart Association functional class I. Seven patients in whom calculated pulmonary vascular resistance was 10-20 U m2 after surgery survived with subsequent regression of PH. Residual PH was diagnosed in 36% of survivors. Two patients in whom pulmonary vascular resistance was 26 and 36 U m2, respectively, died after surgery. In patients with TGA, severe PH was not necessarily fatal and was potentially reversible after successful surgery.

Ventriculolumbar perfusion chemotherapy with methotrexate and cytosine arabinoside for meningeal carcinomatosis: a pilot study in 13 patients

Thirteen patients with meningeal carcinomatosis were treated by ventriculolumbar perfusion using methotrexate (MTX) and cytosine arabinoside (Ara-C). MTX (10-30 mg) and Ara-C (40 mg) were infused at 8- to 12-hour intervals on six or nine occasions via an Ommaya reservoir placed in the lateral ventricle. Nine of thirteen patients had evaluable response (69% response rate with a mean survival of 8.8 months among responders) and ventriculolumbar perfusion therapy was effective in improving cerebral, cranial nerve, and spinal root signs and symptoms, especially sensorimotor disturbance in the lower limbs. Three of the six bedridden patients became ambulatory without assistance and two of the four patients who were walking with assistance became ambulatory without assistance. Urinary incontinence also markedly improved, except in one nonresponder. Lumbar cerebrospinal fluid parameters (cytological findings and tumor markers) also improved in association with the clinical improvement. Our pilot results were encouraging, especially the improvement of sensorimotor function in the lower limbs. However, the toxicity was unacceptable when compared with that of standard intrathecal chemotherapy. Thus, this therapy needs to be investigated further to establish the most appropriate drug doses and perfusate volume to reduce toxicity as well as determine its true efficacy in the treatment of meningeal carcinomatosis.

Comparative pharmacodynamics of eight calcium channel blocking agents in Japanese essential hypertensive patients

The relationships between plasma drug concentration and antihypertensive effect of eight calcium channel antagonists (nicardipine, nifedipine, nilvadipine, benidipine, manidipine, barnidipine, nitrendipine and efonidipine) in Japanese essential hypertensive patients were analyzed. Based on the effect compartment model, we could explain the long duration of the pharmacological effect, and there was significant correlation (r = 0.876, p < 0.05) between estimated EC50 values and the dissociation constants (Kd) obtained from in vitro binding studies. We also developed the ion-channel binding model to understand the pharmacodynamics of long acting calcium antagonists. The model was also well fitted to antihypertensive effect data. A significant correlation between the apparent in vivo dissociation constants and in vitro Kd values was observed with a slope of 1.45 (r = 0.913), suggesting that the mechanism of long-lasting antihypertensive effect of newer developed calcium antagonists is due to their high binding affinity at ion-channel sites.

Costimulation of fibronectin receptor promotes Fc gamma R-mediated rescue of IL-3-dependent bone marrow-derived cells from apoptosis

The IL-3-dependent murine bone marrow-derived cell line FDC-P2/185-4 (185-4) undergoes apoptosis when IL-3 is withdrawn from the culture medium. However, a high concentration of aggregated mouse IgG prevents apoptosis of 185-4 cells by an autocrine mechanism, producing IL-3. An analysis of flow cytometry revealed that 185-4 cells expressed Fc gamma RIII on their surface and that these effects of IgG are inhibited by anti-Fc gamma RIII mAb. These results indicated that the effect of IgG is mediated by low affinity Fc gamma RIII. In contrast, a low concentration of mouse IgG cannot prevent the apoptosis of 185-4 cells, but in the presence of fibronectin (FN), cell survival is prolonged. It is generally accepted that the interaction of cells with FN is mediated by several integrins such as alpha 5 beta 1 (VLA-5) or alpha 4 beta 1 (VLA-4), and analysis of flow cytometry showed that 185-4 cells express these integrins on their surface. Furthermore, these effects of FN are blocked specifically by RGD peptide or anti-VLA-4 mAb. These findings indicated that FN induces the costimulatory signal through integrin receptor and enhances the proliferative effect through Fc gamma RIII by a low concentration of IgG. The findings presented here suggested that the engagement of FN-integrin receptors on 185-4 cells increases the sensitivity of the cells for cellular activation of IgG. Since inflammatory cells in the microenvironment are surrounded by extracellular matrix proteins, it is possible that adhesion molecules play important roles in inflammatory states such as autoimmune diseases caused by increased levels of IgG.

Inhibition of outflow cushion mesenchyme formation in retinoic acid-induced complete transposition of the great arteries

OBJECTIVE

Endocardial cushion tissue formation, the primordia of valves and septa, is a critical event in cardiac morphogenesis. Maternally administrated all-trans retinoic acid is known to induce complete transposition of the great arteries (TGA) in the mouse embryo. To address the mechanisms of TGA, the effect of retinoic acid on cushion tissue formation was examined.

