Regulation of granulocyte colony-stimulating factor and parathyroid hormone-related protein production in lung carcinoma cell line OKa-C-1

Previously we have established a clonal squamous cell carcinoma cell line OKa-C-1 derived from lung cancer of a patient with marked leukocytosis and hypercalcemia. OKa-C-1 cells simultaneously produce granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP) at the single cell level and cause paraneoplastic syndromes in nude mice bearing the tumor. It is known that the production of G-CSF and PTHrP is individually regulated by inflammatory cytokines in various malignant cells. To investigate the common factors in the regulation of G-CSF and PTHrP production in OKa-C-1 cells, we examined the effects of some inflammatory agents [lipopolysaccharide (LPS), phorbol-12-myristate-13-acetate (PMA), tumor necrosis factor-alpha (TNF-alpha), interleukin-1 (IL-1) beta and IL-6] on G-CSF and PTHrP production, by means of enzyme-linked immunosorbent assay (ELISA), immunoradiometric assay (IRMA) and quantitative reverse transcription-polymerase chain reaction (RT-PCR). TNF-alpha or IL-1beta induced both G-CSF and PTHrP production in the conditioned medium. TNF-alpha synergized with IL-1beta to significantly increase G-CSF production. In addition, TNF-alpha and IL-1beta strongly induced G-CSF mRNA with peaks at 2 and 6 h respectively. Although PTHrP production was also strongly induced by TNF-a PTHrP mRNA expression was more strongly induced by PMA than by TNF-alpha. Thus, TNF-alpha and IL-1beta could be common factors that individually and synergistically regulate G-CSF and PTHrP production in OKa-C-1 cells. Moreover, G-CSF and PTHrP production could be not only transcriptionally, but also posttranscriptionally regulated by other factors.

Formation of the male-specific muscle in female Drosophila by ectopic fruitless expression

The Drosophila fruitless (fru) gene product Fru has been postulated to be a neural sex-determination factor that directs the development of at least two male-specific characteristics, namely courtship behaviour and formation of the muscle of Lawrence (MOL). The fru gene encodes a putative transcription factor with a BTB domain and two zinc-finger motifs, and with consensus Tra-binding sequences. The binding of Tra to these sequences results in sex-specific alternative splicing of the fru mRNA, leading to production of the 'male-type' or 'female-type' Fru protein. We show here that the Fru protein is not detected in the female central nervous system (CNS), despite the similar level of expression of fru mRNA in both male and female CNS. As ectopic expression of both the 'male-type' (with the sequence for the amino-terminal extension) and 'female-type' (without the sequence for the amino-terminal extension) fru cDNA can induce formation of the MOL in females, the presence or absence of the Fru protein, and not its sex-specific structure, seems to be responsible for the sexually dimorphic actions of the fru gene.

Cyclic nucleotide-gated channels colocalize with adenylyl cyclase in regions of restricted cAMP diffusion

Cyclic AMP is a ubiquitous second messenger that coordinates diverse cellular functions. Current methods for measuring cAMP lack both temporal and spatial resolution, leading to the pervasive notion that, unlike Ca(2+), cAMP signals are simple and contain little information. Here we show the development of adenovirus-expressed cyclic nucleotide-gated channels as sensors for cAMP. Homomultimeric channels composed of the olfactory alpha subunit responded rapidly to jumps in cAMP concentration, and their cAMP sensitivity was measured to calibrate the sensor for intracellular measurements. We used these channels to detect cAMP, produced by either heterologously expressed or endogenous adenylyl cyclase, in both single cells and cell populations. After forskolin stimulation, the endogenous adenylyl cyclase in C6-2B glioma cells produced high concentrations of cAMP near the channels, yet the global cAMP concentration remained low. We found that rapid exchange of the bulk cytoplasm in whole-cell patch clamp experiments did not prevent the buildup of significant levels of cAMP near the channels in human embryonic kidney 293 (HEK-293) cells expressing an exogenous adenylyl cyclase. These results can be explained quantitatively by a cell compartment model in which cyclic nucleotide-gated channels colocalize with adenylyl cyclase in microdomains, and diffusion of cAMP between these domains and the bulk cytosol is significantly hindered. In agreement with the model, we measured a slow rate of cAMP diffusion from the whole-cell patch pipette to the channels (90% exchange in 194 s, compared with 22-56 s for substances that monitor exchange with the cytosol). Without a microdomain and restricted diffusional access to the cytosol, we are unable to account for all of the results. It is worth noting that in models of unrestricted diffusion, even in extreme proximity to adenylyl cyclase, cAMP does not reach high enough concentrations to substantially activate PKA or cyclic nucleotide-gated channels, unless the entire cell fills with cAMP. Thus, the microdomains should facilitate rapid and efficient activation of both PKA and cyclic nucleotide-gated channels, and allow for local feedback control of adenylyl cyclase. Localized cAMP signals should also facilitate the differential regulation of cellular targets.

Mediastinal myelolipoma: CT and MRI appearances

A 72-year-old man presented with a mediastinal mass on chest radiograph. Computed tomography and MR imaging showed that the mass consisted of both fatty and small nodular soft tissue components, highly suggestive of an extramedullary hematopoiesis or a myelolipoma. A CT-guided needle biopsy was next performed and confirmed the diagnosis. We discuss the CT and MR imaging appearances es of this tumor and usefulness of a CT-guided needle biopsy to avoid surgery in asymptomatic patients.

Scalp marking for a craniotomy using a laser pointer during preoperative computed tomographic imaging: technical note

OBJECTIVE

The preoperative localization of superficial intracranial lesions is often necessary for accurate burr hole placement or craniotomy siting. It is not always easy, however, to localize the lesions over the scalp working only from computed tomographic images. We developed a simple method for such localization using a laser pointer during the preoperative computed tomographic examination.

METHODS

The angle of incidence, extending from a point on the scalp to the center of the computed tomographic image, is measured by the software included with the scanner. In the gantry, at the same angle as on the image, a laser is beamed from a handmade projector onto the patient's scalp toward the center of the gantry. The point illuminated on the patient's head corresponds to that on the image. The device and the method are described in detail herein.

RESULTS

We applied this technique to mark the area for the craniotomy before surgery in five patients with superficial brain tumors. At the time of surgery, it was confirmed that the tumors were circumscribed precisely.

CONCLUSION

The technique is easy to perform and useful in the preoperative planning for a craniotomy. In addition, the device is easily constructed and inexpensive.

[Diagnosis--radiologic imaging]

One of the most important recent advances in imaging technology for the diagnosis of lung cancer is CT consisting of high-resolution and helical volumetric techniques. CT has made a detailed morphological analysis correlated with histopathology as well as the detection of small peripheral lung cancers possible. MRI still remains as a complementary role to CT, but MR angiography using fast gradient-echo technique has achieved a great progress. FDG-PET is the most encouraging development in nuclear medicine and is vigorously evaluated for its cost-effective clinical value in differentiating benign and malignant nodules as well as in staging of lung cancer. In chest radiography, the development of computer-aided diagnosis is underway and seems promising.