METHODS

Using a three-dimensional collagen gel culture model, we performed various types of endothelial-mesenchymal transformation assays of co-cultured endocardium with myocardium obtained from 9.5-day mouse embryonic hearts. In vivo immunohistochemical detections of extracellular matrices, fibronectin and type I collagen, were also performed.

RESULTS

Endothelial-to-mesenchymal transformation at the onset of cushion tissue formation was suppressed in the outflow tract of embryos exposed to retinoic acid in culture. This inhibitory effect of retinoic acid was spatially restricted to the outflow tract and reversed by treatment with embryonic myocardial conditioned medium enriched in extracellular inductive molecules. Mesenchyme formation in the outflow tract was inhibited at a lower concentration of retinoic acid (10(-10) mol/l) than that which inhibited the atrio-ventricular canal (10(-7) mol/l) in culture. The fibronectin and type I collagen depositions in pre-migratory outflow tract cardiac jelly in retinoic acid-treated embryonic heart were reduced compared to those in the control.

CONCLUSIONS

Exogenously applied retinoic acid inhibits outflow tract cushion mesenchyme formation in the embryonic heart with TGA. It is suggested that retinoic acid inhibits the expression of extracellular matrices and inductive molecules synthesized by myocardium in the outflow tract.

Effect of cisplatin on the disposition of endogenous serotonin and its main metabolite, 5-hydroxyindole-3-acetic acid, in rats and dogs

Emesis after the administration of cisplatin is a severe complication, and its treatment is an important problem clinically. Cisplatin forces the release of serotonin (5-HT) from enterochromaffin cells in the mucosa, and emesis occurs by the stimulation of 5-HT3 receptors. In this study, we established a simple and simultaneous method of determining 5-HT and its main metabolite, 5-hydroxyindole-3-acetic acid (5-HIAA), in plasma and urine by high performance liquid chromatography with electrochemical detection (HPLC-ECD), and determined the disposition of endogenous 5-HT and 5-HIAA after the administration of cisplatin in rats and dogs. In rats, we found no change in the plasma concentration of 5-HIAA after cisplatin administration, while a distinct increase was shown in the plasma concentration of 5-HT, but it was not significantly different from that of the control rats. The urinary excretion of 5-HIAA was also not different between the two groups. In dogs, we observed intense vomiting in all cisplatin treated dogs. However, we could not detect any change in the 5-HIAA or 5-HT level in the dog plasma. Furthermore, no significant difference in the urinary excretion of 5-HIAA was observed between the cisplatin group and the controls. From these results, the plasma concentration of 5-HT and the urinary excretion of 5-HIAA may not be suitable markers for the evaluation of emesis induced by anticancer drugs in dogs.

EM523L, a nonpeptide motilin agonist, stimulates gastric emptying and pancreatic polypeptide secretion

We investigated the efficacy and the mechanism of action of EM523L, a nonpeptide motilin agonist (motilide), on the stimulation of gastric emptying and on the release of gut peptides after ingestion of a solid meat in normal controls (n = 8) and in diabetic patients (n = 8) with signs of neuropathy. A dose of 2 mg EM523L was administered IV over 15 min just after ingestion of a solid meal (200 kcal Gastric emptying was measured by a radionuclide technique. EM523L accelerated gastric emptying and markedly augmented postprandial pancreatic polypeptide (PP) response in both normal control and diabetic patients. This may suggest the mediation of the Vagal-cholinergic pathway to accelerate gastric emptying. The present study offers a promising therapeutic potential of the motilide in gastrointestinal motility disorders like those observed in diabetics mellitus.

[Functional imaging of the sensorimotor cortex using an ultra-fast MR imaging method]

The aim of this study was to assess changes in brain activity during a motor task and variable sensory stimulation using echo planar imaging, which represents the fastest clinically usefull imaging technique available.

MATERIALS AND METHODS

The subjects of this study were 11 healthy-volunteers, 4 males and 11 females, with an average of 26.4 years. The subjects were instructed to tap the fingers of one hand as the motor task. Compressed air was applied 5 times a second as "simple" sensory stimulation. Simple figures were drawn on the subjects palm as "complex" sensory stimulation. In all cases, functional imaging was performed by T2*-weighted echo planar imaging (TE = 53 msec, TR = 3000 msec, flip angle = 90 degrees, matrix 64 x 64, FOV = 205 mm, slice thickness = 8 mm) alternately at rest and during the task (intervals: 30 sec). A total of 60 images was collected in 3 minutes. Images obtained by subtracting images at rest and during the task were analyzed.

RESULTS AND DISCUSSION

Almost all subjects showed a transient signal increase in the contralateral paracentral region during simple sensory stimulation. Continuous signal increases in the contra- and/or ipsi-lateral para-central region were observed during complex sensory stimulation. Some exhibited signal increases in the parietal or frontal association cortex, but they disappeared when subject's attention was distracted during stimulation. All subjects displayed signal increases in the contralateral para-central region during the motor task. Some of them exhibited signal increases in the medial frontal area (supplementary motor area) and ipsilateral para-central region. These results suggest that the signal increases of functional MRI reflect not only simple reactions to stimulation but higher cerebral function as well.