Isolation of Pseudomonas aeruginosa from Ushubetsu River water in Hokkaido, Japan

To provide information on the ecology of Pseudomonas aeruginosa in nature, bacteriological surveillance was performed in the defined area in Hokkaido, Japan. P. aeruginosa was isolated from water samples of Ushubetsu River in the down stream from the urban area of Asahikawa. P. aeruginosa was isolated from fecal samples of pigs but not from samples of soil of a tomato field, sand of sandboxes in vest-pocket parks, fresh vegetables, or feces of wild deer. The present results indicate that P. aeruginosa strains isolated from the river water is originated from the environment of human activity and not from wild life or domestic animals.

Spontaneous coughing up of a polyp

We report the case of an 18-year old female with right lower lobe atelectasis, who was admitted to our hospital because of a nonproductive cough. She underwent fiberoptic bronchoscopy that revealed a peduncular polyp in the right truncus intermedius or middle bronchus. Before admission for laser polypectomy, she spontaneously coughed up the tissue mass, and the right lower lobe atelectasis disappeared. We report a rare case of 'autopolypectomy' of a bronchial adenoma.

Minimally invasive direct coronary artery bypass grafting in a patient with brainstem infarction

Brainstem infarction associated with the primitive trigeminal artery is rare. We describe the case of a 61-year-old man with an acute myocardial infarction as well as a brainstem infarction. The patient was referred for coronary artery bypass grafting. Minimally invasive direct coronary artery bypass grafting (left internal thoracic artery to the second diagonal branch anastomosis) could be safely performed 10 weeks after an episode of brainstem infarction.

Effectiveness of spray application of ACNU in the local control of malignant gliomas: report of two cases

Malignant gliomas encompassing the eloquent areas cannot be removed totally and their surgical extirpation is followed by adjuvant therapy for the residual tumor. Recently, we have employed fibrin glue as a vehicle for the sustained release of ACNU (nimustine hydrochloride) by spray application following subtotal tumor removal in two patients with recurrent malignant gliomas. Follow-up MRI at six months demonstrated no neuroradiological evidence of tumor recurrence in the site of operation. We conclude, this novel mode of intra-operative local chemotherapy by spray application of fibrin glue containing antineoplastic agent is effective in the control of residual tumor progression and may also prevent local recurrence and hence suggests its possible role as an adjuvant therapy in the management of malignant gliomas.

[Usefulness of temporal subtraction images of chest computed radiography for detection of metastatic pulmonary nodules]

Temporal subtraction is a technique by which a previous chest radiograph is subtracted from a current radiograph in order to enhance interval changes. Our purpose in this study was to evaluate the usefulness of temporal subtraction for the detection of metastatic pulmonary nodules. We examined 19 cases of metastatic nodules less than 15 mm in diameter (8.4 mm on average). Temporal subtraction images were created based on the matching of local lung areas in pairs of chest radiographs. By using the subtraction images, the detectability of nodules was clearly improved in 5 cases and moderately improved in 8 cases; there was no improvement in 6 cases. The subtraction images were especially useful for nodules superimposed over normal structures, such as rib, mediastinum, and diaphragm, as well as for small nodules. In 6 of the 19 cases, the nodules had been missed clinically; however, the temporal subtraction images clearly demonstrated half of missed small nodules. Temporal subtraction made it possible to enhance subtle interval changes and helped in detecting small pulmonary metastases. This technique seems promising for augmenting the capabilities of computed radiography of the chest.

Evolution of peripheral lung adenocarcinomas: CT findings correlated with histology and tumor doubling time

OBJECTIVE

This study was performed to evaluate the evolution of peripheral lung adenocarcinomas using CT findings and histologic classification related to tumor doubling time.

MATERIALS AND METHODS

The subjects were 34 patients, each with an adenocarcinoma smaller than 3 cm. All patients underwent chest radiography and 10 of them had previously undergone CT more than 6 months before surgery. Tumor doubling time was estimated by examining sequential radiographs using the method originally described by Schwartz. Tumor growth was also observed by studying the changes on CT in the 10 patients who had previously undergone CT. The histologic classification (types A-F) was evaluated according to the criteria of Noguchi et al.

RESULTS

Five (83%) of the six adenocarcinomas with tumor types A or B showed localized ground-glass opacity on high-resolution CT. All six tumors had a tumor doubling time of more than 1 year. Fifteen (71%) of the 21 tumors with type C showed partial ground-glass opacity mixed with localized solid attenuation on high-resolution CT. Ten (48%) of these 21 type C tumors had a tumor doubling time of more than 1 year. In types B and C, the solid component or the development of pleural indentation and vascular convergence increased during observation before surgery. All seven tumors with types D, E, and F showed mostly solid attenuation, and the tumor doubling time was less than 1 year in six (87%) of the seven tumors.

CONCLUSION

Two main types of peripheral lung adenocarcinoma exist. The first type appears on CT as a localized ground-glass opacity with slow growth, and the other appears as a solid attenuation with rapid growth.

Auto-induction of E5110 metabolism, a novel non-steroidal anti-inflammatory drug, during toxicokinetic studies in beagle dogs

Following single-dose intravenous and oral studies to determine the absolute bioavailability of E5110 in beagle dogs, repeated dose pharmacokinetic studies were conducted as toxicokinetics in a subacute toxicity test. E5110 was administered orally once a day for 91 days at doses of 0, 1, 10, 50 and 250 mg/kg/day to dogs. On the first day during repeated administration, the Cmax and AUC values of E5110 in females were lower than those for males, and it seems that this may be due to a sex-related difference in the activity of cytochrome P450 (CYP) 3A. During repeated administration of E5110, the plasma levels of E5110 on day 15 and day 91 were markedly lower than those on the first day. On day 91, the AUCs for E5110 were 55.9%, 38.8%, 10.9% and 7.8% in males, and 76.2%, 80.3%, 10.5% and 11.9% in females on the first day, for doses of 1, 10, 50 and 250 mg/kg/day, respectively. Liver microsomes prepared after the last dose of E5110 showed increased activities of benzphetamine N-demethylase, p-nitroanisole O-demethylase, and aminopyrine N-demethylase, at doses of 1 mg/kg/day or more. A dose-dependent increase in P450 content was also observed. Furthermore, the capacity for 5-hydroxylate E5110 was increased, and Western blot analysis indicated an induction of CYP2B and 3A; therefore CYP3A may contribute to a main metabolic pathway of E5110. These results suggested that the decrease in plasma concentrations of E5110 that were observed during repeated administration represents a typical case of auto-induction of the phenobarbital type.

Acute aortic thrombosis after intra-aortic balloon pumping

Acute aortic occlusion is a rare but devastating complication of intra-aortic balloon pumping. Prompt diagnosis of aortic occlusion and immediate therapeutic decision making are keys for saving patients in such cases. We describe a 72-year-old man who underwent emergency surgical removal of a thrombus and aortoiliac bifurcated grafting for acute aortic occlusion after withdrawal of the intra-aortic balloon pumping catheter. The presence of a small unrecognized abdominal aortic aneurysm was considered to be the cause of thrombosis in this patient. Ultrasonographic screening for an abdominal aortic aneurysm is recommended for patients who require intra-aortic balloon pumping support.

Inhibition by calcium of mammalian adenylyl cyclases

Ca(2+) regulates mammalian adenylyl cyclases in a type-specific manner. Stimulatory regulation is moderately well understood. By contrast, even the concentration range over which Ca(2+) inhibits adenylyl cyclases AC5 and AC6 is not unambiguously defined; even less so is the mechanism of inhibition. In the present study, we compared the regulation of Ca(2+)-stimulable and Ca(2+)-inhibitable adenylyl cyclases expressed in Sf9 cells with tissues that predominantly express these activities in the mouse brain. Soluble forms of AC5 containing either intact or truncated major cytosolic domains were also examined. All adenylyl cyclases, except AC2 and the soluble forms of AC5, displayed biphasic Ca(2+) responses, suggesting the presence of two Ca(2+) sites of high ( approximately 0.2 microM) and low affinity ( approximately 0.1 mM). With a high affinity, Ca(2+) (i) stimulated AC1 and cerebellar adenylyl cyclases, (ii) inhibited AC6 and striatal adenylyl cyclase, and (iii) was without effect on AC2. With a low affinity, Ca(2+) inhibited all adenylyl cyclases, including AC1, AC2, AC6, and both soluble forms of AC5. The mechanism of both high and low affinity inhibition was revealed to be competition for a stimulatory Mg(2+) site(s). A remarkable selectivity for Ca(2+) was displayed by the high affinity site, with a K(i) value of approximately 0.2 microM, in the face of a 5000-fold excess of Mg(2+). The present results show that high and low affinity inhibition by Ca(2+) can be clearly distinguished and that the inhibition occurs type-specifically in discrete adenylyl cyclases. Distinction between these sites is essential, or quite spurious inferences may be drawn on the nature or location of high affinity binding sites in the Ca(2+)-inhibitable adenylyl cyclases.

Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes

OBJECTIVE

To evaluate the degree of psychological dysfunction and levels of stress hormones in postmenopausal women with climacteric syndromes and effect of Korean red ginseng (RG) on them.

METHODS

ACTH, cortisol and DHEA-S in peripheral blood from 12 postmenopausal women with climacteric syndromes or 8 postmenopausal women without any climacteric syndrome were measured before and 30 days after treatment with daily oral administration of 6 g RG. Blood samples were collected in the early morning on the bed-rest. In postmenopausal women with climacteric syndromes such as fatigue, insomnia and depression, psychological tests using the Cornell Medical Index (CMI) and the State-Trait Anxiety Inventory (STAI) were performed before and 30 days after treatment with RG.

RESULTS

CMI score as well as anxiety (A)-state in STAI score in postmenopausal women with climacteric syndromes was significantly higher than that without climacteric syndrome, while DHEA-S levels in postmenopausal women with climacteric syndromes were about a half of those without climacteric syndrome. Consequently, cortisol/DHEA-S (C/D) ratio was significantly higher in postmenopausal women with climacteric syndromes than in those without climacteric syndrome. When postmenopausal women with climacteric syndromes were treated with daily oral administration of 6 g RG for 30 days, CMI and STAI A-state scores decreased within normal range. Although the decreased DHEA-S levels were not restored to the levels in postmenopausal women without climacteric syndrome, the C/D ratio decreased significantly after treatment with RG.

CONCLUSIONS

Improvement of CMI and STAI scores in postmenopausal women suffering climacteric syndromes, particularly fatigue, insomnia and depression, by RG seemed to be brought about in part by effects of RG on stress-related hormones as shown by a decrease in C/D ratio.

Immunohistochemical analysis on the role of adenosine A1 receptors in epilepsy

Adenosine has an anticonvulsant effect in various models of epilepsy. This effect appears to be mediated through the activation of adenosine A1 receptors (A1Rs). We immunohistochemically investigated the changes of A1Rs expression in kainate-treated and hippocampus-kindled rats as chronic models of epilepsy. In the normal hippocampus, a predominant expression of A1Rs was detected in the CA2/CA3a field. The A1Rs immunoreactivity in this field began to decline drastically approximately 4 weeks after kainate treatment and remained minimal 8 weeks after treatment. In the hippocampus-kindled animals, A1Rs expression was minimal in the stimulated side but remained high in the nonstimulated side. The reduced expression of A1Rs in the CA2/CA3a field may be related to chronic epileptogenesis.

Efficacy of donor screening for HTLV-I and the natural history of transfusion-transmitted infection

BACKGROUND

It has been 10 years since the implementation in Japan of donor blood screening for human T-cell lymphotropic virus type I (HTLV-I). This report reviews the effectiveness of screening in preventing transmission of HTLV-I through blood transfusion and the current status of patients with confirmed seroconversion due to transfusions given before the implementation of screening.

STUDY DESIGN AND METHODS

Patients who received blood at Kyushu University Hospital from 1990 to 1997 were followed. Serum samples were collected before transfusion and 60 days or more after transfusion. Seroconversion was determined by a second-generation particle agglutination test. Confirmation tests were an immunofluorescence assay, enzyme-linked immunosorbent assay, and immunoblotting. Confirmed seroconverted patients were followed by a search of hospital records.

RESULTS

Seroconversion was found in one of 4672 transfused patients, but the donor was identified and confirmed to be negative for anti-HTLV-I and virus genome by nested polymerase chain reaction. A total of 23,323 red cell concentrates and 17,237 platelet concentrates were transfused to these 4672 patients. Therefore, the anti-HTLV-I prevalence in blood for transfusion after screening was estimated at 1 in 45,560 (0.0022%; the upper 95% CI was 0.0080%). One hundred two seroconverted patients who were transfused before donor screening for HTLV-I were followed. One patient developed HTLV-I-associated myelopathy, diagnosed 18 weeks after seroconversion, and another patient developed uveitis 1 month after seroconversion. No patients developed adult T-cell lymphoma, and the survival rate of seroconverted patients was 92.5 percent 15 years after transfusion.

CONCLUSION

This study confirmed that the present donor screening program for HTLV-I by the new particle agglutination test can almost completely prevent virus transmission by transfusion. Complications of HTLV-I transmission were at lower rates than expected.

High level of adenosine A1 receptor-like immunoreactivity in the CA2/CA3a region of the adult rat hippocampus

We describe the immunocytochemical distribution of adenosine A1 receptors in the rat hippocampus. Adenosine A1 receptor-like immunoreactivity was seen on the cell soma and dendrites of pyramidal cells and the cell soma and proximal part of dendrites of granule cells, but not on glial cells. Developmentally, adenosine A1 receptor-like immunoreactivity was diffuse on postnatal day 7 and increased in intensity in individual cells by day 21. In the CA2/CA3a region, the adult pattern of A1 receptor distribution was established by day 28. In the adult rat hippocampus, rostrocaudal inspection revealed that immunoreactivity in CA2/CA3a was greatest. Confocal microscopy revealed differences in the staining patterns for the adenosine A receptor and synaptophysin, a marker of presynaptic terminals. This result suggests that the adenosine A1 receptor might have postsynaptic physiological functions. Double-labeling of adenosine A1 receptors and anterogradely-labeled fibers from the supramammillary nucleus showed that the fibers from the supramammillary nucleus terminate directly on the cell soma of the A1 receptor-immunopositive neurons in CA2/CA3a and the dentate gyrus. These results indicate that the adenosine A 1 receptor in CA2/CA3a and the dentate gyrus are in a position to regulate hippocampal theta activity and that resultant strong synaptic depression in CA2/CA3a could play a role in regulating the intrinsic signal flow between CA3 and CA1.

[Clinical usefulness of half-dose gadolinium-enhanced MR angiography of portal venous system (MR portography)--combined use with conventional dynamic MR imaging]

The clinical usefulness of half-dose Gadolinium-enhanced MR portography combined with the conventional full-dose dynamic MR imaging was evaluated on normal volunteers and patients. Half-dose MR portography was performed immediately following conventional full-dose Gd-enhanced dynamic MR imaging. The visualization of the extrahepatic portal system was either good or excellent in most cases excluding the splenic vein which was poor in 20.7%. That of the right and left main portal branches was also excellent. As for segmental branches, the visualization was poor of the left lobe. The comparison with digital subtraction angiography showed that the visualization of the right and left main portal branches was mostly equal. That of the splenic vein alone was worse on MR portography. We conclude that half-dose Gadolinium-enhanced MR portography is useful for the overall assessment of the portal venous system and can be added to the conventional dynamic MR imaging.

[The accuracy and reverse effects of thallium myocardial SPECT using adenosine triphosphate loading in the diagnosis of coronary artery disease: comparison with other loading methods semiquantitatively]

The adverse effects and diagnostic accuracy of thallium-201 myocardial SPECT after intravenous infusion of adenosine triphosphate (ATP) were studied and compared with SPECT examinations with other type of loading. The subjects of the study were 147 patients with or without coronary artery disease, who underwent some type of loading SPECT and coronary arteriography (CAG) within 30 days. Myocardial ischemia was evaluated qualitatively in SPECT and was compared with CAG for the diagnostic accuracy of coronary artery disease. The degree of myocardial uptake defect was also calculated semiquantitatively using visual scoring method and compared with coronary artery severity score. The adverse effects occurred in 46.7% of ATP loading SPECT which was more frequent than DIP loading SPECT, but all of them were transient and mild. As for the diagnostic ability, the ATP loading SPECT was as effective as other type of loading in qualitative interpretation, and the perfusion defect scores showed a good correlation with coronary artery stenosis grade. The myocardial SPECT using ATP is safe and useful for the diagnosis of coronary artery disease especially in patients who cannot exercise.

Cellular localization of adenosine A1 receptors in rat forebrain: immunohistochemical analysis using adenosine A1 receptor-specific monoclonal antibody

Monoclonal antibodies were generated against the adenosine A1 receptor (A1R) purified from rat brain. In immunoblot analyses of purified or partially purified A1R preparations from rat brain, these antibodies recognized a solitary band, the size of which corresponded to that expected for A1R. These antibodies recognized not only the native form of A1R but also the deglycosylated form of A1R. Immunocytochemical analysis of Chinese hamster ovarian cells that were transfected stably with rat A1R cDNA showed that their cell bodies were stained intensely by these antibodies, whereas nontransfected Chinese hamster ovarian cells were not. These antibodies detected the A1R naturally present in the DDT(1)( )MF-2 smooth muscle cells. One of these antibodies (the 511CA antibody) was then used to examine the immunohistochemical distribution of A1Rs in rat forebrain. On light microscopy, A1R immunoreactivity was observed in the cerebral cortex, septum, basal ganglia, hippocampal formation, and thalamus. However, in some regions of the forebrain, regional differences in staining intensity were found as follows: In the cerebral cortex, the strongest immunoreactivity was found in the large pyramidal neurons of layer V. This immunoreactivity was detected in the pyramidal cell bodies, dendrites, and axon initial segments. In the hippocampus, A1R immunoreactivity was detected mainly in the stratum pyramidale. The pyramidal cells in fields CA2-CA3 of the hippocampus were stained more intensely or more clearly than those in field CA1 or the dentate gyrus. More intense A1R immunoreactivity of the apical dendrites was detected in field CA2 compared with other hippocampal fields and the dentate gyrus. Many interneurons of the hippocampus were stained by the 511CA antibody. The subcellular distribution of A1Rs in the forebrain was examined by using a digital deconvolution system and electron microscopy. In the cerebral cortex, the view obtained by removing the background haze by deconvolution revealed that the immunofluoresence-labeled A1Rs were distributed on the surfaces of the cell bodies and dendrites and in the cytoplasm of layer V neurons as small spots. In field CA1, immunoreactivity was detected in the areas surrounding pyramidal cells. Electron microscopy revealed the presence of A1R-immunoreactive products in both the presynaptic terminals and the postsynaptic structures. The specific cellular distribution of A1Rs is consistent with the physiological premise that endogeneously released adenosine exerts control over the excitability of forebrain neurons at both presynaptic and postsynaptic sites through A1Rs.

The radiological findings in chronic expanding hematoma

OBJECTIVE

To identify the characteristic MRI findings of chronic expanding hematoma correlated with the pathology.

DESIGN AND PATIENTS

Three patients who had a chronic expanding hematoma involving the musculoskeletal system were reviewed retrospectively.

RESULTS AND CONCLUSION

Huge soft tissue masses suggestive of malignancy with destruction of the bony structure were revealed on radiography and computed tomography. MRI showed the masses to exhibit heterogeneous signal intensity on both T1 and T2-weighted images with a peripheral rim of low signal intensity, reflecting the central zones of fluid collection due to fresh and altered blood with a wall of collagenous fibrous tissue. These MRI findings were seen in all three patients and are considered to be characteristic; they assist in differentiation from neoplasm in consideration of the history of trauma or surgery.

Simultaneous determination of donepezil (aricept) enantiomers in human plasma by liquid chromatography-electrospray tandem mass spectrometry

A rapid, sensitive and enantioselective LC-MS-MS method using deuterium-labeled internal standard was developed and evaluated for the simultaneous quantitative determination of donepezil enantiomers in human plasma without interconversion during clean-up process and measurement. The use of an avidin column allowed the separation of donepezil enantiomers, which were specifically detected by MS-MS without interference from its metabolites and plasma constituents. Evaluation of this assay method shows that samples can be assayed with acceptable accuracy and precision within the range from 0.0206 ng/ml to 51.6 ng/ml for both R-donepezil and S-donepezil. This analytical method was applied to the simultaneous quantitation of donepezil enantiomers in human plasma.

An EGF receptor-mediated signal attenuates the inhibitory effect of LPA on an adenylate cyclase activity

A tyrosine kinase receptor-mediated and a heterotrimeric G protein-coupled receptor-mediated signals have been shown to evoke distinct intracellular signaling events. There has been increasing evidence that cross-talk exists between a tyrosine kinase receptor-mediated and a heterotrimeric G protein-coupled receptor-mediated signal transduction pathways. In the present study, we have studied effects of EGF receptor activation on activities of inhibitory G protein (Gi). We show that the amounts of Gi/Go ADP-ribosylated by islet-activating protein (IAP) increased by 30-40% in the membranes of Rat 1 fibroblast cells pretreated with EGF compared with those without pretreatment. When an effect of lysophosphatidic acid (LPA) stimulation on an adenylate cyclase activity was examined, LPA partly attenuated forskolin-stimulated adenylate cyclase activity via Gi because IAP pretreatment blocked the inhibitory effect of LPA. Pretreatment with EGF reduced the ability of LPA to inhibit the forskolin-stimulated adenylate cyclase activity, while the pretreatment did not have any effects on the forskolin-stimulated activity. Thus, the EGF receptor-mediated signal appears to cause the impairment of Gi function in Rat 1 fibroblast cells.

Clinical evaluation of irreversible data compression for computed radiography of the chest

Efficient data compression is essential for practical daily operation of computed radiography (CR) systems. In this study the clinical applicability of type III irreversible high data compression using an FCR 9501 chest unit (Fuji Photo Film, Tokyo, Japan) was evaluated. Sixty-eight normal and 93 various abnormal cases, with an additional 15 cases of lung cancers with solitary lung nodules, were selected from the file. A pair of hard copies of original images and images reconstructed using type III compression was made for each case. Six radiologists evaluated the image quality by visual rating and receiver operating characteristic (ROC) curve analysis. For all five anatomic regions of normal cases, "original equal to compressed" was the most common response, followed by "original significantly better than compressed." When abnormal cases were evaluated for diagnostic information, there was no significant difference between the compressed and original images. ROC curve analysis on lung nodules with lung cancer showed no significant difference between the two. Compressed CR images using the type III irreversible technique are clinically applicable and acceptable despite slight degradation of image quality.

Oncogenic ras induces gastrin gene expression in colon cancer

BACKGROUND & AIMS

The expression of gastrin, as a tumor growth factor, is significantly increased in some colon cancers compared with the low levels found in normal mucosa. The aim of this study was to elucidate the transcriptional mechanisms of gastrin induction in colon cancer.

METHODS

Gastrin messenger (mRNA) levels and K-ras genotype were determined in colon cancer cell lines and surgical specimens. Colon cancer cells were transfected with oncogenic ras expression vectors, and transcriptional activity was assayed with gastrin-luciferase reporter genes.

RESULTS

Colon cancer cell lines and tissues with K-ras mutations all had significantly higher gastrin mRNA levels than those that were ras wild type. Treatment of several ras mutant cell lines with PD98059, an inhibitor of mitogen-activated protein kinase kinase, resulted in a decrease in endogenous gastrin mRNA levels. The effects of ras on gastrin expression appeared to be mediated through the gastrin promoter because transfection of oncogenic ras and activated raf expression vectors both induced gastrin-promoter, luciferase-reporter genes. The inductive effects of oncogenic ras could be blocked by the coexpression of dominant negative forms of raf and extracellular regulated kinase.

CONCLUSIONS

Oncogenic ras induces gastrin gene expression through activation of the Raf-MEK-ERK signal transduction pathway.

Heterogeneity of protein profiles of Helicobacter pylori isolated from individual patients

BACKGROUND

In order to characterize the diversity of Helicobacter pylori (H. pylori) in infected individuals, 10 colonies of H. pylori were isolated from the gastric juice of 25 patients with gastroduodenal diseases (total 250 isolates).

METHODS

Protein profiles of isolates were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Results were confirmed by Western blotting (immunoblotting) test using rabbit antisera against three different strains of H. pylori.

RESULTS

The protein profiles of 18 of 25 cases (72%) showed a single type of H. pylori with the same polypeptide pattern. In contrast, heterogeneity in the protein profiles was seen in isolates from seven cases (28%). Two differing H. pylori types with two very different polypeptide patterns were found in 10 isolates from one case. In six patients, the protein profiles of isolates were found to have variations in their polypeptides between molecular weights of 30,000 (30K) and 14K, which are thought to be associated with bacterial membrane protein. In some isolates, a polypeptide band of the 16K was missing. Each of three different antisera confirmed differences among the distinct isolates from individual patients.

CONCLUSIONS

These findings suggest that more than one antigenically different strain of H. pylori may exist in same infected individuals.

Clinical evaluation of irreversible data compression for computed radiography of the hand

We evaluated the clinical utility of high data compression for computed radiography (CR) of the hand. Paired original and compressed CR images were obtained using an FCR 9000 system in 35 patients with various abnormalities of the hand. For the paired original and compressed images, we compared the depiction of the bone cortex, bone trabeculae, soft-tissue, and the margin of the abnormalities. The overall impressions for detectability of the abnormalities and for diagnostic capability were also evaluated. Poorer image quality of the compressed images was noted for most of the structures, but there was no significant difference between the original and compressed images as for the overall impressions for detectability of the abnormalities or for diagnostic capability. We conclude that a high data compression may be clinically acceptable with caution in radiography of the hand.

Inhibitory effects of ginsenoside Rh2 on tumor growth in nude mice bearing human ovarian cancer cells

Ginsenoside Rh2 (Rh2), isolated from an ethanol extract of the processed root of Panax ginseng CA Meyer, inhibits the growth of B16 melanoma cells. This study was designed to evaluate the ability of Rh2 to inhibit growth of human ovarian cancer cells (HRA) in vitro and in nude mouse. Rh2 inhibited proliferations of various established human ovarian cancer cell lines in a dose-dependent manner between 10 and 60 microM in vitro and induced apoptosis at around the IC50 dose. When HRA cells were inoculated s.c. into the right flank of nude mice, all mice formed a palpable tumor within 14 days. Although i.p. administration of Rh2 alone hardly inhibited the tumor growth, when Rh2 was combined with cis-diamminedichloroplatinum(II) (CDDP) the tumor growth was significantly inhibited, compared to treatment with CDDP alone. When mice were treated p.o. with Rh2 daily (but not weekly), the tumor growth was significantly (P<0.01) inhibited, compared to CDDP treatment alone. When Rh2 was combined with CDDP, the degree of tumor growth retardation was not potentiated. The survival time was significantly (P<0.05) longer than that of medium alone-treated controls or the group treated with CDDP alone. Then, we examined whether p.o. administration of Rh2 has a dose-dependent inhibitory effect on the tumor growth. I.p. and weekly administration of CDDP had more potent antitumor activity in the order of 1 mg/kg, 2 mg/kg and 4 mg/kg, whereas p.o. and daily administration of Rh, (0.4 to 1.6 mg/kg) not only had antitumor activity comparable to that of 4 mg/kg CDDP, but also resulted in a significant increase of the survival. Doses of Rh2 used in this study did not result in any adverse side-effects as confirmed by monitoring hematocrit values and body weight, unlike 4 mg/kg CDDP, which had severe side-effects. It is noteworthy that p.o. but not i.p. treatment with Rh2 resulted in induction of apoptotic cells in the tumor in addition to augmentation of the natural killer activity in spleen cells from tumor-hearing nude mice. Thus, particularly in view of the toxicity of CDDP, Rh2 alone would seem to warrant further evaluation for treatment of recurrent or refractory ovarian tumor.

Comparison of the signal transduction pathways activated by gastrin in enterochromaffin-like and parietal cells

BACKGROUND & AIMS

Gastrin stimulates acid secretion from parietal cells and histamine release from enterochromaffin-like (ECL) cells through identical gastrin receptors. However, gastrin has been shown to have a trophic effect only on ECL cells. The aim of this study was to compare gastrin-induced signal transduction pathways in the ECL and parietal cells of Mastomys natalensis, an African rodent.

METHODS

Both ECL and parietal cells were isolated from the gastric mucosa of M. natalensis, and intracellular signal transduction events in response to gastrin were investigated.

RESULTS

Gastrin elicited histamine release from ECL cells and acid secretion from parietal cells in association with enhanced inositol phospholipid turnover. Although gastrin increased [3H]thymidine incorporation into ECL cells, it had no effect on parietal cells. Moreover, tyrosine phosphorylation and activation of mitogen-activated protein (MAP) kinase as well as c-fos and c-jun gene expression were augmented only in ECL cells. In addition, gastrin increased the formation of guanosine triphosphate-Ras with a simultaneous decrease in guanosine diphosphate-Ras levels in ECL but not in parietal cells.

CONCLUSIONS

Although gastrin receptors are present in both ECL and parietal cells, they activate the Ras-MAP kinase pathway only in ECL cells.

Rat gastric mucosal cells express ICAM-1 and proinflammatory cytokines during indomethacin-induced mucosal injury

Adhesion molecules and cytokines are known to be involved in the formation of acute gastric mucosal injury. However, it is not clear whether the gastric mucosal cells express these molecules and modulate the inflammation. To clarify whether gastric mucosal cells express intercellular adhesion molecule-1 (ICAM-1) and proinflammatory cytokines (tumor necrosis factor-alpha (TNF-alpha), interleukin-1-alpha (IL-1-alpha), and cytokine-induced neutrophil chemoattractant-2-beta (CINC-2-beta)) in the formation of gastric mucosal injury, we have used rat indomethacin-induced gastric mucosal lesions as an in vivo model. The gene expression of all cytokines and ICAM-1 increases at the early stages of indomethacin-induced gastritis (TNF-alpha and IL-1-alpha gene expression began to increase earlier than that of ICAM-1 and CINC-2-beta) and can mainly be detected in the gastric epithelial layer. To further identify the source of those molecules, the epithelial cells were separated into seven fractions according to their sizes by a counterflow elution. ICAM-1 and CINC-2-beta gene expressions are particularly enhanced in the middle-sized cell fractions that are rich in gastric mucous-producing cells. The effect of TNF-alpha or IL-1-alpha on the gene expression of ICAM-1 and cytokines was examined by using RGM-1 cells as a model for gastric mucosal cells. RGM-1 cells show an augmented ICAM-1 and proinflammatory cytokine expression in response to TNF-alpha or IL-1-alpha stimulation. Moreover, immunohistochemical staining also reveals an increase in ICAM-1 and CINC protein production in RGM-1 cells in response to TNF-alpha stimulation. We conclude that gastric mucosal cells express various cytokines and an adhesion molecule during the formation of acute gastric mucosal injury and that they may modulate the inflammation.

Indirect tactual discrimination of heights by blind and blindfolded sighted subjects

The ability of blind and blindfolded sighted subjects to discriminate cubes of different heights was measured using the method of constant stimuli. Five male blind and 5 male blindfolded sighted students, ages 22 to 28 years, were subjects. All blind subjects had undergone orientation and mobility training at a school for the blind. The cubes, made of wood, were explored using a long cane. Subjects were presented the standard cube and a comparison cube and required to judge whether the comparison cube height was taller, the same, or shorter than the standard. Analysis showed that the difference thresholds of blind and blindfolded sighted subjects were 1.93 and 2.14 cm, respectively. No significant difference in accuracy of discrimination was found between the two groups. The blind subjects showed significantly better performance than the blindfolded sighted subjects on the discrimination task. The blind subjects performed the task significantly faster than the blindfolded sighted subjects. The results suggest that braille reading, use of a long cane, and daily physical activities which required prolonged haptic or proprioceptive learning, may enhance nonvisual motor skills.

Comparative study of p120 GTPase-activating protein and its point mutant in the pleckstrin homology domain

GTPase-activating protein (GAP) enhances the intrinsic GTPase activity of cellular Ras. In addition to two Src homology 2 (SH2) domains and one Src homology 3 (SH3) domain, it contains a pleckstrin homology (PH) domain. The wild-type or point mutant in the PH domain of p120 GAP (W568A) was expressed by using the baculovirus/Sf9 cell system. Direct effects of the G protein beta gamma subunit (G beta gamma) and several sphingolipids and the effects of phosphorylation by c-Src on the GTPase-stimulating activity of these GAPs on Ras were examined by using immunoprecipitates of these GAPs. The activities of neither of these GAPs were affected by the addition of G beta gamma, although the W568A mutant bound less to G beta gamma compared with the wild type. Several sphingolipids had no effect on the activity of these GAPs. Only in the W568A mutant was GTPase-stimulating activity reduced by tyrosine phosphorylation by c-Src.

Effect of growth factor on GTPase-activating protein (Ras GAP) in Chinese hamster ovary cells

GTPase-activating proteins (GAPs) stimulate the hydrolysis of GTP bound to small G-proteins and regulate the signal transduction pathway. Changes in the expression of p21-Ras p120-GAP induced by growth factor treatment were examined in cultured Chinese hamster ovary (CHO) and human choriocarcinoma (BeWo) cells. Expression of p120-GAP and GAP activity were measured. Fetal bovine serum induced a significant increased level of GAP in CHO cells, but did not increase GAP in BeWo cells. The results suggest that growth factors affect Ras GAP expression in CHO cells, while they do not in other cells such as BeWo cells.

In vitro inhibition of hepatic cytochrome P450 and enzyme activity by butyltin compounds in marine mammals

The present study attempted to examine the in-vitro inhibition of hepatic microsomal P450 content and activity by butyltins in marine mammals and discussed on their possible effects in animals in the wild. Decreases in P450 content and the activities of ethoxyresorufin O-deethylase (EROD, catalyzed by CYPIA subfamily) and penthoxyresorufin O-depentylase (PROD, catalyzed by CYP2B subfamily) by tributyltin (TBT) were observed in in-vitro experiments using hepatic microsomes of a pinniped and a cetacean. Among P450 family, EROD activity is more sensitive to TBT than P450 content and PROD activity, indicating a specific mode of action of TBT on different P450 forms. On the other hand, dibutyltin and monobutyltin have no inhibitory effect on EROD activity at concentrations less than 0.5 mM, indicating that the inhibition of enzyme activity in hepatic microsome of marine mammal is mainly by TBT. TBT concentrations that affect P450 contents and activities are above 10 times higher than the values found in the liver of various marine mammals.

RGS8 accelerates G-protein-mediated modulation of K+ currents

Transmembrane signal transduction via heterotrimeric G proteins is reported to be inhibited by RGS (regulators of G-protein signalling) proteins. These RGS proteins work by increasing the GTPase activity of G protein alpha-subunits (G alpha), thereby driving G proteins into their inactive GDP-bound form. However, it is not known how RGS proteins regulate the kinetics of physiological responses that depend on G proteins. Here we report the isolation of a full-length complementary DNA encoding a neural-tissue-specific RGS protein, RGS8, and the determination of its function. We show that RGS8 binds preferentially to the alpha-subunits G(alpha)o and G(alpha)i3 and that it functions as a GTPase-activating protein (GAP). When co-expressed in Xenopus oocytes with a G-protein-coupled receptor and a G-protein-coupled inwardly rectifying K+ channel (GIRK1/2), RGS8 accelerated not only the turning off but also the turning on of the GIRK1/2 current upon receptor stimulation, without affecting the dose-response relationship. We conclude that RGS8 accelerates the modulation of G-protein-coupled channels and is not just a simple negative regulator. This property of RGS8 may be crucial for the rapid regulation of neuronal excitability upon stimulation of G-protein-coupled receptors.

Helicobacter pylori independent chronological change in gastric acid secretion in the Japanese

BACKGROUND

Gastric acid secretion in Japanese subjects decreases with aging. One of the possible causative mechanisms of this attenuated acid secretion is speculated to be a Helicobacter pylori induced chronic gastritis. The infection rate of this microorganism has decreased recently in Japan.

AIMS

To investigate whether gastric acid secretion has altered over the past 20 years, and if so, what the influence of H pylori infection might be in the Japanese population.

SUBJECTS AND METHODS

Gastric acid secretion, serum gastrin and pepsinogen I and II concentrations, and H pylori infection were determined in 110 Japanese subjects in both the 1970s and 1990s.

RESULTS

Basal acid output as well as maximal acid output have greatly increased over the past 20 years, not only in individuals with H pylori infection but also in those without infection. Furthermore, subjects with H pylori infection tended to show decreased gastric acid secretion in comparison with those without infection, particularly in geriatric subjects. There was a positive correlation between gastric acid secretion and serum pepsinogen I concentrations.

CONCLUSIONS

In Japan, both basal and stimulated gastric acid secretion have increased over the past 20 years; some unknown factors other than the decrease in H pylori infection may play an important role in this phenomenon.

Helicobacter pylori induces proinflammatory cytokines and major histocompatibility complex class II antigen in mouse gastric epithelial cells

Although Helicobacter pylori has been reported to stimulate the release of various cytokines from gastric tissue, it remains unknown whether normal and nontumorous gastric epithelial cells produce these cytokines. Therefore, in this study, we used a normal mouse gastric surface mucous cell line (GSM06) to determine whether gastric epithelial cells produce proinflammatory cytokines in response to H. pylori. The expression of MHC class II antigen was also examined, to investigate whether gastric epithelial cells participate in the immune response to H. pylori. In the study, GSM06 cells were incubated with H. pylori or its lipopolysaccharide (LPS). Proinflammatory cytokines were detected by Northern and Western blot analysis. The expression of MHC class II antigen was examined by fluorescence activated cell sorter (FACS) analysis. Genetic expression of proinflammatory cytokines such as interleukin-1alpha, tumor necrosis factor-alpha, and cytokine-induced neutrophil chemoattractant-2beta was enhanced by both intact and sonicated H. pylori, but not by H. pylori LPS. The expression of MHC class II antigen was induced by H. pylori more strongly than by interferon-gamma. We conclude that H. pylori induces the expression of proinflammatory cytokines and MHC class II antigen in gastric epithelial cells. Gastric epithelial cells may act as antigen-presenting cells and participate in the immune response to H. pylori infection.

[Bronchial hyperresponsiveness in patients with vasospastic angina pectoris (VSAP)]

To determine the relationship between airway and coronary artery spasmogenesity in patients with vasospastic angina pectoris (VSAP), we measured the bronchial responsiveness to inhaled methacholine in 21 VSAP patients (V-group) and compared it to that of 17 chest pain syndrome patients with normal coronary (N-group). In the V-group, logarithmic values of the minimum cumulative dose required to decrease respiratory conductance from the baseline (Log Dmin) was significantly lower than that in N-group (0.47 +/- 0.60 log units vs. 0.98 +/- 0.60 log units respectively, p < 0.05). Log Dmin was significantly correlated with the dose of acetylcholine which induced a greater than 90% stenosis of the coronary artery (r = 0.383, p < 0.05). We concluded that both the coronary artery and the airway show hyperresponsiveness to cholinergic agonists in patients with VSAP.

Molecular identification of a G protein-coupled receptor family which is expressed in planarians

We identified four guanine nucleotide binding protein (G protein)-coupled receptors from planarians by polymerase chain reaction (PCR) with degenerate primers. They all showed a significant homology to human 5HT1A serotonin receptor and therefore were designated as serotonin receptor-like planarian receptor 1 similar to 4 (5HTLpla1 similar to 4). cDNA clones of 5HTLpla4 and 5HTLpla1 were isolated from the planarian cDNA library and their complete nucleotide sequences were determined. The deduced amino acid sequences of these planarian receptors, which are highly homologous to one another, show significant similarity to that of Drosophila 5HTdrol serotonin receptor. Northern blot analysis revealed that expression of 5HTLpla4 mRNA increased during planarian regeneration, suggesting that 5HTLpla4 might be involved in the regeneration mechanism.

Evaluation of an automatic-mode image processing method in chest computed radiography

RATIONALE AND OBJECTIVES

The automatic image processing mode of the storage phosphor computed radiography system was evaluated.

MATERIALS AND METHODS

A dedicated chest unit designed for erect view was used to examine a chest phantom. Lucite plates 1, 2, and 3 cm thick that conformed to the shape of the lung were attached to the phantom, and images were obtained in automatic and manual image processing modes. The changes in the optical density of the lung, rib, and heart and the changes in contrast were measured. The degree of diffuse opacity due to the plates and the visibility of superimposed simulated nodular and honeycomb opacities were evaluated.

RESULTS

The decrease in optical density and contrast caused by increasing thickness of the Lucite plates was less pronounced in the automatic mode compared with the manual mode. When plates were placed only on the right lung, the optical density and the contrast on the contralateral side either increased or remained unchanged with the automatic mode. The degree of diffuse opacity was rated higher in the manual mode, and the visibility of superimposed simulated opacities was considered relatively constant in the automatic mode.

CONCLUSION

The automatic image reading mode used in the computed radiography chest system may mask the detection of abnormalities such as diffuse homogeneous lung opacity.

[Serological differences in Helicobacter pylori]

To study antigenic differences in Helicobacter pylori (H. pylori), we performed immunoblot (IB) analysis with monoclonal antibody, MAb102, and measured the serum antibody titer with captured ELISA method with MAb102 antibody. In IB analysis, specific 54 K antigen was detected in 39 strains derived from patients with gastritis, gastric ulcer, duodenal ulcer, and gastric carcinoma. But only one strain (GC32 strain) isolated from a patient with gastric cancer did not react with MAb102 antibody. In the result of antibody titer with captured ELISA method using other six strains of H. pylori as antigen, H. pylori strains were divided into 3 groups, group R (RD26, T7, and T13 strains), group E (England and MR31 strains), group T (T37 strain). However, four cases belonged to false negative in ELISA method. These cases could have been infected with H. pylori strains such as GC32 strain. These strains did not have 54 K antigen nor 54 K related antigen which is different in its antigenicity from the 54 K antigen of the six strains. Thus the GC35 strain and the strain(s), which infected these four cases, consisted of other group, group N. These results suggested that 54 K antigen is usually stable in many strains, but occasionally different in antigenicity in some strains.

Treatment strategy for patients with surgically discovered N2 stage IIIA non-small cell lung cancer

BACKGROUND

The treatment strategy for patients with non-small cell lung cancer and clinically negative, but surgically detected mediastinal lymph node metastasis (surgically discovered N2 disease) is controversial.

METHODS

From August 1979 through December 1994, 53 patients with non-small cell lung cancer were found to have surgically discovered N2 disease. We retrospectively studied the clinical characteristics and the factors that influenced the prognosis in these patients.

RESULTS

The 3-year and 5-year survival rates and the median survival for the 53 patients with surgically discovered N2 disease were 44%, 21%, and 26 months. Two thirds of the patients had adenocarcinoma. Only complete resection affected long-term survival; adjuvant therapy had no effect on survival. In regard to lymph node status, a single metastatic focus in the aortic area was associated with long-term survival.

CONCLUSIONS

Patients with adenocarcinoma may require histologic determination of N2 disease. Complete resection, including extensive and complete mediastinal lymph node dissection, is warranted in patients with surgically discovered N2 disease. In particular, when the aortic lymph node (including stations 5 and 6) alone is involved, the patients should undergo as complete a resection as possible.

Relationship between changes of bone mineral content and twelve-minute walking distance in men with chronic obstructive pulmonary disease: a longitudinal study

Cross-sectional studies have revealed that bone mass is reduced in patients with chronic obstructive pulmonary disease (COPD). To elucidate the factors influencing bone mass in COPD, we measured whole body bone mineral content (BMC) by dual energy X-ray absorptiometry (DXA), pulmonary function, and twelve-minute walking distance (TMD) in men with COPD, who had been monitored for at least one year. We studied the body composition in 22 male patients with COPD and 19 age-matched male controls (age 72.6 +/- 7.2 vs 67.5 +/- 10.1 years, mean +/- SD). COPD patients showed a significantly lower body weight (49.3 +/- 5.7 vs 57.9 +/- 3.5 kg, respectively), body mass index (18.9 +/- 2.1 vs 22.1 +/- 1.3 kg/m2) and BMC (1.9 +/- 0.4 vs 2.2 +/- 0.4 kg) than controls. The changes in BMC were significantly correlated with TMD (r=0.53, p<0.02). These results demonstrate that decreased exercise capacity, at least in part, accounts for acceleration of bone mass loss in COPD patients.

[Evaluation of left ventricular systolic function using cine MRI--application to hypertrophic cardiomyopathy]

Cine MRI is a useful means to analyse the anatomical and functional changes of hypertrophic cardiomyopathy. The visual evaluation of hypertrophic regions and the motion patterns of their walls is in most cases possible on cine MR images. To complement a subjective method a certain quantitative analysis is necessary. Left ventricular regional systolic function can be quantitatively evaluated using cine MRI images printed on films. There is a good correlation between % thickness of LV wall and its thickness at end diastolic phase. The comparison of % thickness of normal subjects with that of hypertrophic cardiomyopathies shows a tendency of its value being less at the region of more severe hypertrophic change.

Expression of Ras GTPase-activating protein (GAP) in human normal chorionic villi and hydatidiform mole

Ras GTPase-activating protein (GAP), an important downregulator of Ras activity, has previously been shown to be abundant in human placenta. The expression of p120 and p100 isoforms of GAP in human normal chorionic villi (n=5) and hydatidiform mole (n=5) was investigated to clarify the involvement of Ras GAP in the growth of chorionic villi in the first trimester of pregnancy. Immunoblot analysis revealed that both p120- and p100-GAP isoforms were remarkably less expressed in mole villi than in normal chorionic villi. The expression of p100-GAP significantly reduced in comparison with that of pl20-GAP in mole villi. Northern blot analysis showed that the amount of GAP mRNA reduced in hydatidiform mole less than one-third of that in normal chorionic villi. The GAP activity, measured by the effect of tissue extract on the hydrolysis of Ras-bound GTP, was significantly lower in hydatidiform mole than in normal chorionic villi. These results suggest that Ras GAP may play an important role in the normal growth and differentiation of human chorionic villi in the first trimester.